Presentation
Palpable swelling
Patient Data
Diffuse involvement of the skull base, right mastoid, left greater wing of the sphenoid, left orbital roof and left parietal bones with expansion, loss of the normal a homogeneous ground glass appearance. The right orbital roof as well as right parietal bone harbors two large expansile lesions with internal lytic foci causing marked bone deformity. Patent examined skull base foramina.
Right maxillary sinus mucosal thickening.
Case Discussion
The involvement of the facial bones makes craniofacial fibrous dysplasia much more likely than Paget disease. Also the absence of history of primary tumors makes the possibility of metastasis a remote one.
The expansile ground-glass appearance, most pronounced at the skull base is typical of fibrous dysplasia.