Fibrous Dysplasia of the Sphenoid Sinus and Skull Base Presents in an Adult With Localized Temporal Headache

Abstract

Fibrous dysplasia (FD) of the sphenoidal sinus is a rare disease, especially during adulthood. We report a case of FD of the right sphenoidal sinus in an adult male patient who presented with nonspecific symptoms limited to headache localized to the right temporal area and to the inferior orbital rim of both sides. Magnetic resonance imaging revealed a dense mass that occupied the entire right sphenoidal sinus and skull base with typical ground-glass opacification and bony sclerosis of the whole sphenoidal wall. The diagnosis of FD was confirmed on pathological examination of a biopsy taken through sphenotomy. The patient underwent a subcranial craniotomy for tumor resection. After more than 4 years of follow-up, the patient was disease-free. On the basis of these clinical features, it is important to consider sphenoidal FD in both young and adult patients complaining of an unexplained headache, because it may present unusually with headache localized to the temporal region or the inferior orbital rim.

Fibrous Dysplasia of the Clivus

“…This bone swelling can lead to intracranial extension and central neurological manifestations, neurovascular entrapment, orbito-sino-nasal obstruction, recurrent sinusitis, epiphora, proptosis, malocclusion, and cosmetic deformity 3,5,17,25) . On involvement of basal cranium by FD, compressive cranial neuropathy that mainly affect the facial, auditive, trigeminal, olfactory, and visual function occurs from thickening and narrowing of neural canals and foramina 1,2,9,16,18) . Majority of the monostotic clival dysplasia do not appear to produce any functional limitations and aesthetic problems, and are mostly identified incidentally in early adulthood 3) .…”

Resection of Fibrous Dysplasia of the Sphenoid Bone and a Concomitant Calcified Pituitary Adenoma via an Endoscopic Endonasal Transsphenoidal Approach

“…It has also been reported in association with other diseases, as in McCune-Albright syndrome [3][4][5][6] . Trabeculae of woven bone are contained in fluid-filled cysts embedded in a collagenous fibrous matrix, which contributes to the generalized hazy appearance of the bone on x-rays and CT scans 7 .…”

Fibrous Dysplasia of the Sphenoid Bone: Case Report

“…tem po ral böl ge ye lo ka li ze baş ağ rı sı şika ye ti ile baş-vu ran sfe no id si nüs te izo le FD ol gu su bil dir miş tir. 16 Bü yü klü ve ark. tüm sfe no id si nü sü dol du ran FD ol gu su bil dir miş tir.…”

“…Oy sa ta nı nın er ken ko nul ması, ta ki bi ve ge re kir se te da vi nin za ma nın da uy gulan ma sı ola sı komp li kas yon la rın ön len me si açı sın dan önem li dir. 6,16,21 Sel ma ni ve ark. sfe no id si nüs te izo le FD ol gu la rın da cer ra hi te da vi den sonra 4 yıl lık ta ki bin de nüks bil dir me miş tir.…”

“…sfe no id si nüs te izo le FD ol gu la rın da cer ra hi te da vi den sonra 4 yıl lık ta ki bin de nüks bil dir me miş tir. 16 Pa pa dopo u los ve ark. akut gör me kay bı ge li şen 2 adet kra ni yo fa si yal fib röz disp la zi ol gu la rın da cer ra hi te da vi son ra sı gör me de ta ma ya kın dü zel me ol duğu nu ra por et miş tir.…”