Juvenile ossifying fibroma of the maxilla in a 6-year-old male: case report.

Fibro-osseous lesions encompass a category of histopathology characterized by the presence of a fibrous stroma with varying amounts of mineralized material resembling bone or cementum.One such fibro-osseous lesion is the rarely occurring juvenile ossifying fibroma (JOF). No clear-cut criteria exist for separating this tumor from the more common forms of ossifying fibroma; however, these juvenile tumors behave differently from the common ossifying fibroma. The tumor can grow rapidly, expanding in the affected area; thus they are also referred to as "active" or "aggressive" ossifying fibromas.JOF usually occurs between the ages of 5 and 15 years, although cases in older patients have been reported.' Usually JOF involves the maxilla, paranasal sinuses, orbital and frontoethmoid bones. It is believed that the majority of these tumors arise in the paranasal sinuses. As the JOF expands it may involve the orbital, nasal, and cranial cavities. Mandibular lesions have been reported.Radiographic features are highly variable depending on the amount of calcification. Varying degrees of radiolucency and opacity are commonly seen, along with fair demarcation of the tumor. Erosion and invasion of the surrounding bone may be noted in more aggressive tumors. The JOF is a neoplasm composed of polyhedral and spindle cells in a relatively sparse collagen stroma. In addition, immature cellular osteoid forms within the lesion and multinucleated giant cells may be present, and sometimes may be very numerous. As the lesion matures, the bone formation may take on a more woven appearance.-This case report details the diagnosis and management of JOF that resulted in significant facial destruction in a 6-year-old child.