Ossifying fibroma of the maxillary sinus: a case report

A case of ossifying fibroma of the maxillary sinus that occurred in a 45-year-old white female is reported. The lesion's radiographic, histologic and clinical behavior are examined. The clinical and radiographic features of ossifying fibroma distinguish it from monostatic fibrous dysplasia despite histologic similarities. The uncommon location of this ossifying fibroma in the maxillary sinus accounts for its large size, aggressive behavior and widespread osseous destruction. The prognosis is excellent after complete enucleation of the ossifying fibroma has been achieved. The benign fibro-osseous lesions of the jaws share similarities in radiographic and clinical appearance, histogenesis and histopathology, and consequently, pose difficulty in classification and treatment. Common histologic features of these lesions include an active proliferation of fibroblats, young and mature collagenous connective tissue, focal areas of mineralization which may resemble small cemeticles and/or irregular bone trabeculae, and multinucleated giant cells. Differential diagnosis of benign fibro-osseous lesions can therefore be made if clinical behavior, radiographic features, and hematologic changes are correlated with the histologic picture. Representatives of this group include true fibrous dysplasia, ossifying fibroma (both central and peripheral types), osteoid osteoma, osteoblastoma, cementifying fibroma, florid osseous dysplasia, proliferative periostitis of Garré, focal sclerosing osteomyelitis and osteitis deformans (Paget's disease).