Swelling of the right max...

A 20-year-old male with swelling of the right maxilla and frontal bone of the face for the past two years presented to the hospital. There was no H/o trismus, trauma, diminished vision, loosening of teeth or epistaxis. However, the extraoral examination revealed well-defined bony hard swelling in the right maxillary region with the left frontal bone involvement. Intraorally, the enlargement of the right side of the palate and expansion of the alveolar buccal plate was presently extending from 11 to 17. Routine investigations were within normal limits except ALP. Therefore, ALP was raised to 300 U/L.

The CT scan showed a radio-dense mass with ground-glass appearance involving left frontal and right maxillary bone and its expansion causing facial asymmetry as shown in the figure. An incisional biopsy was obtained. Macroscopy led two pieces of bony hard-tissue greyish white measuring 1 cm × 0.5 cm. In addition, the microscopic examination showed irregular bony trabeculae in Chinese script patterns scattered within the fibrous stroma. Bony trabeculae showed no osteoblastic rimming. Poorly formed metaplastic bone was isolated by cellular fibrous connective tissue stroma. Based on all the evidence, a diagnosis was made.