Juvenile Trabecular and Psammomatoid Ossifying Fibroma: A Clinicopathologic Case Series and Review of the Literature

Ossifying fibroma (OF) is a rare benign fibro-osseous neoplasm predominantly involving the maxillofacial skeleton. In the fifth edition (2022), the World Health Organization classified it into three variants: cemento-OF, juvenile trabecular OF (JTOF), and psammomatoid OF (PsOF). JTOF and PsOF are considered separate entities from OF due to their locally aggressive behavior and tendency to occur at a young age. Histologically, JTOF is characterized by trabeculae of fibrillary osteoid and woven bone, whereas PsOF shows numerous small, spherical psammoma-like ossicles within a cellular stroma. With a focus on the clinicoradiologic and histopathologic association, we present a case series, including one trabecular and two psammomatoid variants, all involving the maxilla. Key diagnostic considerations are outlined in a focused review of the literature to guide effective surgical care and reduce recurrence rates.