Juvenile active ossifying fibroma

A juvenile active ossifying fibroma is a benign fibro-osseous neoplasm composed of mixture of stroma and bone characterized by rapid and destructive growth.

[1] Most patients are asymptomatic, and come to clinical attention when a mass is discovered incidentally on routine dental X-rays.

[2] When patients are symptomatic, they present with non-specific symptoms, such as chronic sinusitis, rhinorrhea, obstruction, pain, facial enlargement and possibly visual changes.

[2] The tumors are described as "shelling out" by the surgeon, which gives a well-circumscribed, smooth surface of tan, white, firm-gritty material.

[1][3] By microscopic evaluation, the tumors are composed of a variably cellular stroma make up of spindled to stellate fibroblast-like cells.

Within this stroma, are numerous small, rounded, mineralized collagenous ossicles and immature osteoid.

The maxilla is the second most common location after the paranasal sinuses, while the mandible and temporal bone are infrequently affected.