Massive juvenile ossifying fibroma of the frontal bone

Abstract

Ossifying fibroma is a rare, benign fibro-osseous lesion composed of lamellar bone and fibrous tissue. It occurs as an osseous lesion in the craniofacial skeleton. Clinically, lesions are usually asymptomatic, slow-growing and well-circumscribed. However, in very few cases, particularly in younger patients these tumors have demonstrated an aggressive course of development. Surgical management via a wide local excision is a necessity since it is notorious for recurrence, especially paranasal sinuses lesions. Here, we describe a case of a 9-yearold male child who had left forehead swelling with painless, progressive proptosis and downward lateral displacement of the globe for approximately 8 months. Computed tomography showed a massive expansile lesion involving the left frontal bone. The mass was excised surgically via a Lynch Howarth approach and proved histopathologically to be a juvenile ossifying fibroma. The radiological interpretation will be discussed which is helpful for diagnosis and selecting appropriate surgical approach in growing child.