Juvenile Trabecular Ossifying Fibroma of the Orbit

An 11-year-old male presented to the hospital with severe headache, nausea, and proptosis of the OD. Imaging revealed a 4 × 3 × 1 cm mass originating in the right orbital roof with adjacent bony remodeling, a calcific rim along the inferior extent of the lesion, and a heterogenous central component with hyper- and hypo-dense components. An orbitotomy with biopsy with near-total resection was performed, which yielded a diagnosis of juvenile trabecular ossifying fibroma, a tumor rarely found in the orbit. Two months later, given the concern for residual/recurrent disease based on increased signal abnormality on MRI, resection of the residual mass was achieved via bifrontal craniotomy.