A Massive Craniofacial Polyostotic Fibrous Dysplasia of Midface - A Rare Case Report

Rationale: Fibrous dysplasia (FD) is a fibro-osseous lesion of the osseous structures of the body. With an incidence of 1:4000-1:10,000, it seems to be a rare disease. Polyostotic craniofacial fibrous dysplasia involves the skull base bones and facial bones.

Patient concerns: The patient complained of a huge swelling over the right side of her face for the past 12 years.

Diagnosis: Based on clinical, radiological and histopathological findings, the swelling was diagnosed as polyostotic craniofacial FD.

Treatment: Swelling over the right side of the midface around 6 cm × 5 cm involving right maxilla, zygoma, floor of orbit, lateral side of nose (pyriform aperture) and skull base bones. Since the patient had no functional deficit, we opted for surgical recontouring.

Outcomes: The patient was satisfied with post-operative results.

Take-away lessons: In huge asymptomatic facial deformity, rather than going for resection, we can remove bone in a piecemeal manner followed by recontouring.