Surgical approach for a rare case of bilateral trabecular juvenile ossifying fibroma in the mandible

Abstract

Trabecular juvenile ossifying fibroma (TJOF) is a rare benign fibro-osseous tumor that may develop in the craniofacial bones at an early age. To the best of our knowledge, there is no published case of bilateral monostotic TJOF in the literature. The aim of this study was to report the surgical treatment of a rare case of bilateral mandibular TJOF in an adolescent. A 13-year-old male patient presented with no symptoms other than a slight increase in volume in the lower right facial region. Tomographic examination revealed well-defined hypodense areas, hyperdense islands, and expansion of the involved bone cortices in the posterior mandible bilaterally. After histological and immunohistochemical analysis, the diagnosis was TJOF. Using a rapid prototyping biomodel, enucleation combined with curettage and peripheral osteotomy of the tumors was performed, followed by the placement of a reconstruction plate and screws. After one year, there was a recurrence on the left side, which was treated again with curettage and peripheral osteotomy. The patient is currently under follow-up for 24 months with a favorable prognosis. Despite its aggressive potential and risk of recurrence, an individualized surgical plan should be developed. A conservative approach should be the preferred treatment, aiming to minimize deformation and functional impairment.