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Although fibrous dysplasia (FD) is a benign fibro-osseous lesion, locally aggressive behaviour has rarely been described but is poorly characterised. In this study, we document clinical, radiological and pathological (including molecular genetics) findings in three cases of locally aggressive FD, two of which involved the ribs. Lesions in these cases, one of which was a recurrent lesion, were followed up for 2-7 years. All of the lesions showed typical histological features of FD but were characterised by extension through the bone cortex into the extra-osseous soft tissue. The lesions did not exhibit overexpression/amplification of CDK4 and MDM2; in two of the cases, a GNAS mutation was identified. Our findings confirm that FD can rarely exhibit locally aggressive behaviour with extension beyond the bone compartment into the surrounding soft tissue; these lesions can be distinguished from low-grade intramedullary osteosarcoma by lack of amplification/overexpression of CDK4 and MDM2 and the presence of a GNAS mutation.

Original publication

DOI

10.1007/s00428-013-1437-x

Type

Conference paper

Publication Date

07/2013

Volume

463

Pages

79 - 84

Addresses

Department of Histopathology, NDORMS, University of Oxford, Oxford, UK.

Keywords

Humans, Fibrous Dysplasia of Bone, Proto-Oncogene Proteins, Nuclear Proteins, Tomography, X-Ray Computed, Adult, Aged, Middle Aged, Female, Male, Cyclin-Dependent Kinase 4