An Atypical Bilateral Presentation of Fibrous Dysplasia (FD) in the Mandible: Clinical, imaging and therapeutic characterization

Abstract

Introduction and importance Fibrous Dysplasia (FD) is a benign fibro-osseous lesion, characterized by replacement with fibrous connective tissue instead of normal bone. The best treatment option for the condition has not yet been established, although several therapeutic approaches have been reported. The present case report describes the clinical, imaging and therapeutic aspects of an atypical bilateral presentation of FD in the mandible. Case presentation A 26-year-old afro-descendent woman, who had previously undergone surgery to remove FD in the right hemimandible, complained of asymptomatic swelling in the left hemimandible. Imaging analysis showed an ipsilateral extensive multilocular mandibular lesion, with thinning of the cortical bone. After diagnosis of FD, complete surgical removal was performed, associated with immediate local reconstruction with xenograft and covering membrane, with primary wound closure. Clinical discussion Bilateral presentation of FD is uncommon, and its diagnosis by means of clinical data, imaging and histopathological analysis, is relevant in order to establish the correct therapy. Conclusion Complete surgical removal associated with immediate local bone reconstruction, has shown satisfactory clinical results, when adequate follow-up is performed.

Fibrous Dysplasia With Atypical Bilateral Upper Extremity Pattern

“…In overwhelming majority of cases (more than 75%), fibrous dysplasia is monostotic. [1][2][3][4][5] Polyostotic fibrous dysplasia is usually diagnosed in first years of life with almost no new lesions appearing after age of 15 years. [1][2][3][4] Unusual cases of fibrous dysplasia in elderly population were reported in the skull, maxilla, and pelvic bones.…”

“…Immunohistochemistry was performed and did not support a neoplastic process. In overwhelming majority of cases (more than 75%), fibrous dysplasia is monostotic 1–5 . Polyostotic fibrous dysplasia is usually diagnosed in first years of life with almost no new lesions appearing after age of 15 years 1–4 .…”