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Clinical Challenge
March 2018

Generalized Radiopacities of the Craniofacial Skeleton

Author Affiliations
  • 1Division of Oral Medicine, Diagnosis, and Radiology, Department of Oral Health Practice, University of Kentucky College of Dentistry, Lexington
  • 2Division of Neuroradiology, Department of Radiology, University of Utah Health Sciences Center, Salt Lake City
JAMA Otolaryngol Head Neck Surg. 2018;144(3):266-267. doi:10.1001/jamaoto.2017.2633

An adolescent girl presented with a history of multiple, slowly growing masses of the face and head. The lesions were first reported when she was 5 years of age and gradually increased in size. However, her medical history was otherwise unremarkable. On clinical examination, the lesions were hard in consistency with normal overlying skin. There was significant bilateral exophthalmos (the left eye was more pronounced), with visual changes, and dental malocclusion. However, there were no clinical signs of endocrinopathy. A skeletal survey showed no involvement of other bones. The patient’s serum calcium, phosphate, alkaline phosphatase, thyroid, and parathyroid hormone levels were within normal limits. A computed tomographic (CT) examination of the craniofacial skeleton was performed (Figure).