Fibrous dysplasia of the anterior mandible: A rare case report

Abstract

Fibrous dysplasia (FD) is a rare bony disorder in which normal bone is replaced by abnormal fibro-osseous tissue. It often involves the long bones, craniofacial bones, ribs, and pelvis. Approximately 30% of monostotic FD (MFD) lesions are found in the cranial or facial bones. In general, FD is found in teenagers, and it usually becomes static after adulthood. FD involves the maxilla almost two times more often than the mandible. It frequently appears in the posterior region of the jaw bone and is usually unilateral. Here, we present an unusual case of symptomatic MFD affecting the anterior region of the mandible in a 43-year-old female with the clinical, radiographical, and histopathological features. The clinical examination showed both the labial and lingual bone expansion in the anterior mandible. The radiographic examination revealed a lesion with both radiopaque and radiolucent features showing a "ground-glass" appearance. The diagnosis was obtained after confirmatory intrabony biopsy with the histopathological examination, and it was diagnosed with benign FD. The patient preferred regular follow-up of MFD after discussion. During the regular follow-up, MFD lesion showed no obvious signs of progression or malignancy features.

Keywords: Fibrous dysplasia; Mandible; Middle-aged person; Monostotic.

Figure 1

Clinical photograph showing expansion of both the labial and lingual cortical plates of the anterior mandible

Figure 2

Panoramic radiography reveals a mixed radiolucent and radiopaque lesion with a ground glass appearance in the anterior mandible which is crossing the midline

Figure 3

Periapical radiograpy demonstrates details of the mixed radiolucent and radiopaque lesion extending from the mesial side of the tooth 21 root apex to the distal side of the tooth 27 root apex and the two other apical lesions of teeth 18 and 31

Figure 4

Cone-beam computed tomography reveals a “ground glass” appearance in the buccal and lingual bone expansion regions and relatively well-defined borders. (a) Sagittal view. (b) Coronal view. (c) Transverse view. (d) Three dimensional rendered image of the jaw bone

Figure 5

Biopsy performed at the most protruding site of the labial cortical plate

Figure 6

Irregularly shaped trabeculae of woven bone and lamellar bone in a cellular, loosely arranged fibrous stroma