Trabecular Juvenile Ossifying Fibroma Involving the Maxilla: A Rare Case

Trabecular juvenile ossifying fibroma (TrJOF) is a rare, benign, fibro-osseous lesion that predominantly affects children and adolescents. The lesion is locally aggressive, has a high recurrence rate, and is often misdiagnosed due to its clinical and radiographic similarities to other lesions. A seven-year-old female presented with a history of swelling and pain on the right side of her face for the last month. Extraoral examination revealed facial asymmetry and exophthalmos of the right eye. Intraoral examination showed obliteration of the buccal vestibule, though the mucosal lining and teeth were intact. Cone-beam computed tomography (CBCT) demonstrated a large, expansile, osteolytic lesion occupying the right maxillary sinus and adjacent structures, suggesting a fibro-osseous lesion. The enucleated specimen showed a highly cellular connective tissue stroma with irregular bony trabeculae rimmed by osteoblasts, numerous multinucleated giant cells, and basophilic cementum-like calcifications. The histopathological evaluation confirmed the diagnosis of trabecular juvenile ossifying fibroma. This case highlights the diagnostic challenges of TrJOF due to its overlapping features with other fibro-osseous and giant cell lesions. Early diagnosis and surgical intervention are critical in preventing local destruction and recurrence.