Large juvenile ossifying fibroma in the maxilla of a 12-year-old boy: A case report

Abstract

Ossifying fibroma （OF） is a benign tumor composed of fibrous connective tissue with cementum and bone-like tissue formation. Juvenile OF （JOF） is a rare, rapidly growing OF that occurs in patients aged＜15 years. We present a case of maxillary large JOF in a 12-year-old Japanese boy who presented with worsening gum swelling in the left maxillary canine region. After his initial visit to our hospital, the painless swelling extended to his right cheek and buccal and palatal gingiva, reaching the maxillary first premolar and maxillary central incisor. Panoramic X-ray imaging and computed tomography revealed a well-circumscribed radiolucent mass with irregularly structured hard tissue scattered internally from the right maxillary first molar to the left maxillary canine. He was diagnosed with a benign maxillary tumor and underwent surgical enucleation and curettage. Histopathologically, the lesion primarily comprised fibrous tissue with intricate thick collagen bundles and contained scattered cement-like calcified pellets and small clusters of bone-like calcified material, which led to the diagnosis of OF. The final diagnosis was JOF, and the tumor grew rapidly. No signs of recurrence were noted 2 years after the surgery. Given the high recurrence rate of this tumor, careful follow-up was continued.