Spontaneous involution of diffuse fibrous dysplasia of paranasal sinuses

Fibrous dysplasia of the head and neck in Southern Finland: a retrospective study on clinical characteristics, diagnostics, and treatment

PURPOSE

Fibrous dysplasia (FD) is a rare genetic disease with benign bone tumors. FD can affect one (monostotic FD) or multiple bones (polyostotic FD), with craniofacial lesions being common. Because of its rarity, there are only few clinical reports on FD in the head and neck region and its clinical characteristics remain incompletely defined. This study aimed to determine patient demographics, symptoms, diagnostics, and given treatment in patients with FD of the head and neck in a Finnish population.

METHODS

A retrospective review on all patients diagnosed with or treated for FD of the head and neck at the Helsinki University Hospital during 2005-2020.

RESULTS

In total 74 patients were identified; 54% were male and the mean age 45 years. Overall 95% had monostotic FD. Mandibula and maxilla were the most common anatomic sites. Majority of patients had symptoms, most commonly pain and lesion growth, and 49% had extra-skeletal symptoms. For all, diagnosis was primarily based on imaging findings, biopsies were obtained from 41%. Altogether 54 patients (73%) were managed by observation only, 20 patients (27%) received treatment; ten bisphosphonates, six surgery and four both.

CONCLUSION

Although highly variable in its clinical manifestations, head and neck FD lesions are often symptomatic and impose risk for extra-skeletal complications. Treatment is often conservative but should be individually tailored. Future studies are encouraged to better define the disease characteristics and hopefully offer new treatment possibilities.

Characteristics of sinonasal fibrous dysplasia: experience from a single department

OBJECTIVES

We summarized the characteristics of fibrous dysplasia patients in our department to obtain clinical data on this disease.

METHODS

We retrospectively reviewed 28 patients who were diagnosed with sinonasal fibrous dysplasia based on pathological examination results from March 2012 to February 2017 in our department.

RESULTS

The 28 patients included 16 females and 12 males, and the median age was 31.5 (range, 7-69) years. The three most common symptoms were nasal obstruction (25%), impaired vision (21%) and headache (18%). Most of the tumors were located in the sphenoid sinus (50%), nasal cavity (39%) or ethmoid sinus (36%). The surgical strategy included an exclusive endoscopic approach (25 cases) and an endoscopic approach combined with sublabial incision (three cases). The median follow-up period was 29 months (range, 3-62 months), and three patients were lost to follow-up. Two of the remaining 25 patients developed recurrence. However, since the second surgery, there has been no recurrence to date.

CONCLUSIONS

Our study indicates that the treatment of fibrous dysplasia patients should be tailored according to patient and disease characteristics. The main surgical procedure is the endoscopic approach, and the effect is good. Although the recurrence rate is low, follow-up is necessary.