Imaging Sci Dent.  2016 Dec;46(4):259-265. 10.5624/isd.2016.46.4.259.

Fibrous dysplasia of the maxilla in an elderly female: Case report on a 14-year quiescent phase

• Lee BD
• Lee W
• Park YC
• Kim MH
• Choi MK
• Yoon JH

• KMID: 2362744
• DOI: http://doi.org/10.5624/isd.2016.46.4.259

Abstract

Fibrous dysplasia (FD) is an uncommon skeletal disorder in which normal bone is replaced by abnormal fibro-osseous tissue. Mainly, FD is found in children, and by adulthood it usually becomes quiescent. Our case showed FD of more than 14-year duration in the left maxilla. Our evaluation was that growth ceased in adulthood and had achieved the static stage. Because FD cases in elderly patients are rarely reported, we hereby present a monostotic FD case in a 65-year-old female. We presented sequential radiographic images and scintigraphic images of this case, and combined them with a literature review that emphasized the progression of the disease.

Keyword

Fibrous Dysplasia, Monostotic; Radiography

MeSH Terms

Aged*
Child
Female*
Fibrous Dysplasia, Monostotic
Humans
Maxilla*
Radiography

Figure

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  Fig. 1 An intraoral photograph (2016) shows bucco-lingual expansion in the left maxilla.

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  Fig. 2 Computed tomography images of axial (A), coronal (B), and sagittal (C) views (2002) show a lesion of homogeneous radiopacity on the left maxilla, with expanded cortex but no cortical destruction.

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  Fig. 3 A panoramic image (2007) shows gross radiopacity from the midline to left maxillary tuberosity, and the left maxillary sinus in the left maxilla.

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  Fig. 4 A periapical radiograph (2007) shows indistinct anterior border of the lesion. Loss of alveolar lamina dura is also seen. The trabeculae seem to be shorter, irregularly shaped, and more numerous than normal trabeculae.

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  Fig. 5 A. A whole-body bone scan (2008) shows intense uptake of radioisotope in the left maxilla. There is focal increased uptake in the lesser trochanter of the left femur that was supposed to be enthesopathy. B. Mild uptake of radioisotope in the vascular and blood pool phase and intense uptake in delayed bone scan.

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  Fig. 6 A cropped panoramic radiograph (A, 2016) shows a similar image of the lesion in the left maxilla, compared with the cropped panoramic view B (2012) and C (2008).

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  Fig. 7 Cone-beam computed tomography images (A and B, 2016) show a similar image and no change in size, compared with the 2012 image (C and D). The lesion size has remained almost the same, approximately 11.8 mm×5.2 mm.

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  Fig. 8 The histopathologic exam shows irregular shaped woven bone within a cellular fibrous stroma. The trabecular woven bone reveals a lack of osteoblastic rimming and lamellation (H&E stain, ×100).

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