Fibro-Osseous Lesions of the Craniofacial Region: An Account of Fifty Cases Seen in a Resource-Challenged Setting

Abstract

Background: Craniofacial Fibro-osseous lesions (CFOLs) are a diverse group of relatively rare entities which aetiology range from reactive to dysplastic with a potential for malignant transformation. Their clinical presentations range from asymptomatic, causal radiographic findings to huge lesions which may present with endocrinopathies. The differential characterization of members of the CFOLs presents a diagnostic dilemma due to their overlapping clinico-radiologic features, while the various treatment modalities described in the literature attest to the controversy surrounding their management. Aim: to determine the pattern of presentation of CFOLs in the study location and compare same to reported patterns from other geographic locations. Methods: Consecutive patients diagnosed with CFOLs who presented at the Ahmadu Bello University Teaching Hospital (A.B.U.T.H), Shika-Zaria, Kaduna State from May 2016 to December 2017, were recruited for the study. The clinical and radiological presenting features were recorded and tumour classification was done using the Speight and Carlos' classification of CFOLs. Observation, shaving/paring down, excision and jaw resections were the management modalities employed in this study. Treatment outcomes were assessed 6 months post-operatively or after 6 months of observation. Results: CFOLs were commoner in males than females (ratio 1: 1.38). Fibrous dysplasia (64%) was the most prevalent lesion most of which are of the craniofacial variant (68.7%), while the maxilla was the most affected site (62%). The mixed radiological pattern (56%) was the most prevalent radiologic pattern, while most of the subjects had excision or jaw resection. Six months after surgery or observation, most (66%) of the subjects had no evidence of recurrence, while 6% either recurred or developed morbidity. Conclusion: the pattern of presentation of CFOLs in our environment largely agrees with reported pattern in most of the African studies.