Monostotic fibrous dysplasia of the metacarpal: a case report

Abstract

Fibrous dysplasia is a bone disease characterized by abnormal differentiation of fibrous tissue in the bones; it is often asymptomatic. It may affect one bone (monostotic) or several bones (polyostotic). The monostotic form primarily affects the ribs, but hardly ever affects the hand. It is important to make the differential diagnosis with malignant bone tumors. This article describes the treatment and outcome of a rare case of a patient admitted with a history of tumor growth in the right hand, diagnosed as fibrous dysplasia of the right second metacarpal. Male patient, 14 years of age, admitted to the Sarah Hospital with lesion on the dorsum of the right hand without pain complaints, previous history of trauma, nor local signs of inflammation. Physical examination revealed swelling on the dorsum of the second metacarpal, painless, with unaltered mobility and sensitivity. Radiography, computed tomography, and magnetic resonance imaging indicated the involvement of the entire length of the second metacarpal: only the distal epiphysis was preserved, with areas of bone lysis. After biopsy confirmation, the patient underwent surgery, using a long cortical graft for reconstructing the metacarpal. During the follow-up period of five years there were no signs of recurrence, and proper digital growth and functionality of the operated hand were observed.

Fibrous dysplasia: clinicopathologic presentation of 36 cases

“…Vertebrae, pelvic bones, radius, fibula, and short tubular bones of hand and foot are rarely affected (2,6,8). Metacarpal involvement is extremely rare and is reported as sporadic cases only (9). In a multi-central clinicopathological study supported by the European Pediatric Orthopedic Society, the femur was the most frequent site of the lesion, followed by the tibia.…”

Benign Hand Tumors (Part I): Cartilaginous and Bone Tumors

“…Fibrous dysplasia is characterized by growth of fibrous tissue and immature bone replacing the normal bone. 40 One patient (0.65%) presented with this disease and a pathological fracture on the metacarpal of the ring finger. The patient was treated by curettage after consolidation of the fracture without recurrence.…”

Rare case of symptomatic (painful) fibrous dysplasia of 12th Rib

“…It is a benign lesion that may involve one (monostotic) or more bones (polyostotic) or be accompanied by other systemic alterations and endocrine disorders, such as in the McCune-Albright syndrome. 2 Polyostotic forms are observed in head, face, humerus, leg, upper limbs, iliac bone, ribs and vertebrae. On the other hand, monostotic forms are mainly observed in ribs.…”