Fibro-osseous lesions of the head and neck

An Atypical Bilateral Presentation of Fibrous Dysplasia (FD) in the Mandible: Clinical, imaging and therapeutic characterization

Introduction and importance

Fibrous Dysplasia (FD) is a benign fibro-osseous lesion, characterized by replacement with fibrous connective tissue instead of normal bone. The best treatment option for the condition has not yet been established, although several therapeutic approaches have been reported. The present case report describes the clinical, imaging and therapeutic aspects of an atypical bilateral presentation of FD in the mandible.

Case presentation

A 26-year-old afro-descendent woman, who had previously undergone surgery to remove FD in the right hemimandible, complained of asymptomatic swelling in the left hemimandible. Imaging analysis showed an ipsilateral extensive multilocular mandibular lesion, with thinning of the cortical bone. After diagnosis of FD, complete surgical removal was performed, associated with immediate local reconstruction with xenograft and covering membrane, with primary wound closure.

Clinical discussion

Bilateral presentation of FD is uncommon, and its diagnosis by means of clinical data, imaging and histopathological analysis, is relevant in order to establish the correct therapy.

Conclusion

Complete surgical removal associated with immediate local bone reconstruction, has shown satisfactory clinical results, when adequate follow-up is performed.

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There are few reports based on the atypical bilateral presentation of FD.

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The bilateral presentation of FD in young non-syndromic patients is rare.

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There is a lack of consensus regarding the best treatment for FD.

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The surgical approach is still the best choice for avoiding recurrences.

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Bone grafting after the removal of FD lesions has shown clinical satisfactory results.