Management of juvenile trabecular ossifying fibroma of bone of the maxilla in a child: A case report at a tertiary hospital in Northern Tanzania

Introduction and importance: Juvenile trabecular ossifying fibroma (JTOF) is a rare variant of ossifying fibroma. Though it is benign, it has aggressive clinical behavior. JTOF may pose diagnostic and therapeutic difficulties due to their clinical, radiological and histological variability. Herein, we describe our experience in encountering this unusual disease entity in terms diagnostics as well as surgical procedure and the differential diagnoses to be considered. Case presentation: An 8-year old female child presented to our facility because of a rapidly growing right maxillary swelling. Clinical examination revealed facial asymmetry resulted from the swelling on the right side of her face extra-orally, especially in her posterior upper jaw which was about 12 cm x 7 cm in dimension. Intraoral examination revealed solitary mass, well-defined, firm in consistency and non-tender. There were no palpable lymph nodes. Infra- orbital nerves were bilaterally intact. Based on the clinical findings and history, the differential diagnoses of ossifying fibroma, ameloblastoma and fibrous dysplasia were given. Clinico-pathological and radiological correlation confirmed the diagnosis of JTOF. Hemimaxillectomy and reconstruction of maxilla with a rib were performed. Afterwards, the child reported with normal facial appearance, acceptable aesthetics and better chewing function. Clinical discussion: The clinical presentation of JTOF, and its rapid growth, can cause alarm of other pathologies such as osteosarcoma. The radiological features should reassure the practitioner and a histological examination confirmed the diagnosis. Conclusion: JTOF is a benign tumor and it should be operated at an early stage because of its rapid growth.