Fibrous dysplasia: parameters to be considered for surgical decision making

Abstract

Introduction: Fibrous dysplasia is an uncommon, benign pathology that affects the bones and is characterized by the gradual replacement of bone tissue by a fibrous one, creating aesthetic and functional bone disorders.  Histologically, it presents an excessive proliferation of the mesenchymal cells that form the bone.

Objective: To know the aspects related to decision making, regarding surgical treatment or the option of carrying out clinical and radiographic controls of fibrous dysplasia.

Case presentation: We report two cases of pediatric patients who attended the Children´s Hospital Napoleón Franco Pareja (HINFP) in Cartagena–Colombia presenting fibrous dysplasia that produced unilateral facial asymmetry compromising the aesthetics of patients, but reporting no painful symptoms.  We describe the characteristics of the pathology and the basic useful criteria in making therapeutic decisions, with either conservative radical surgical approach or only performing a clinical and radiographic control of the lesion.

Conclusions: Clinical criteria such as facial asymmetry, aesthetic deformity, and functional commitment are basic aspects in the therapeutic option for patients with in fibrous dysplasia.

 Keywords: Fibrous Dysplasia of Bone, Monostotic Fibrous Dysplasia, Surgery, benign disease.