Juvenile Aggressive Cemento-ossifying Fibroma of the Maxilla

Fibro-osseous lesions of the face and paranasal sinuses are relatively uncommon. The biological characteristics of fibroosseous lesions range from indolent to aggressive and from inflammatory to neoplastic. Cemento-ossifying fibroma is a rare, benign fibro-osseous lesion composed of lamellar bone, fibrous tissue and cementum. It is usually found in the jaw bone and presents in several variant pathological subtypes. The overlapping clinical, radiologic and histomorphologic features of these subtypes have led to diagnostic dilemma for the clinician, radiologist and the histopathologist. Clinically, the lesions are usually asymptomatic, slow-growing and wellcircumscribed. However, in very few cases, these tumors have demonstrated an aggressive course of development. Lesions that involve the midface and paranasal sinuses and presenting in earlier age tend to demonstrate aggressive behavior and rapid growth. We describe a case of a 13 years old young boy with aggressively behaving cemento-ossifying fibroma of the maxilla presenting acutely as right cheek swelling with gingival growth.