Ossifying Fibroma with Co-existent Squamous Cell Carcinoma in Maxilla

INTRODUCTION: Ossifying fibroma is a rare benign bone lesion characterized by gradual development and asymptomatic presentation, typically affecting craniofacial bones in individuals, particularly females, during their second to fourth decades of life. The concurrent occurrence of oral squamous cell carcinoma (OSCC) with ossifying fibroma is exceedingly rare, with only one previous case reported. CASE REPORT: We describe a 71-year-old male presenting with a gradually enlarging swelling in the oral cavity, initially treated five years prior for a mandibular fracture. Clinical examination revealed a large swelling in the right maxillary area, and imaging showed a radiolucent lesion with expansile characteristics. Histopathological analysis of the excised tissue initially suggested a benign fibro-osseous lesion. However, upon recurrence, a further biopsy revealed a coexistence of ossifying fibroma and well-differentiated squamous cell carcinoma in the previously affected palatal region. DISCUSSION: The simultaneous presence of ossifying fibroma and OSCC is extremely rare. This case underscores the importance of thorough diagnostic evaluation and highlights potential associations between trauma and tumor development. Further research is needed to elucidate the relationship between these lesions and improve diagnostic and therapeutic approaches for such rare occurrences.