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Craniofacial fibrous dysplasia

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Increasing lump on scalp. Trauma 2 months previously.

Patient Data

Age: 10 years
Gender: Female

Sclerotic expansile groundglass appearances to the left zygomatic process extending to the frontozygomatic suture.  This extends to involve the superior orbital margin and to a lesser extent the greater wing of sphenoid.

No cortical breech.

No soft tissue component.

Bilateral maxillary sinusitis.

Case Discussion

Lesson number one of radiology - take the clinical history with a pinch of salt.

This case has the typical appearances of fibrous dysplasia in a patient with the correct demographics for the disease.

  • smooth groundglass change to the bone
  • sharp delineation of the pathological and normal bone (narrow zone of transition)
  • expansile and sclerotic in nature
  • typical craniofacial location
  • cortex remains intact

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