Fibrous dysplasia of the skull

Case contributed by Dr James Sheldon

Presentation

Headache

Patient Data

Age: 30
Gender: Female
CT

No intracranial collection, acute hemorrhage or infarction identified. Normal grey white matter differentiation. The ventricles and basal cisterns are unremarkable for patient's age. No abnormal hyperdensity within the venous sinuses.

Expansion of the inferior right frontal bone with heterogeneous density and regions of ground glass internal matrix, likely represent Fibrous Dysplasia. This involves the orbital roof but there is no extension into the surrounding sphenoid, zygomatic or temporal bones.

The visualized paranasal sinuses and mastoid air cells are clear.

MRI

The MRI of the brain was performed to further assess for any cause of the patient's headache. Normal appearance of the brain with no intracranial hemorrhage, collection or infarct.

Hypointense T1 and T2 signal in the right frontal bone support the diagnosis of fibrous dysplasia.

Case Discussion

Fibrous dysplasia (FD) is a non-neoplastic tumor-like congenital process, manifested as a localized defect in osteoblastic differentiation and maturation, with replacement of normal bone with large fibrous stroma and islands of immature woven bone. FD has a varied radiographic appearance. If they are asymptomatic, they do not require treatment. 

As this is an incidental finding and the patient is asymptomatic, a biopsy will not be performed.

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Case information

rID: 34584
Published: 2nd Mar 2015
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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