Abstract
Cranial fibrous dysplasias (FDs) are rare and comprise less than 1% of all primary bone lesions. They may produce cosmetic deformities, peripheral compressive cranial neuropathies, and compressive central neurologic manifestations. We describe an unusual presentation of a fronto-orbital sphenoethmoidal FD in a 32-year-old woman with conventional radiographic, CBCT, and MRI findings. In the head and neck examination, an asymmetry was noticed on the left side, without evidence of adenopathy, paresthesia, or motor nerve deficiency. Panoramic radiographs showed a radiopaque expanded bone in the region of the posterior maxillary sinus and orbita. Computed tomography with three-dimensional reconstruction demonstrated an expanding lesion of the cranial bones, involving the ethmoid and periorbital bone, producing a ground-glass appearance. After the radiologic examination, the patient was referred for surgery with a diagnosis of cranial FD and underwent a cranioplasty. The CT and MRI features were typical for FD, but physicians and dental professionals should be aware of this diagnosis, even if no symptom is apparent and the patient came in only for a routine dental examination. Maxillofacial radiologists should also consider that the signal intensity on both T1- and T2-weighted images and the degree of contrast enhancement on T1-weighted images depend on the amount and degree of bony trabeculae, cellularity, collagen, and cystic and hemorrhagic changes.
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References
Weisman JS, Hepler R, Vinters HV. Reversible visual loss caused by fibrous dysplasia. Am J Ophthalmol. 1990;110:244–9.
Delap TG, Kaberos A, Dowling P, Rees J, Golding-Wood D. Cranio-facial fibrous dysplasia: a case report and overview of the management of the condition. Int J Pediatr Otorhinolaryngol. 1996;37:179–91.
Edelstein C, Goldberg RA, Rubino G. Unilateral blindness after ipsilateral prophylactic transcranial optic canal decompression for fibrous dysplasia. Am J Ophthalmol. 1998;126:469–71.
Goisis M, Biglioli F, Guareschi M, Frigerio A, Mortini P. Fibrous dysplasia of the orbital region: current clinical perspectives in ophthalmology and cranio-maxillofacial surgery. Ophthal Plast Reconstr Surg. 2006;22:383–7.
Mohammadi-Araghi H, Haery C. Fibro-osseous lesions of cranio-facial bones: the role of imaging. Radiol Clin North Am. 1993;31:121–34.
Osguthorpe JD, Gudeman SK. Orbital complications of fibrous dysplasia. Otolaryngol Head Neck Surg. 1987;97:403–5.
Jee WH, Choi KH, Choe BY, Park JM, Shinn KS. Fibrous dysplasia: MR imaging characteristics with radiopathologic correlation. AJR Am J Roentgenol. 1996;167:1523–7.
Sharma RR, Mahapatra AK, Pawar SJ, Lad SD, Athale SD, Musa MM. Symptomatic cranial fibrous dysplasias: clinico-radiological analysis in a series of eight operative cases with follow-up results. J Clin Neurosci. 2002;9:381–90.
Angelopoulos C, Thomas SL, Hechler S, Parissis N, Hlavacek M. Comparison between digital panoramic radiography and cone-beam computed tomography for the identification of the mandibular canal as part of presurgical dental implant assessment. J Oral Maxillofac Surg. 2008;66:2130–5.
Ludlow JB, Davies-Ludlow LE, Brooks SL. Dosimetry of two extraoral direct digital imaging devices: NewTom cone beam CT and Orthophos Plus DS panoramic unit. Dentomaxillofac Radiol. 2003;32:229–34.
Chen YR, Noordhoff MS. Treatment of craniomaxillofacial fibrous dysplasia: how early and how extensive? Plast Reconstr Surg. 1990;86:835–44.
Lustig LR, Holliday MJ, McCarthy EF, Nager GT. Fibrous dysplasia involving the skull base and temporal bone. Arch Otolaryngol Head Neck Surg. 2001;127:1239–47.
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Orhan, K., İcen, M., Paksoy, C.S. et al. Fronto-orbital sphenoethmoidal fibrous dysplasia. Oral Radiol 25, 135–141 (2009). https://doi.org/10.1007/s11282-009-0017-x
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DOI: https://doi.org/10.1007/s11282-009-0017-x