Woman, 27, baffles docs with large jaw – needing bone from her leg to repair
A 27-year-old woman underwent drastic facial reconstruction after a rare, usually benign ossifying fibroma swelled her lower jaw, forcing surgeons to remove the diseased bone
A young woman baffled doctors with an enormous jaw that needed to be rebuilt using bone taken from her leg(Image: Jam Press)
A young woman baffled doctors with an enormous jaw that needed to be rebuilt using bone taken from her leg. The 27-year-old was forced to undergo a dramatic facial reconstruction after a rare bone tumour caused her jaw to swell to an enormous size.
Doctors found the growth was caused by an ossifying fibroma, a rare, usually benign tumour that replaces normal bone with fibrous tissue and abnormal bone material. By the time she sought treatment, scans showed the tumour had expanded through a large section of her lower jaw, stretching and thinning the surrounding bone.
Although the tumour had not invaded surrounding tissues, surgeons warned that its size meant she’d need to undergo a major operation to prevent further deformity and reduce the risk of recurrence.
The patient underwent a segmental mandibulectomy, where surgeons removed a large section of her diseased jaw. To rebuild her face, doctors harvested a section of fibula, the smaller of the two bones in the lower leg, and used it to create a replacement jaw.
Around 12 to 14 centimetres of bone was taken from her leg while preserving enough of the fibula to maintain stability of the knee and ankle joints. The donor bone was carefully cut and reshaped into multiple segments to recreate the natural curve of the jaw before being secured in place with titanium plates.
Surgeons at the hospital in Chitwan District, Nepal, then performed delicate microvascular surgery, connecting blood vessels from the transplanted fibula to blood vessels in the face using ultra-fine sutures. The operation restored both the structure and blood supply of the reconstructed jaw, allowing the transplanted bone to survive and integrate with the surrounding tissue.
Laboratory analysis of the removed tumour confirmed it was a conventional ossifying fibroma, with clear surgical margins indicating the entire growth had been successfully removed. She spent the first two days in intensive care while doctors closely monitored the blood supply to the transplanted tissue.
By the third day after surgery she was able to begin a liquid diet, later progressing to soft foods. 10 days after the operation she was discharged from hospital.
The case was reported in a recent edition of a medical journal, published online. Ossifying fibromas are exceptionally rare growths of the jaw and facial bones.
Because they are benign (non-cancerous), they are not typically included in national cancer statistics or tracked by central public health bodies in the way malignant tumours are. However, clinicians can draw on published data from UK teaching hospitals and international jaw-tumour registries to understand how uncommon the condition is.
Across the oral and maxillofacial region, ossifying fibromas are estimated to account for less than 1% to 2% of tumours and similar growths.
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