Bisphosphonate treatment in craniofacial fibrous dysplasia--a case report and review of the literature.
Fibrous dysplasia (FD) is a benign skeletal disorder which may affect one or multiple bones. Lesions often involve long bones, ribs, and craniofacial bones and cause pain, fractures, and disfigurement. We describe an adolescent girl with mandibular FD who was successfully treated with bisphosphonates. She presented with a tumor-like lesion of the mandible. During the 2-year follow-up, the lesion expanded and caused significant disfigurement and pain necessitating psychiatric support. Treatment with bisphosphonate administered intravenously resulted in rapid pain relief, normalization of bone turnover, and cosmetic improvement. Management of FD has previously consisted of either conservative follow-up or surgery depending on disease activity and localization. Based on published reports and our experience, bisphosphonates should be considered in the treatment of symptomatic cases. This line of treatment may be suitable especially for craniofacial FD in which surgical treatment is particularly challenging.
Mäkitie
Antti A
AA
Department of Otolaryngology--Head and Neck Surgery, Helsinki University Hospital, P.O. Box 220, 00029 Helsinki, Finland. antti.makitie@helsinki.fi
Törnwall
Jyrki
J
Mäkitie
Outi
O
D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002648:Child; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D005357:Fibrous Dysplasia of Bone / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D006801:Humans; D008334:Mandible / Q000000981:diagnostic imaging* / Q000187:drug effects; D011877:Radionuclide Imaging
D050071:Bone Density Conservation Agents; D004164:Diphosphonates