Computed tomographic features of fibrous dysplasia of maxillofacial region

Abstract

PurposeThis study was to find the computed tomographic features of fibrous dysplasia of the maxillofacial region.Materials and MethodsAll eight cases included in the study reported either to Government Dental College and Hospital or Nair Hospital Dental College, Mumbai between 2003 and 2009. The patients were prescribed computed tomogram in addition to conventional radiographs of maxillofacial region which were studied for characteristic features of fibrous dysplasia. The diagnosis of fibrous dysplasia was confirmed by histopathological report.ResultsAll cases showed the ill-defined margins of lesions except in the region where the lesions were extending to cortex of the involved bone. Internal structure of all cases showed ground glass appearance. Four cases of maxillary lesion showed the displacement of maxillary sinus maintaining the shape of maxillary sinus. Two cases showed complete obliteration of maxillary sinus. Displacement of inferior alveolar canal did not follow any typical pattern in any of the cases but was displaced in different directions.ConclusionThe craniofacial type of fibrous dysplasia is as common as fibrous dysplasia of jaw. The margins, extent, internal structure and effect on surrounding structure are well detected on computed tomographic images.

Craniofacial fibrous dysplasia: A case report and literature review

“…Thus, on plain films, FD may display the following appearances: radiolucent, ground-glass, smoky, cloudy, peau d'orange, finger print, or diffuse sclerosis. [9,10] A CT bone window displays FD features similar to those exhibited on X ray films, CT attenuation coefficient values, which vary between 34 and 513 Hounsfield units in the different series, in relation with the amount of fibrous and osseous tissue and the rate of bone deposition, leading to three major imaging patterns: lytic or cystic (20%-30%), dense or sclerotic (20%-30%) and mixed or pagetoid (40%-50%). [11][12][13] MRI offers greater specificity in neurovascular and ocular involvement and in detection of other soft tissue lesions.…”

“…In the first stages of FD, there may be areas of hyperintensity on T2-weighted images. [10,11,14] The differential diagnosis of Craniofacial FD must include ossifying fibroma, histiocytosis, Paget's disease, aneurismal bone cyst, central giant cell granuloma, hemangioma, meningioma, eosinophilic granuloma and brown tumor of hyperparathyroidism. [6,15] The rate of variation to malignant tumor is more high in monostótic craniofacial disease (0.05%).…”

Ossifying Fibroma of the Mandible

“…Usually the lesion displays concentric growth and buccolingual expansion. Tooth displacement and root resorption are seen in larger lesions [5,7,8]. The recommended treatment is complete surgical resection or enucleation since incomplete resection has a high recurrence rate.…”

Odontogenic Sinusitis Caused by an Inflammation of a Dentigerous Cyst and Subsequent Finding of a Fibrous Dysplasia. A Case Report

“…The extent of the lesion can be determined by computed tomography imaging, but a presumptive diagnoses must be confirmed by a histopathological study. Radiographic findings include radiolucency, ground-glass appearance, and a smoking cloudy and even radiopaque fingerprint [17, 18]. …”

“…FD must be differentially diagnosed from ossifying fibroma, Paget´s disease and giant cell tumor [18, 21]. Regarding the prognosis, fibrous dysplasia commonly has a slow growth.…”