Juvenile ossifying fibroma in a 24-year-old female with systemic comorbidities: a rare case report.

Introduction: Juvenile ossifying fibroma (JOF) is a rare, benign, fibro-osseous lesion characterized by aggressive growth and potential for recurrence. It primarily affects children and adolescents, with two histopathological subtypes: trabecular JOF (TrJOF) and psammomatoid JOF (PsJOF). TrJOF typically presents in the jaws of younger individuals, often before the age of 15.

Case presentation: A 24-year-old female with chronic kidney disease (CKD) and hypertension presented with progressive teeth displacement, mobility, and facial asymmetry. Radiographic evaluation revealed a well-defined radiolucent lesion affecting both jaws, displacing teeth, and perforating the cortical bone. Biopsy confirmed the diagnosis of TrJOF. Due to the aggressive growth and contraindications for chemotherapy or radiation therapy, surgical excision was performed. Postoperatively, the patient remains under observation, with ongoing management of CKD to prevent complications and ensure recovery.

Discussion: TrJOF is an uncommon and aggressive variant of JOF that typically affects younger patients. This case is atypical due to the patient's age and the involvement of both jaws. While JOF usually grows slowly, the lesions in this patient expanded rapidly, emphasizing the importance of prompt diagnosis and intervention. Surgical management remains the preferred approach, especially in cases complicated by systemic conditions like CKD. Recurrence rates vary widely, necessitating long-term follow-up.

Conclusion: This case underscores the significance of early detection and multidisciplinary care in managing rare, aggressive jaw lesions such as TrJOF, particularly in patients with systemic comorbidities. Tailored surgical interventions and vigilant postoperative monitoring are crucial to achieving optimal outcomes and preventing recurrence.