Fibro-osseous lesion of the cranium in an adolescent patient

Park, Brian; Abode-Iyamah, Kingsley; Lee, Siang Liao; Kirby, Patricia; el-Khoury, G Y; Wilson, Saul

doi:10.4103/2152-7806.149848

Cited by 2 publications

(1 citation statement)

References 26 publications

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“…Careful review of the literature reveals that many cranial cases of FD begin asymptomatic with more aggressive symptoms manifesting as the lesion grows. [ 19 30 ] Symptoms of aggressive lesions include worsening headaches, severe edema, mass effect, compromised vision, compromised hearing, and altered cosmetic appearance. [ 2 12 16 18 25 ] Our case offers 18 years of insight into the natural history of cranial FD with worsening mass effect and headaches manifesting from a growing lesion in the frontotemporal area.…”

Section: Discussionmentioning

confidence: 99%

Natural history of cranial fibrous dysplasia revealed during long-term follow-up: Case report and literature review

Penn¹,

Rj²,

Glass³

et al. 2017

Surg Neurol Int

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Background:Fibrous dysplasia (FD) is a rare developmental disease characterized by the replacement of bone marrow with proliferating fibro-osseous tissue. There exist three forms of FD—monostotic, polyostotic, and that associated with McCune-Albright syndrome. The disease can present in different locations and with a variety of symptoms. One of the more common locations of FD occurrence is the craniofacial region. Treatment of asymptomatic FD often involves conservative management with serial imaging. Medical management with bisphosphonates is an option, though long-term efficacy data are lacking. Surgical resection is usually reserved for very large or symptomatic lesions.Case Description:We discuss the most unusual case of a 52-year-old male found to have a left pterional mass while being worked up for sinus headaches. The patient elected to follow this lesion conservatively, and imaging several years later showed obvious growth which accelerated in the last 4 years during an 18-year observational period. He ultimately underwent successful resection of an extradural and intradural FD.Conclusions:The significant growth potential of these lesions was revealed in this patient, in whom conservative management had been adopted. Despite optimal surgical resection and outcome in this case, the importance of surveillance imaging and perhaps earlier intervention cannot be underestimated when managing cranial FD.

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