Posttraumatic Reactive Fibrous Bone Neoformation of the Anterior Skull Base Mimicking Osteosarcoma

Abstract

Objectives: Malignant bone tumors and fibro-osseous bone lesions of the skull base are uncommon, although fibrous dysplasia in this anatomic location is not a rare condition. In general, fibro-osseous lesions of the skull are often difficult to classify on either clinical presentation, radiological findings, or histological presentation alone. The objective of this article is to present a probably important differential in the management of bony neoformations of the skull and to highlight the diagnostic difficulties when dealing with osseous and fibro-osseous conditions affecting the craniofacial bones. Design: We present here a novel case of posttraumatic reactive fibrous bone neoformation of the anterior skull base mimicking osteosarcoma in a 16-year-old boy. Results: Diagnostic steps, clinical, histological, and radiological presentation, as well as surgical treatment are described in detail. The international medical literature concerning reactive fibrous bone neoformations is reviewed, and the problem of adjusting the correct differential diagnosis when dealing with fibro-osseous bone lesions of the skull base is discussed. Conclusions: The highlights of this case are an uncommon location of a rare pathological entity, which might constitute an important differential of fibro-osseous conditions affecting the craniofacial bones.

Dental perspectives in fibrous dysplasia and McCune–Albright syndrome

“…Furthermore, the variable clinical, radiological and histological presentations of FD, as well as apparent risk of malignant transformation, cause some dental practitioners to delay or avoid dental surgical procedures in FD 32, 34–36 . Also, some dental healthcare providers may also feel uneasy about treating FD/MAS patients because of previous subjective reports that dental surgery might exacerbate jaw FD, transforming a quiescent lesion to an aggressively growing lesion 32, 33, 40 . There are also concerns regarding bisphosphonate-associated osteonecrosis of the jaw (ONJ) 29, 30, 32, 34, 35, 37 .…”