Open Access
CC BY-NC-ND 4.0 · Arch Plast Surg 2023; 50(01): 049-053
DOI: 10.1055/s-0042-1758468
Pediatric/Craniomaxillofacial/Head & Neck
Case Report

Psammomatoid Juvenile Ossifying Fibroma of the Maxilla Misdiagnosed as Fibrous Dysplasia: A Clinicopathologic Case Report

Jong-Ho Kim 
1   Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Republic of Korea
,
Jiwon Kang 
1   Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Republic of Korea
,
Seong-ik Kim 
2   Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea
,
Byung Jun Kim 
3   Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Republic of Korea
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Abstract

Juvenile ossifying fibroma (JOF) is a variant of the ossifying fibroma and includes two histopathological subtypes: trabecular and psammomatoid. Psammomatoid JOF (PJOF) in craniofacial structures should be distinguished from other fibro-osseous lesions, such as fibrous dysplasia (FD), considering the difference in the treatment protocols. Here, we present a rare case of PJOF that was initially misdiagnosed as a case of FD and emphasize the importance of considering JOF in the differential diagnosis of patients with craniofacial fibro-osseous lesions. A 4-year-old boy demonstrated progressive enlargement of the zygomaticomaxillary area on his left side for the last 6 months. The patient was diagnosed as a case of FD based on the clinical features and radiographic findings, and was operated considering the rapid progression. To achieve facial symmetry, contouring of the zygomatic bone and arch was performed. However, the patient demonstrated rapid enlargement at the 3-month postoperative follow-up. The decision was made to surgically remove the tumor due to visual field impairment. Intraoperatively, a rubbery mass, which was separated from the surrounding cortical bone, was identified and excised. The lesion was confirmed as PJOF by histopathological examination. The possibility of PJOF should not be ruled out in the differential diagnosis of patients with fibrous-osseous lesions. In the event of suspected PJOF, accurate diagnosis should be made through definitive biopsy.

Keywords

psammomatoid juvenile ossifying fibroma - fibrous dysplasia - fibro-osseous lesions - surgical treatment - differential diagnosis

Authors' Contributions

JH Kim and BJ Kim conceptualized the study. JH Kim, J Kang, and S Kim were involved in data curation. JH Kim, J Kang, and S Kim did formal analysis. JH Kim was involved in methodology. BJ Kim did project administration. JH Kim and J Kang contributed to visualization. JH Kim was involved in writing—original draft. JH Kim, J Kang, and BJ Kim reviewed and edited the manuscript.


Ethical Approval

Ethical approval for this study was obtained from the Institutional Review Board in Seoul National University Hospital (IRB no.: H-2206-047-1330)


Patient Consent

Patients provided written informed consent for the publication and the use of their images.




Publication History

Received: 19 February 2022

Accepted: 17 August 2022

Article published online:
06 February 2023

© 2023. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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