Juvenile psammomatoid ossifying fibroma: A radiolucent lesion to suspect preoperatively

Abstract We present the cases of 2 expansive juvenile psammomatoid ossifying fibromas from sinonasal origin. Our first patient presented with a fronto-ethmoidal mass invading the orbit and the cranial base and had a bicoronal approach for tumor removal. The second patient also had orbital involvement and underwent an endoscopic surgery. Complete resection of juvenile psammomatoid ossifying fibromas is paramount to avoid recurrence, thus preoperative recognition of their characteristic thick outer mantle and radiolucent core on imaging is key, but can be challenging. We herein discuss and propose a novel algorithm of differential diagnoses of facial bone lesions based on radiologic appearance.