Osteofibrous Dysplasia in a 4-Month-Old: A Rare Presentation in Early Infancy

Introduction: Osteofibrous dysplasia (OFD) is a non-malignant lesion of cortical bone, where fibrous tissue replaces normal bone. Its presentation is rare in infants and may clinically and radiologically mimic other malignant lesions such as adamantinoma, making diagnosis challenging. Biopsy and imaging play a key role in diagnosis. Case Report: The patient, a 4-month-old infant of Indian origin, presented with a tender swelling over the proximal aspect of the right tibia. Radiographic evaluation revealed a lytic lesion. Further magnetic resonance imaging and histopathological evaluation confirmed the diagnosis of OFD. We planned to treat it conservatively and monitor the lesion size regularly, given the patient's age and absence of complications. Surgical intervention was deferred unless there is progres---sion or functional compromise. Conclusion: This case highlights the diagnostic challenges of OFD in infants and its differentiation from malignant lesions. Through this report, we aim to broaden clinical awareness regarding the occurrence of OFD in young infants and emphasize the role of imaging and biopsy in establishing a definitive diagnosis.