Abstract
Stafne’s bone defect (SBD) is an uncommon bone alteration that affects the mandible and usually presents as an asymptomatic radiolucency located in the posterior region of body or angle of the mandible, below the alveolar canal. Although clinical and radiographic features are more often sufficient for the diagnosis, other lesions and bone alterations have been described in the differential diagnosis and may lead to a misinterpretation and an incorrect diagnosis. Herein, we report a case of an 89-yearold man with metastatic prostate cancer to multiple bones, presenting an asymptomatic solitary well-defined radiolucent image on the right side of the posterior body of the mandible, in close contact with its inferior border. A bone depression was confirmed by computed tomography scans of the mandible and a metastatic inclusion was ruled out by bone scintigraphy with a final diagnosis of SBD. The aim of this report was to highlight the importance of differentiating SBD from metastases in cancer patients and to reinforce the usefulness of multiple imaging modalities in the differential diagnosis of SBD. Key words:Stafne’s bone defect, Mandible, Depression, Metastases, Imaging modalities.
Highlights
Stafnes’s bone defect (SBD) known as Stafne’s bone cyst/cavity, salivary gland lingual mandibular bone depression and lingual cortical mandibular bone depression, among others names, is an asymptomatic condition affecting the mandible that was first described by Stafne in 1942 (1)
A slight depression could be accessed on the head and neck physical examination of the correspondent mandibular area, this signal is commonly absent and is believed to be restricted to the lesions involving the inferior border of the mandible (9)
Embryonic and congenital remnant tissues, as salivary glands and cartilaginous tissue were suggested to be entrapped during development and ossification of the mandible which could generate the defects (1,2)
Summary
Stafnes’s bone defect (SBD) known as Stafne’s bone cyst/cavity, salivary gland lingual mandibular bone depression and lingual cortical mandibular bone depression, among others names, is an asymptomatic condition affecting the mandible that was first described by Stafne in 1942 (1). The etiology of this bone defect remains controversial, with some authors that believe in congenital or embryonic causes (1,2) and other groups that accept a bone resorption process caused by pressure from submandibular or other glandular tissues (3). Sialography (7), as well as surgical exploration (3), can be used to confirm the presence of salivary gland tissue in regard to characterize SBD These procedures aim to exclude other potential lesions in the differential diagnosis, especially, in atypical cases and anterior lingual mandibular bone depressions (8). We report one case of a patient with primary prostate adenocarcinoma with multiple bone metastases, who presented an asymptomatic unilocular radiolucent cavity in the right posterior body of the mandible diagnosed as a SBD
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