A 55 y/o female with an intermittent headache

 

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Doctor's Information

Name :  Farhad
Family :Niaghi
Email :   This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident :  ----------------

 

Patient's Information

Gender :  Female
Age :  55

 

Case Section

Head & Neck Imaging

 

Clinical Summary

This lesion was found on a routine work up for intermittent headache and did not change during a 1 year follow up.

 

 

Imaging Procedures and Findings

There is an expansile sclerotic lesion in the mastoid portion of right petrous bone which has ground-glass appearance. no periostal reaction or erosion is noted. Other parts of petrous bone demonstrate normal appearance

 

Discussion

Fibrous dysplasia is a benign congenital process that can be seen in a patient of any age and can look like almost any pathologic process radiographically. It can be wild looking, discretely lucent, patchy, sclerotic, expansile, multiple, and many other descriptions. Fibrous dysplasia will not have periostitis associated with it; therefore, if periostitis is present, one may safely exclude Fibrous dysplasia. Fibrous dysplasia virtually never undergoes malignant degeneration and should not be a painful lesion unless there is a fracture. An occult fracture often occurs in long bones with Fibrous dysplasia; therefore, it is not unusual to have it present with pain and no obvious fracture seen in a long bone. Pain in a flat bone, such as the ribs or pelvis (non weight-bearing bones), should not occur with Fibrous dysplasia Fibrous dysplasia can be either monostotic (most commonly) or polyostotic and has a predilection for the pelvis, proximal femur, ribs, and skull. The classic description of Fibrous dysplasia is that it has a ground-glass or smoky matrix . Fibrous dysplasia is often purely lytic and becomes hazy or takes on a ground-glass look as the matrix calcifies . It can go on to calcify significantly, and then it presents as a sclerotic lesion.

 

Final Diagnosis

fibrous dysplasia

 

References

Brant WE, Helms CA. Fundamentals of Diagnostic Radiology, 3rd edition p.1064-1065

 

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