Displasia fibrosa. Reporte de caso

Fibrous dysplasia is a disease with proliferation of abnormal fibrous connective tissue that gradually replaces normal bone marrow. Clinically it presents as an asymptomatic, hamartomatous, non-neoplastic growth with unilateral swelling producing facial asymmetry. The radiographic appearance is variable, from a radiolucent lesion to a dense radiopaque mass, where the latter is the most common. It can affect one or several bones concomitantly (monostotic or polyostotic), being more frequent in the maxilla than in the mandible. Histopathologically there is a cellular proliferation of fibrous connective tissue containing foci of immature bone, with irregularly shaped trabeculae. The surgical treatment of choice in most cases is bone remodeling surgery for lesions that cause obvious aesthetic deformities. Taking into account its uniqueness, we present a clinical case of an 18-year-old young man with unilateral swelling at the level of the right maxilla. Extraoral clinical examination showed right facial asymmetry, with greenish skin macula in the middle third of the face on the right side. Intraorally, at the level of the right upper jaw there was absence of premolars and molars with deformity of the contour of the vestibular bone table and alveolar ridge. Radiographically a radiopaque image was observed. The decision was made to perform an incisional biopsy under local anesthesia of the lesion in the upper maxilla, upper quadrant, and the complementary examinations and the histopathological result revealed the presence of fibrous dysplasia. The case represents an important contribution to a better understanding of fibro-osseous lesions.