Presentation
Incidental findings in trauma patient.
Patient Data
There is a sclerotic lesion with bone expansion involving the left mastoid with ground glass matrix, no cortical destruction, no periosteal reaction, findings are suggestive of fibrous dysplasia.
There is a comminuted fracture with multiple depressed fragments noted involving the anterior wall of the left maxillary sinus and left orbital floor associated with dense (blood density) opacification of the left maxillary sinus, with overlying subcutaneous soft tissue swelling
There is swelling of the left lower eyelid with foci of preseptal emphysema.
Mucosal thickening of the right maxillary sinus.
Case Discussion
Fibrous dysplasia is a developmental disorder in which normal bone marrow is replaced by fibro-osseous tissue. It is often incidentally found on imaging taken for other clinical indications.
Fibrous dysplasia usaually presents as a non-aggressive intramedullary lesion, it has variable appearances between sclerotic, cystic or mixed lesions.
The matrix is usually described as having a ground glass appearance, and aggressive features like cortical disruption or periosteal reaction are absent ulness complicated by a pathological fracture.
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