Giant central ossifying fibroma of the maxilla presenting with a pus discharging intra-oral sinus

Central ossifying fibroma (COF) is a rare benign fibro-osseous neoplasm which has a predilection for mandible and is encountered in middle aged women. It arises from mesenchymal blast cells of the periodontal ligament, and with a potential to form fibrous tissue, cementum and bone. It is a well circumscribed lesion mainly comprising of fibrous tissue with varying amounts of bone or cementum or osteo-cementum like tissue. We present an uncommon case of COF of the maxilla in a 35-year-old male who presented with a pus discharging sinus in the maxilla. Due to the bizarre size of the lesion we have termed as 'giant' COF. There is extensive facial asymmetry on the right side with obliteration of the maxillary antrum, deviation of the nose and upward displacement of the orbit.