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

Wilber E Bernaola-Paredes; Henrique Rocha Mazorchi Veronese; Miriã de Andrade Celestino; Ivan Solani Martins; Arthur Ferrari de Arruda; Kleber A Vallejo-Rosero

doi:10.1016/j.ijscr.2021.106049

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

Int J Surg Case Rep. 2021 Jul:84:106049. doi: 10.1016/j.ijscr.2021.106049. Epub 2021 May 29.

Authors

Wilber E Bernaola-Paredes¹, Henrique Rocha Mazorchi Veronese², Miriã de Andrade Celestino², Ivan Solani Martins³, Arthur Ferrari de Arruda⁴, Kleber A Vallejo-Rosero⁵

Affiliations

¹ Department of Radiation Oncology, A.C. Camargo Cancer Center, Sao Paulo, Brazil. Electronic address: edison.bernaola@gmail.com.
² Department of Stomatology, School of Dentistry, University Center "UNIFAMINAS", Muriaé, Minas Gerais, Brazil.
³ Department of Oral and Maxillofacial Surgery, Hospital Sirio Libanes, Sao Paulo, Brazil.
⁴ Department of Anatomic Pathology, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
⁵ Department of Oral and Maxillofacial Surgery, Central University of Ecuador, Quito, Ecuador.

Abstract

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.

Keywords: Bone diseases developmental; Craniofacial fibrous dysplasia; Fibrous Dysplasia of bone; Heterografts; Oral surgical procedure; Reconstructive surgical procedures.