Abstract
We present a case of periostitis ossificans, noted as a fast-growing mass involving the posterior mandible in a 27-year-old-man. Image examination showed a hyperdense area in the mandible. With a provisional diagnosis of osteomyelitis or osteosarcoma, incisional biopsy was performed. Histopathologic analysis revealed reactive bone, surrounded by pleomorphic osteoblasts and osteoid matrix close to the bone formation, mimicking an osteosarcoma. The diagnosis was inconclusive; additional biopsies were performed to rule out osteosarcoma. Subsequent microscopic analysis revealed new trabecular bone formation with osteoblastic rimming, arranged in a parallel pattern, and the intertrabecular space was filled with vascularized connective tissue and inflammatory infiltrate. Analysis of the images and the histopathologic aspects led to the diagnosis of periostitis ossificans. An inflammatory odontogenic cyst was also present, associated with the third molar, adjacent to the bone lesion. The patient underwent antibiotic therapy, and complete healing was achieved after 2 months.
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