Presentation
Incidental finding.
Patient Data
An expansile bone lesion is located in the occipital bone, clivus and basiocciput. The bone cortex is intact and the lesion has a typical ground-glass appearance with areas of lower bone attenuation.
Case Discussion
Clival lesions may present with headache and cranial neuropathies or can be an incidental imaging finding, as in this case.
Fibrous dysplasia is a benign fibro-osseous lesion. Diagnosis is suggested by a ground-glass appearance on CT scan; usually the cranial foramina are preserved but narrowed. MRI and FDG-PET can be confusing as it is frequently hypermetabolic, heterogeneous and may enhance with contrast medium. This is an important lesion to recognize as it is a ‘don’t touch’ lesion that should not be confused with the following:
metastases: typically in patients with known malignancy (breast, lung)
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