Recurrent Juvenile Psammomatoid Ossifying Fibroma of the Mandible: A Case Report Mandibular Psammomatoid Juvenile Ossifying Fibroma

Background: Juvenile ossifying fibroma (JOF) is a rare benign fibro-osseous neoplasm of the craniofacial bones that typically affects children and young adults. It is characterized by local aggressiveness and a high tendency for recurrence. Two histopathological subtypes are recognized: trabecular and psammomatoid. The psammomatoid variant (PJOF) often arises in the paranasal sinuses or orbits and only infrequently involves the jaws.
Case Summary: A 23-year-old female presented with swelling in the left posterior mandible persisting for 3 years with intermittent pain. Imaging revealed an expansile lytic lesion with a ground-glass appearance and no cortical breach. Differentials included dentigerous cyst and aneurysmal bone cyst. Orthopantomogram showed mixed radiolucent–radiopaque changes. Serum calcium, vitamin D, and PTH were normal. Histopathology revealed a cellular fibrous stroma with concentric calcified ossicles resembling psammoma bodies, consistent with PJOF. One month later, the lesion recurred in the mandibular alveolar bone, showing similar histopathological features without malignant transformation.
Conclusion: PJOF of the mandible is rare but demonstrates locally aggressive behaviour and early recurrence if incompletely excised. Complete resection with clear margins and long-term follow-up is essential for management.

Juvenile ossifying fibroma; Psammomatoid variant; Mandible; Fibro-osseous lesion; Recurrence

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