Fibrous dysplasia of the orbital roof

Case contributed by Dr Abdel-Rahman Abdel-Halim

Presentation

Facial deformity in a teenager.

Patient Data

Age: 16
Gender: Male

Axial CT images of the skull (bone window) revealed an expansile bone lesion with a typical ground glass appearance involving the roof of the right orbit.

Note the mass effect on the ipsilateral frontal sinus and right orbit.

Case Discussion

Fibrous dysplasia is a developmental anomaly manifested as a defect in osteoblastic differentiation and maturation. It can affect any bone of the body. The skull and facial bones are the affected sites in 10–25% of patients with monostotic fibrous dysplasia and in 50% of patients with polyostotic fibrous dysplasia. 

CT radiological features have three patterns:

  1. Ground glass pattern (>50%): as in this case.
  2. Homogeneously dense pattern (~25%).
  3. Cystic pattern (~20%). 

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