A Giant Pediatric Ossifying Fibroma: A Case Report of a Rare Occipital Presentation

Ossifying fibroma is a very uncommon tumor that affects craniofacial structures. Occipital bone presentation is extremely rare; it is more commonly found in the jaw. Its locally aggressive behavior and expansion near brain tissue require total surgical removal. We report a nine-year-old girl with a five-year history of a growing, painless mass in the occipital region of the skull and progressive loss of vision. In the imaging studies, an extra-axial mass arising from the occipital bone was identified, with significant compression of the brain parenchyma. An occipital craniectomy and complete en bloc resection were performed, with histopathology confirming ossifying fibroma. Improvement in vision after surgery was noted. To our knowledge, this is the fifth reported case and is complemented by a review of the literature. The uncommon presentation of bone tumors, such as ossifying fibroma, with locally aggressive behavior should always be considered in the differential diagnosis in the pediatric population, because total resection decreases morbidity and can be curative.