Psammomatoid Ossifying Fibroma/Juvenile Psammomatoid Ossifying Fibroma

Abstract

Juvenile psammomatoid ossifying fibroma is a rare benign fibro-osseous neoplasm with locally aggressive behaviour and a high propensity for recurrence. We report a case of a 13-year-old female who presented with a painless right cheek swelling of 15 days' duration. Computed tomography revealed an expansile lesion involving the anterior wall of the right maxillary sinus with a ground-glass matrix, initially suggesting fibrous dysplasia. Histopathological examination demonstrated a cellular fibrous stroma containing numerous psammoma-like ossicles and irregular bony trabeculae with osteoblastic rimming, consistent with JPOF. Complete surgical excision was performed. JPOF may mimic other fibro-osseous lesions clinically and radiologically; therefore, histopathological evaluation remains essential for definitive diagnosis. Early recognition and complete excision are crucial because of the lesion's aggressive local growth and risk of recurrence. This case highlights the importance of considering JPOF in the differential diagnosis of expansile craniofacial lesions in pediatric patients.

JPOF (Juvenile Psammomatoid Ossifying Fibroma) is a rare benign fibro-osseous neoplasm characterised by aggressive local growth and a high tendency for recurrence despite its non-malignant nature. It is recognised as a distinct clinicopathological entity in the recent

WHO classification of head and neck tumours and predominantly affects children and young adults, with a predilection for the craniofacial bones, particularly the paranasal sinuses, orbit, and maxilla.^[1,2] Clinically and radiologically, JPOF may mimic other fibro-osseous lesions such as fibrous dysplasia, making histopathological examination essential for definitive diagnosis. We report a case of JPOF involving the right maxillary sinus in a 13-year-old female, highlighting its clinicopathological features and diagnostic challenges.