13/10/2025
A 30-year-old female presented with a progressive facial swelling, diagnosed 10 years ago as fibrous dysplasia and treated with repeated recontouring.
A recent biopsy submitted to our lab revealed a Juvenile Trabecular Ossifying Fibroma (JTOF), a true neoplasm requiring complete surgical excision, unlike fibrous dysplasia, which is developmental and typically managed conservatively.
Radiographically, fibrous dysplasia shows an ill-defined, ground-glass appearance, while ossifying fibroma is well-circumscribed with a clear border from normal bone as shown in this case (arrows).
Histologically, fibrous dysplasia exhibits irregular woven bone trabeculae within fibrous stroma whereas ossifying fibroma shows well-formed trabeculae and osteoid rims within a cellular stroma, often encapsulated or sharply demarcated.
Unfortunately, in this case, misdiagnosis led to years of inadequate management, allowing the lesion to become extensive and destructive.
A clear reminder that in fibro-osseous lesions, accurate clinical, histopathological and radiographic correlation is essential for proper treatment, prognosis and the patient’s overall quality of life.
Courtesy of Dr. Mohamed Abdel Moez