Fibrous dysplasia: Rare sphenoidal and parietal involvement

Fibrous dysplasia (FD) is a rare congenital disorder characterized by the replacement of normal bone with fibrous tissue. Two forms are described: monostotic, polyostotic. FD shows a slight female predominance and is often asymptomatic. Frequently, this condition is an incidental radiographic finding. Craniofacial involvement is present in 50% of polyostotic and 25% of monostotic cases. Typically affects contiguous bones; noncontiguous involvement is rare. Sphenoid/ethmoid and parietal co-occurrence is uncommon. Classic radiographic signs include ground-glass appearance and cortical thinning/displacement. Magnetic resonance imaging is reserved for complication assessment. Curative surgery is reserved for compressive complications and palliative surgery for deformities. Modern imaging technique include image-guided surgery, 3D reconstruction: optimize functional/esthetic outcomes.

We present an illustrative case of a female patient who developed progressive sphenoid and parietal bone FD, representing the uncommon noncontiguous pattern of involvement. Initial presentation at age 12 featured headaches and a painless cranial mass. Surgical intervention includes craniotomy and acrylic bone cement cranioplasty.

FD is a frequently asymptomatic congenital condition, often discovered incidentally. While craniofacial involvement typically affects contiguous bones, our case highlights the diagnostic and therapeutic challenges of rare sphenoid-parietal co-involvement. Surgical intervention remains pivotal for functional and aesthetic rehabilitation.