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Updated: May 10, 2026

Diagnosis of Neoplasia in Barrett’s Esophagus using Vital-dye Enhanced Fluorescence Imaging

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Locally aggressive fibrous dysplasia.

T G Kashima¹, N M Gamage, H Ye

¹Department of Histopathology, NDORMS, University of Oxford, Oxford, UK.

Virchows Archiv : an International Journal of Pathology

|June 14, 2013

Summary

Fibrous dysplasia (FD) can rarely behave aggressively, extending into soft tissues. Distinguishing aggressive FD from osteosarcoma involves checking for GNAS mutations and the absence of CDK4/MDM2 amplification.

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Area of Science:

Pathology
Oncology
Genetics

Background:

Fibrous dysplasia (FD) is typically a benign fibro-osseous lesion.
Locally aggressive behavior in FD is rare and poorly understood.

Observation:

This study examined three cases of locally aggressive FD, two involving ribs.
Follow-up ranged from 2-7 years, including one recurrent lesion.
All lesions showed typical FD histology but extended through bone cortex into soft tissue.

Findings:

Aggressive FD lesions lacked CDK4 and MDM2 overexpression/amplification.
A GNAS mutation was identified in two of the three cases.
These findings confirm rare aggressive behavior in FD with extra-osseous extension.

Implications:

Aggressive FD can be differentiated from low-grade osteosarcoma.
Distinguishing features include GNAS mutation presence and lack of CDK4/MDM2 amplification.
This aids in accurate diagnosis and appropriate management of rare aggressive FD cases.