Fibrous dysplasia of bone (FDB) is a kind of osseous fibrous tissue development disorder, normal bone tissue is replaced by elastic white fiber, which is a benign tumor-like lesion of bone. Clinically, these patients may present with aching pain, swelling, or even more pathological fracture. The etiology is unclear, and with slow progressive history procedure, it can occur in each bone of the whole body, and the bones of the extremities are mostly easily involved, the second place is pelvis, and craniofacial bone, the prognosis of this disease is good, but it is easy to lead to skeleton malformation. In very few cases, it transformed into bone osteosarcoma or fibrosarcoma. The manifestations of CT and MR of fibrous dysplasia of bone were occasionally reported in the literature. But the radiographic features of FDB is less well recognized, which making diagnosis and differential diagnosis of this disease quietly difficult, and FDB is often mistaken for primary bone malignant tumor or metastases of bone. Furthermore, the reports regarding the features of FDB on 18F-FDG PET/CT images is extremely rare, thus we here in reported a case of FDB with findings on 18F-FDG PET/CT imaging.FDB is a kind of benign and slow progressing disease in bone marrow, the bone fiber cells are deformed and the bone trabeculae are arranged disorder and lose normal structure.

Patients are usually asymptomatic and the main clinical manifestations are local pain and swelling. It could be classified into three subtypes: monostotic lesion, polyostotic lesions and Albright syndrome. There is no gender difference between monostotic lesion type and polyostotic lesions type, ribs and tibia are the most easily involved sites in FD. Most of the lesions were in the bone marrow with clear rim, and showed cystic and frosted glassed-like appearance on CT image. Both benign and malignant bone tumor can show high 18F-FDG uptake on PET image, FDB could exhibit abnormal hypermetabolism in 18F-FDG PET/CT and easily be misdiagnosed as metastases or granulomatous lesion, it is necessary to further differential diagnosis in combination with medical history. Most of the FDB are generally found incidentally without special symptoms, the patient with the disease generally had good prognosis, and few FDB could transformed into malignant tumor, such as osteosarcoma, fibrosarcoma, and so on. 18F-FDG PET/ CT plays a vital role not only in the diagnosis of bone fibrous, but also in the malignant transformation. And at the same time, it could provide the biopsy puncture site of the bone fiber for clinician.

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Mishita
Jornal co-ordinator
Journal of Bone Research and Reports