Juvenile psammomatoid ossifying fibroma with fluid–fluid levels: an unusual presentation

Abstract

Background Juvenile ossifying fibroma is an uncommon benign fibro-osseous tumor commonly involving the craniofacial skeleton of young patients with locally aggressive behavior and a high recurrence rate. Depending on the site of involvement it can present clinically as nasal obstruction, facial swelling, or proptosis. Case presentation Here we present a case of juvenile ossifying fibroma with an aneurysmal bone cyst component in the left nasal cavity in a 15-year-old boy who presented with gradually progressing left-sided nasal obstruction. Imaging findings were consistent with juvenile ossifying fibroma. Endoscopic resection of the tumor was done, and histopathological examination revealed it to be a psammomatoid variant of juvenile ossifying fibroma. Here we discuss its imaging findings, differential diagnosis, treatment options, and histopathological features. Conclusion Despite being a slow-growing benign tumor, early diagnosis and treatment are necessary due to its locally aggressive nature and invasion of adjacent structures. Complete surgical resection is the mainstay of treatment because of the high recurrence rate.

Psamomatoid Ossifying Fibroma Of The Sinonasal Region: A Case Report

“…The patient was subjected to clinical follow-up for possible secondary bony excision later. 10 . The incidence of Juvenile Psamomatoid Ossifying fibroma is higher in children under the age of 15 years and young adults.…”

“…11,12 Juvenile Ossifying fibroma is classified into two distinct groups, the Psammomatoid Juvenile Ossifying fibroma (Psammona like ossicles) types and the trabecular Juvenile ossifying fibroma (Tr JOF) 13 . Psamomatoid ossifying fibroma has a distinct age of patient, site of involvement, high recurrence tendency and aggressive behavior 10 . Our patient had involvement of the maxilla, ethmoidal, frontal, sphenoid bones and nasal cavities as shown in figures 4 & 5.…”

“…Despite the lesion's tendency to invade and recur locally, the prognosis is good. Recurrence after surgical management is reported to range from 30 -56% 10 .…”