Fibrous Dysplasia of the Clivus: Case Report

Introduction: Fibrous dysplasia is a developmental skeletal disorder which may cause distortion, expansion, and weakening of the bone. Involvement of craniofacial bones with fibrous dysplasia is well known and may cause neurovascular impingement and cosmetic deformity. However, fibrous dysplasia of the clivus is rarely reported with only 14 cases in the literature. Because the management of fibrous dysplasia of the clivus differs from that of other pathological conditions that affect that anatomic area, the recognition and differential diagnosis of this disease are very important.

Case Report: A 52-year-old woman was admitted with a 1-year history of headache and tinnitus. Her physical and neurological examinations were unremarkable. Hematological and biochemical profiles were normal. Cranial MRI was performed, and an abnormal lesion was detected in the clivus. The lesion was hypointense on both T1- and T2-weighted images with heterogeneous enhancement. Because of the high probability of fibrous dysplasia we did not choose a more invasive procedure, and the patient was operated upon by an endoscopic transnasal approach and the lesion was gross total resected. There was no neurological deficit after surgery. The histological diagnosis was fibrous dysplasia. The patient has suffered no neurological disturbances and no residue lesion in the clivus during a follow-up period of 1 year.

Conclusion: All clival lesions should be carefully evaluated radiologically in the preoperative period in order to prevent unnecessary aggressive surgery and to prevent the patient from the potential complications of such a surgery.