Cases reported "Fibrous Dysplasia of Bone"

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1/21. Multiple globoid meningiomas associated with craniomandibular fibrous dysplasia: case report.

    A 20-year-old male with craniomandibular deformity and almost total visual loss of the right eye due to bilateral optic atrophy underwent cerebral nonenhanced computed tomography (NECT) examinations. He had multiple sphenoidal-temporoparietal meningiomas, with adjacent hyperostoses and distant calvarial hyperdense lesions, as well as sclerotic expansion of right mandibular condyle. history, clinical and imaging findings were suggestive of associated fibrous dysplasia (FD), which explained the visual loss due to optic nerve compression through sphenoidal optic foramens. Cranial and mandibular FD and concurrent multiple globoid meningiomas in this case may suggest a mutual influence, which may explain the etiopathogenesis of FD lesions and/or bone hyperdensities adjacent or distant to meningiomas.
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2/21. Cranioorbital fibrous dysplasia: with emphasis on visual impairment and current surgical management.

    Fibrous dysplasia is a benign but slowly progressive disorder of bone in which normal cancellous bone is replaced by immature woven bone and fibrous tissue. Significant deformity and both acute and chronic visual impairment can result. A contemporary understanding of fibrous dysplasia, emphasizing the origins of visual impairment, indications for decompressive surgery, and the techniques for correction of the cosmetic deformity are presented. In their experience and review of the literature, the authors found the most frequent clinical presentations to be exophthalmos, displacement of the globe, abnormalities of extraocular motility, cosmetic deformity, and visual impairment. Although traditionally the cause of visual impairment has been ascribed to impingement of the optic canal on the optic nerve, the authors' experience is that the most common cause of visual loss is cystic degeneration of the tumor, particularly with those involving the anterior clinoid process. exophthalmos and optic canal stenosis are less common causes of visual impairment. Indications for surgical intervention include acute and/or serially radiographically documented and relentless visual impairment and significant cosmetic deformity. Individualized management strategies are also discussed.
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3/21. thoracic outlet syndrome caused by tumor of the first rib.

    We report a new case of thoracic outlet syndrome caused by a tumor of the first rib and review 11 other reports found in the literature. A 25-year-old man was admitted with thoracic outlet syndrome in the C8-T1 nerve roots. The first rib was removed through a supraclavicular approach with excision of the medial clavicle. All symptoms disappeared. On histologic examination fibrous dysplasia was found in the rib. Tumors of the first rib are uncommon and are rarely responsible for thoracic outlet syndrome. When the tumor is very large, as in our case, we recommend a supraclavicular approach associated with excision of the medial clavicle. During the liberation of the brachial plexus, great care should be exercised to avoid nerve injuries. Because malignancy of the tumor cannot be eliminated with certainty before or during the operation, wide excision of the entire rib is recommended.
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4/21. Fibrous dysplasia of the skull with progressive cranial nerve involvement.

    The purpose of this report is twofold. First, to discuss fibrous dysplasia of bone as it relates to the neurosurgeon, and second to present a case of fibrous dysplasia of the skull with progressive involvement of the optic and trigeminal nerves. Of special interest in this case is the progression of the disease after puberty and the technical problems of decompression of the involved nerves. A combined approach to the lesion with otolaryngological assistance was undertaken.
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5/21. trigeminal neuralgia-like pain in an aged woman with fibrous dysplasia of the skull base.

    A 72 year old woman with attacks of severe lancinating pain in the right frontotemporal region of her face had, on CT scan of the skull base, fibrous dysplasia of the right sphenoid bone, involving the areas traversed by the trigeminal nerve. Her pain ceased following treatment with methysergide. In patients with hemifacial pain but no evident facial or skull deformities, CT scan of the skull base may be helpful in elucidating the diagnosis.
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6/21. Reversible visual loss caused by fibrous dysplasia.

    Fibrous dysplasia is a developmental anomaly of bone, often affecting the facial bones. We treated a patient who had fibrous dysplasia involving the right maxillary and sphenoid bones. The patient had a sudden loss of visual acuity to R.E.: counting fingers. visual fields demonstrated a central scotoma, and retrobulbar neuritis was diagnosed. When vision failed to improve spontaneously, however, radiologic studies were performed. These showed compromise of the optic canal by bony proliferation and an apparent mucocele at the orbital apex. Surgical exploration disclosed fibrous dysplastic bone and a cystic structure overlying the optic nerve. Successful surgical excision of the cyst and debulking of the fibrous dysplasia resulted in visual acuity returning to R.E.: 20/25.
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7/21. hemorrhage into fibrous dysplasia following minor head injury--effective decompression for the ophthalmic artery and optic nerve.

    We performed an effective optic canal decompression in a patient with ethmoid and sphenoid fibrous dysplasia and visual impairment following minor head trauma. On admission, the patient's left visual acuity consisted only of light perception, and the left ophthalmic artery was not visible by angiography. A hematoma and fibrous dysplasia tissue in the sphenoid sinus were excised and the left optic canal was decompressed. The vision was markedly improved to an ability to count fingers in the following 2 weeks. The left ophthalmic artery was fully opacified in the postoperative angiogram.
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8/21. Fibrous dysplasia of the skull with acromegaly and sarcomatous transformation. Two cases with a review of the literature.

    Two cases of fibrous dysplasia of the skull are reported. Both patients were young women with acromegaly and were treated with radiotherapy. Progressive pareses of cranial nerves, pain, and a malignant course of the disease were characteristic in both patients, and the diagnosis of osteogenous sarcoma proved in one of them by histological examination. The clinical picture of fibrous dysplasia of the skull and the role of radiotherapy with the risk of development of malignancy is discussed.
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9/21. Fibrous dysplasia of the temporal bone.

    A 38-year-old woman with fibrous dysplasia of the entire right half of the mandible and the right temporal bone is presented. She had a unilateral progressive conductive hearing loss and stenosis of the auditory canal complicated by a chronic external otitis, a hidden cholesteatoma, destruction of the ossicles and an impending facial palsy. Surgery was performed to create a new auditory canal, to eradicate the cholesteatoma and to decompress the facial nerve from the surrounding fibrous dysplasia.
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10/21. Parasellar and optic nerve lesions: the neurosurgeon's perspective.

    For neuroradiologic evaluation of parasellar lesions, a wide array of examinations may be utilized. CT and MRI are used in the assessment of these lesions to establish the diagnosis and to assist the neurosurgeon in defining the precise location. Careful neuroradiologic assessment and close cooperation between the neurosurgeon and the neuroradiologist have much bearing on the surgical planning and eventual outcome of the patient.
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