Case Report
Monofocal maxillary fibrous dysplasia with orbital, nasal and oral obstruction

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Summary

Fibrous dysplasia is a condition characterised by excessive proliferation of bone-forming mesenchymal cells. Although a variety of causative factors are described, the exact aetiology is yet to be fully known. The maxilla is the most commonly affected facial bone, with facial asymmetry being the usual complaint. Surgery is the treatment of choice with two available options, namely, conservative bone shaving and radical excision and reconstruction.

We describe the case of a 25-year-old male who presented with a giant monofocal fibrous dysplasia of the left maxilla with facial asymmetry, including obstruction of the left orbit, nasal and left half of the oral cavities and was treated with conservative surgery.

Section snippets

Case report

A 25-year-old male presented with a huge swelling (Figure 1) over his left maxillary region which was of insidious onset, painless and had gradually enlarged over a period of 15 years. As the swelling increased in size, it slowly began to obstruct his left nostril, causing difficulty in opening the left eyelids and the left side of the oral cavity resulting in an inability to chew food (Figure 2). On examination, there was a bony, hard swelling of 15 × 17 cm in size with peau d'orange appearance

Discussion

Fibrous dysplasia, also known as ossifying fibroma, is an uncommon condition of the bone which is characterised by excessive proliferation of bone-forming mesenchymal cells. The maxilla is the most commonly affected facial bone and the condition is usually seen in the first and second decade of life with a slight female preponderance, involving a single bone1 [monostotic] or multiple bones [polyostotic]. When monostotic fibrous dysplasia tends to impinge on the adjacent structures, it is known

Conflict of interest

There were no conflicts of interest either of ethical, academic or financial nature and there were no grants or sources of funding.

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Copyright © 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.