Fibrous dysplasia of the maxilla: radiographic and histopathologic correlation in a challenging diagnosis – a case report with literature review

Background. Fibrous dysplasia (FD) is a benign and uncommon bone disorder that arises from a mutation in the GNAS gene, replacing normal bone with fibrous tissue and abnormal (woven) bone. Case report. 50-year-old woman presented with a one-year history of asymptomatic right maxillary swelling that posed a risk of future masticatory dysfunction. CBCT revealed an aggressive unilocular lesion with a granular “ground-glass” pattern expanding into the maxillary sinus – a pattern seen in <10% of maxillary FD cases. Histopathology confirmed FD, showing fibrocellular stroma with immature trabeculae lacking osteoblastic rimming. Due to extensive involvement, a right hemimaxillectomy was performed with no perioperative complications. The case underscores FD’s diagnostic challenges, mimicking other fibro-osseous lesions radiographically, necessitating histopathologic correlation. The patient was discharged in stable condition but was unfortunately lost to follow-up, limiting assessment of postoperative recovery and recurrence risk. Conclusions. FD is typically benign, but rare malignant transformation warrants surveillance. This report highlights the critical role of CBCT-histopathology integration in managing atypical FD and advocates for standardized follow-up protocols.