A case of fibrous dysplasia occurred centering in the maxilla and its review of the literature

• Published in: Japanese Journal of Oral and Maxillofacial Surgery Vol. 36; no. 8; pp. 1874 - 1880
• Main Authors: HASEGAWA, Hideyuki, SHIRAKAWA, Masayori, MARUTA, Osamu, NOMURA, Takeshi, SAKAI, Nobuoki
• Format: Journal Article
• Language: English
• Published: Japanese Society of Oral and Maxillofacial Surgeons 1990
• Subjects: Fibro-osseous lesion; fibrous dysplasia; maxilla
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.36.1874

Fibrous dysplasia is a clinical syndrome generally classified into the following three types; Albright's syndrome, polyostotic fibrous dysplasia, and monostotic fibrous dysplasia. However, its classification has diverse pathological meanings, and due to its necessity of differentiating from osteoid diseases and of selecting an appropriate surgical method a more rational classification is currently required. Thoma proposed that fibrous dysplasia occurring in the maxilla or facial bone should be standardized as facial fibrous dysplasia for discrimineting from the three types mentioned above based on its anatomical peculiarity. Recently, the authors encountered a case of facial fibrous dysplasia as noted by Thoma, the outline of which is reported after discussion of the literatures. The patient, a 17-year-old female, visited our hospital complaining of swelling in the left portion of the exterior bucca. Her case-history revealed that she had noticed the above mentioned symptoms at approximately 13 years of age which were however ignored because of absence of accompanied other subjective symptoms. Recently, she consulted a hospital dentist after the aforementioned swelling had been pointed out by her friends. On the radiogram, diffuse non-permeable images of the maxillary sinus (left side) were observed and the patient was then referred to our department. The swelling was non-symmetry and extended from the zygomatic arch on the left side to the maxillary alveolar region. Radiographic findings showed a non-permeable image with an appearance of frosted glass centering on the maxillary sinus of the left side, which involved all the roots of 3 to 7. A biopsy was performed under a clinical diagnosis of fibrous dysplasia and enucleation was then conducted under general anesthesia. The operation did not proceed with a method exclusively concentrated on the tumor because of its anatomical specificity but initial consideration was given primarily to the reappearance of maxillary sinus morphology and the measurement of the right and left facial symmetry, followed by practicable curettage and enucleation. Pathological and histologic findings revealed that the maxillary sinus was comprised of irregular bone trabecula and fibrous connective tissue, and the former was consisted of in laminar structure and osteoid regions. The postoperative prognosis was favorable, showing no abnormal findings even after a year and four months.