Multimodal imaging diagnosis for bone fibrous dysplasia malignant transformation: A case report

Lu,Jian-Lin; Ke,Miao; Yuan,Xiao-Yan; Zhang,Jin-Shan

doi:10.3892/br.2023.1655

Multimodal imaging diagnosis for bone fibrous dysplasia malignant transformation: A case report

Authors:
- Jian-Lin Lu
- Miao Ke
- Xiao-Yan Yuan
- Jin-Shan Zhang
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Affiliations: Department of Radiation Oncology and Nuclear Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, P.R. China, Department of Medical Ultrasonics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, P.R. China
Published online on: September 1, 2023 https://doi.org/10.3892/br.2023.1655
Article Number: 73
Copyright: © Lu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Fibrous dysplasia of bone (FDB) is a rare benign condition in which fibrous tissue replaces normal bone architecture. FDB rarely undergoes malignant transformation, but there are reports of locally aggressive fibrous dysplasia with cortical destruction and soft tissue extension. Diagnosis of FDB malignant transformation is not easy, especially in monostotic form, because of the overlap in imaging features of locally aggressive fibrous dysplasia and fibrous dysplasia with malignant transformation. The present case study reports a rare case of FDB in a 23‑year‑old man with polyostotic fibrous dysplasia arising in the left side of the pelvis and lower limb bones with partial transformation to fibrosarcoma. This study explored the multimodal imaging features of FDB malignant transformation, to achieve early detection and improve diagnostic accuracy of local FDB aggressiveness and its malignant transformation.

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1	Hakim DN, Pelly T, Kulendran M and Caris JA: Benign tumours of the bone: A review. J Bone Oncol. 4:37–41. 2015.PubMed/NCBI View Article : Google Scholar
2	Qu N, Yao WW, Cui X and Zhang H: Malignant transformation in monostotic fibrous dysplasia: Clinical features, imaging features, outcomes in 10 patients, and review. Medicine (Baltimore). 94(e369)2015.PubMed/NCBI View Article : Google Scholar
3	Martini M, Klausing A, Heim N, Fischer HP, Sommer A and Reich RH: Fibrous dysplasia imitating malignancy. J Craniomaxillofac Surg. 46:1313–1319. 2018.PubMed/NCBI View Article : Google Scholar
4	Riddle ND and Bui MM: Fibrous Dysplasia. Arch Pathol Lab Med. 137:134–138. 2013.PubMed/NCBI View Article : Google Scholar
5	Zoccali C, Attala D, Rossi B, Zoccali G and Ferraresi V: Fibrous dysplasia: An unusual case of a very aggressive form with costo-vertebral joint destruction and invasion of the contralateral D7 vertebral body. Skeletal Radiol. 47:1571–1576. 2018.PubMed/NCBI View Article : Google Scholar
6	Ottaviani G and Jaffe N: The epidemiology of osteosarcoma. Cancer Treat Res. 152:3–13. 2009.PubMed/NCBI View Article : Google Scholar
7	Ruggieri P, Sim FH, Bond JR and Unni KK: Malignancies in fibrous dysplasia. Cancer. 73:1411–1424. 1994.PubMed/NCBI View Article : Google Scholar
8	Hoshi M, Matsumoto S, Manabe J, Tanizawa T, Shigemitsu T, Izawa N, Takeuchi K and Kawaguchi N: Malignant change secondary to fibrous dysplasia. Int J Clin Oncol. 11:229–235. 2006.PubMed/NCBI View Article : Google Scholar
9	Kim HG, Baek JH and Na K: Osteosarcoma arising in fibrous dysplasia of the long bone: Characteristic images and molecular profiles. Diagnostics (Basel). 12(1622)2022.PubMed/NCBI View Article : Google Scholar
10	Su XY, Sun WP, Yuan JQ, Li LX, Jiang ZM and Zhang HZ: Sarcoma arising in fibrous dysplasia: A clinicopathological analysis. Zhonghua Bing Li Xue Za Zhi. 51:733–737. 2022.PubMed/NCBI View Article : Google Scholar : (In Chinese).
11	DiCaprio MR and Enneking WF: Fibrous dysplasia. Pathophysiology, evaluation, and treatment. J Bone Joint Surg Am. 87:1848–1864. 2005.PubMed/NCBI View Article : Google Scholar
12	Singh V, Gupta K and Salunke P: Monostotic craniofacial fibrous dysplasia: Report of two cases with interesting histology. Autops Case Rep. 9(e2018092)2019.PubMed/NCBI View Article : Google Scholar
13	Liu XX, Xin X, Yan YH and Ma XW: Imaging characteristics of a rare case of monostotic fibrous dysplasia of the sacrum: A case report. World J Clin Cases. 9:1111–1118. 2021.PubMed/NCBI View Article : Google Scholar
14	Davidova LA, Bhattacharyya I, Islam MN, Cohen DM and Fitzpatrick SG: An analysis of clinical and histopathologic features of fibrous dysplasia of the jaws: A series of 40 cases and review of literature. Head Neck Patho. 14:353–361. 2020.PubMed/NCBI View Article : Google Scholar
15	Muthusamy S, Subhawong T, Conway SA and Temple HT: Locally aggressive fibrous dysplasia mimicking malignancy: A report of four cases and review of the literature. Clin Orthop Relat Res. 473:742–750. 2015.PubMed/NCBI View Article : Google Scholar
16	Ogul H and Keskin E: Locally aggressive fibrous dysplasia mimicking malign calvarial lesion. J Craniofac Surg. 29:e318–e319. 2018.PubMed/NCBI View Article : Google Scholar
17	Wang Y, Luo Y, Min L, Zhou Y, Wang J, Zhang Y, Lu M, Duan H and Tu C: The West China Hospital radiographic classification for fibrous dysplasia in femur and adjacent bones: A retrospective analysis of 205 patients. Orthop Surg. 14:2096–2108. 2022.PubMed/NCBI View Article : Google Scholar
18	Pozzessere C, Cicone F, Barberio P, Papa A, Coppolino G, Biagini R and Cascini GL: Cross-sectional evaluation of FGD-avid polyostotic fibrous dysplasia: MRI, CT and PET/MRI findings. Eur J Hybrid Imaging. 6(19)2022.PubMed/NCBI View Article : Google Scholar
19	Atalar MH, Salk I, Savas R, Uysal IO and Egilmez H: CT and MR imaging in a large series of patients with craniofacial fibrous dysplasia. Pol J Radiol. 80:232–240. 2015.PubMed/NCBI View Article : Google Scholar
20	Kinnunen AR, Sironen R and Sipola P: Magnetic resonance imaging characteristics in patients with histopathologically proven fibrous dysplasia-a systematic review. Skeletal Radiol. 49:837–845. 2020.PubMed/NCBI View Article : Google Scholar
21	Zhang LQ, He Q, Li W and Zhang RS: The value of ^99mTc-methylene diphosphonate single photon emission computed tomography/computed tomography in diagnosis of fibrous dysplasia. BMC Med Imaging. 17(46)2017.PubMed/NCBI View Article : Google Scholar
22	Wei WJ, Sun ZK, Shen CT, Zhang XY, Tang J, Song HJ, Qiu ZL and Luo QY: Value of ^99mTc-MDP SPECT/CT and ¹⁸F-FDG PET/CT scanning in the evaluation of malignantly transformed fibrous dysplasia. Am J Nucl Med Mol Imaging. 7:92–104. 2017.PubMed/NCBI
23	Gokce E and Beyhan M: Radiological imaging findings of craniofacial fibrous dysplasia. Turk Neurosurg. 30:799–807. 2020.PubMed/NCBI View Article : Google Scholar
24	Wang J, Du Z, Li D, Yang R, Tang X, Yan T and Guo W: Increasing serum alkaline phosphatase is associated with bone deformity progression for patients with polyostotic fibrous dysplasia. J Orthop Surg Res. 15(583)2020.PubMed/NCBI View Article : Google Scholar