A woman in her 40s fell at work, striking her head. She presented to the emergency department where she had a computed tomographic (CT) brain scan which showed sclerotic expansion of the right temporal bone with a spiculated periosteal reaction along the outer and inner tables. All portions of the temporal bone were involved, though it appeared to respect suture lines, because there was no involvement of any other bones of the calvarium. The outer table of bone was serrated and spiculated, while the inner table had a more lobular pattern. The initial interpretation by radiology experts was possible atypical fibrous dysplasia and this prompted referral to the otology clinic.
Shapiro S, Cassis A. Differentiating Hyperostotic Temporal Bone Meningioma En Plaque and Fibrous Dysplasia on Computed Tomographic Imaging. JAMA Otolaryngol Head Neck Surg. Published online September 01, 2016. doi:10.1001/jamaoto.2016.2387