A rare case of fibrous dysplasia in the mandible: a case report

Samson Emeka Obirija, M. W. Rasheed, Juliet Ebele Okonkwo
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Abstract

Background: Fibrous dysplasia (FD) is a benign fibro-osseous lesion of the bone which can be monostotic FD and the polyostotic form. Polyostotic FD with café-au-lait spots of the skin and hormonal imbalances is called McCune–Albright syndrome. Besides, Mazabraud syndrome is characterized by polyostotic FD and intramuscular myxomas. FD has its onset during childhood or early adolescence and usually occurs within the first or second decade of life. The mode of presentation of the FD of the jaw ranges from asymptomatic to dental anomalies, pain, and facial asymmetry. Given the clinical history and radiological assessment, cystic lesions have some important differential diagnoses which range from cystic ameloblastoma, fibrous dysplasia, aneurysmal bone cyst, and odontogenic keratocyst. Case report: This presents a 19-year-old female who presented to the maxillofacial surgeons’ clinic with a referral from a peripheral hospital. Her major complaint was right-sided facial swelling which was noticed 4 years before the presentation. A plain radiograph revealed an expansile lesion of the mid-right mandible appearing as a well-outlined, fairly oval multiloculated cystic radiolucent mass with multiple internal septations. A preliminary diagnosis of a complex cystic right jaw mass with benign features was made with possible differential diagnoses such as ameloblastoma, fibrous dysplasia, aneurysmal bone cyst, and odontogenic keratocyst were suggested as possible differential diagnoses. Finally, she had an excision biopsy with a histological diagnosis of fibrous dysplasia. The outcome of the surgery was satisfactory at one year review.    
下颌骨纤维发育不良的罕见病例:病例报告
背景:纤维发育不良(FD)是一种良性骨纤维性病变,可分为单骨质FD和多骨质FD。伴有皮肤咖啡色斑和内分泌失调的多形性 FD 被称为麦库恩-阿尔布莱特综合征(McCune-Albright Syndrome)。此外,马扎布洛综合征(Mazabraud Syndrome)的特征是多形性 FD 和肌肉内肌瘤。FD 在儿童期或青春期早期发病,通常发生在生命的第一个或第二个十年。颌骨 FD 的表现方式从无症状到牙齿畸形、疼痛和面部不对称不等。根据临床病史和放射学评估,囊性病变有一些重要的鉴别诊断,包括囊性母细胞瘤、纤维发育不良、动脉瘤性骨囊肿和牙源性角化囊肿。病例报告:患者是一名 19 岁的女性,经外围医院转诊来到颌面外科医生诊所。她的主诉是右侧面部肿胀,在就诊 4 年前就已发现。X光平片显示,她的右下颌骨中部有一个扩张性病变,表现为一个轮廓清晰、相当椭圆的多发囊性放射性肿块,内部有多处间隔。初步诊断为具有良性特征的右下颌复杂囊性肿块,可能的鉴别诊断包括牙釉质母细胞瘤、纤维发育不良、动脉瘤性骨囊肿和牙源性角化囊肿。最后,她接受了切除活检,组织学诊断为纤维发育不良。一年后复查,手术结果令人满意。
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