Fibrous dysplasia, a rare skeletal disorder marked by replacement of normal bone with fibrous tissue and disorganized woven bone, most commonly affects the craniofacial region. Although craniofacial fibrous dysplasia (CFD) typically progresses slowly and remains asymptomatic, it can occasionally give rise to complications. The authors report a unique case of an intralesional abscess within maxillary CFD in an 88-year-old man presenting with acute facial pain and swelling. Computed tomography revealed a fluid-filled cavity within the maxillary CFD lesion. Surgical drainage was performed using a multimodal approach involving the Caldwell-Luc procedure, prelacrimal recess approach, and middle meatal antrostomy. Postoperative recovery was favorable. No recurrence or regrowth was observed during 1 year of follow-up. This rare presentation highlights the importance of personalized treatment strategies and watchful surveillance in symptomatic CFD patients.
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