Fibro-osseous lesion of the cranium in an adolescent patient.

Kingsley Abode-Iyamah,Saul Wilson,Siangliao Lee,Patricia Kirby,Brian Park,George El-Khoury

doi:10.4103/2152-7806.149848

Kingsley Abode-Iyamah, Saul Wilson + Show 4 more

Open Access

https://doi.org/10.4103/2152-7806.149848

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Abstract

Background:Fibrous dysplasia, ossifying fibroma, and desmoplastic fibroma are rare benign calvarial lesions, which can have local aggressive behavior. These tumors can present with similar clinical and radiologic characteristics making diagnosis difficult at times.Case Description:A 16-year-old male presents after noting an indentation of his skull. Comparison with current and previous imaging revealed progressive erosion of the skull underlying the indentation.Conclusion:Fibrous dysplasia, ossifying fibroma, and desmoplastic fibroma are rare fibro-osseous tumors with similar characteristics radiographically. Accurate diagnosis of these tumors can be difficult even with the combination of clinical presentation, imaging, and pathology. The treatment of choice is resection and cranial reconstruction, if necessary, with close follow-up as recurrence can occur.

Highlights

Fibrous dysplasia, ossifying fibroma, and desmoplastic fibroma are rare benign calvarial lesions, which can have local aggressive behavior
Fibrous dysplasia (FD) of the skull can affect any of the cranial bones, but most commonly affects the ethmoid and frontal bones typically presenting with cranial asymmetry.[29]
desmoplastic fibroma (DF) was first described by Jaffe et al in 1958 and is defined by World Health Organization (WHO) as a “rare, benign bone tumor, composed of spindle cells with minimal cytological atypia and abundant collagen production.[10]

Summary

Conclusion

Fibrous dysplasia, ossifying fibroma, and desmoplastic fibroma are rare fibro‐osseous tumors with similar characteristics radiographically Accurate diagnosis of these tumors can be difficult even with the combination of clinical presentation, imaging, and pathology. We present a 16‐year‐old male with a bony lesion of the right parietal skull with conflicting imaging and pathologic findings. The patient was noted to have a palpable defect and indentation of the right parietal bone. The first study, from 2 years prior, showed a skull defect in the right parietal bone [Figure 1a]. The abnormal bone was removed and a mesh titanium plate was used to replace the cranial defect [Figures 1d and 3].

Findings

DISCUSSION

CONCLUSION