Left Body Of Mandible Research Articles

Osteosarcoma of mandible in a teenager - A case report with review of literature

Osteosarcomas are highly malignant bone tumours characterised by the presence of malignant mesenchymal cells producing osteoid or immature bone. Though rapidly growing bones are commonly affected like metaphysis in the femur, rare cases of Osteosarcoma of jaw (JOS) too occur; with an incidence of approximately 0.7 per million. The diagnosis involves clinico-radiological and histological correlation. A 14-year old male presented with the chief complaints of swelling and pain in his lower jaw on left side for 15 days and was given a provisional diagnosis of neoplasia of left body of mandible on radiography which was confirmed as osteosarcoma in histopathology. The case presented here highlight the importance of histopathology in diagnosing the lesion. Considering its rarity we present the case and attempt to review the literature associated with this lesion. Osteosarcoma especially of jaw requires a high degree of suspicion and need to be diagnosed and treated promptly to prevent further complications as rapidly growing tumour could predispose to bony outgrowth, facial deformity, airway compromise and metastasis. Key message: Jaw osteosarcoma is a rare entity requiring clinico-radiological and histopathological corelation for early diagnosis.With a clinically distinct profile as compared to its extremity counterpart, early histomorpholgical diagnosis and management with surgery, chemotherapy and radiotherapy can lead to better outcome. Keywords: Bone malignant tumour, Histopathology, Jaw osteosarcoma, Mandible, Osteoblastic.

Use of a Marker for Surgical Treatment of Odontogenic Keratocyst

A 47-year-old woman presented with a left jaw lesion prevailing for over 10 years, without painful symptomatology, and with a histopathologic report of odontogenic keratocysts. Extraoral examination did not reveal abnormalities. Intraoral examination showed signs of a previous treatment in the left retromolar region, performed at another service. Computed tomography of the face revealed a hypodense, well-delimited, unilocular lesion in the left mandible body and angle. A conservative surgical treatment was performed, with total enucleation of the lesion, using methylene blue as a bone marker for peripheral osteotomy. Microscopic analysis revealed a thin fibrous wall without inflammatory infiltrate, an epithelial lining composed of a uniform layer of stratified squamous epithelium, and luminal surface showing corrugated parakeratotic flattened epithelial cells. The basal epithelial layer was composed of a palisade layer of colloidal or columnar epithelial cells. The patient is in a 12-month follow-up, with no lesion recurrence.

UNUSUAL CASE OF MANDIBULAR AMELOBLASTOMA THAT HAS EXCEEDED THE MIDLINE: A CASE REPORT

This study reports a case of mandibular ameloblastoma that has exceeded the midline. A 62-year-old female patient presented with painless swelling complaint in body region and left mandibular symphysis. The clinical examination showed intact mucosa and normal color; facial asymmetry left and dysphagia. The panoramic radiographies suggested image circumscribed radiolucent unilocular in the left mandible body with a length exceeding symphysis and parasymphysis to the opposite side. CT (CT) scan showed hypodense image in the region was to break the buccal bone plate. The incisional biopsy generated histologic sections that revealed odontogenic tumor fragments in the form of nests and strands with peripheral columnar cells similar to ameloblasts, confirming the diagnosis of ameloblastoma unicystic. Marsupialization was performed for tumor decompression in progress, preservation and preparation for subsequent enucleation surgery. Bilateral involvement that goes beyond the midline is unusual in odontogenic tumors, especially in ameloblastoma.

An ‘accidental’ incident leading to an incidental finding of Gorlin–Goltz syndrome in a child

AbstractA 6‐year‐old boy was referred to the oral surgery department for assessment of a cyst‐like lesion in the left body of mandible. The child had previously been managed for developmental delay and a syndromic appearance by medical colleagues with no firm diagnosis. Histology of the lesion confirmed a keratocystic odontogenic tumour (KCOT) and pointed towards a diagnosis of Gorlin–Goltz syndrome (GGS) when combined with other clinical features and confirmed by genetic testing. This case highlights the importance of team work, appropriate and proportionate application of different imaging modalities to characterise intraosseous lesions in children and monitoring for interval change, as well as the conservative approach to management of such lesions in younger patients. Prognosis improves with early recognition of clinical and radiographic manifestations of GGS facilitated by multi‐disciplinary involvement. This may reduce the severity of complications including maxillofacial deformities associated with jaw KCOTs and malignant skin and brain tumours.

Odontogenic Myxoma of Mandible Appeared as an Ameloblastoma on CT Imaging

Odontogenic myxoma is a rare benign tumor of ectomesenchymal origin, which can arise from dental papilla, follicle or periodontal ligament. Most commonly it arises from mandible followed by maxilla. We report a case of odontogenic myxoma in a 23 years old female who came with complaint of painless swelling in left mandible. CT scan revealed an expansile radiolucent lesion involving the left mandible body with cortical thinning and mild destruction at few places. Biopsy was done which was suggestive of odontogenic myxoma. Surgery was done and odontogenic myxoma was proved on the biopsy.

Solitary intraosseous neurofibroma: Report of a unique case

Neural tumors located centrally in jaw bones are relatively rare compared with soft tissue neurofibromas. Less than 50 cases have been reported in the literature with a predilection for mandible. This article aims to elucidate a unique case of intraosseous neurofibroma of mandible in a 62-year-old edentulous female patient associated with facial asymmetry due to the swelling extending from the right body of mandible to left body of mandible. The uniqueness of this case is related to the age and extensiveness of this lesion. A review of clinical, radiographic, histological, and immunohistochemical features, and the surgical management pertaining to this case are discussed along with a review of the literature.

Accessory Mental Nerve: A Case Report

The presence of an Accessory Mental Nerve (AMN) is rare. The mental foramen is an important landmark in the mandible for administration of local anaesthesia and mental nerve identification and its preservation is of paramount importance in various surgical procedures. This article presents a case of an incidental finding of accessory mental nerves during open reduction and fixation of a compound fracture of left body of mandible. Knowledge on anatomic variations is helpful in diagnosis, treatment planning and management during surgical procedures.

Three-Stage Mandible Reconstruction After Firearm Injury

Firearm injuries in the lower jaw may cause significant loss of hard and soft facial tissues, resulting in aesthetic and functional deformity. In this article, we present a case of a patient who suffered avulsion of the soft and hard tissues of the left mandible body and symphysis. After the emergency treatment, the patient was referred to our service, and the treatment was performed in 3 stages: surgical reconstruction with vascularized fibula flap, distraction osteogenesis, and dental implant rehabilitation. During 5 years of follow-up period, the aesthetic and functional condition of the patient improved considerably.

Letter to The Editor: 3D CT Reconstruction of Mandibular Fractures

To the Editor Computed tomography (CT) has become a routine diagnostic tool in the management of maxillofacial trauma [1]. Advances in technology allow multiplanar 2-dimensional (2D) and 3-dimensional (3D) reconstructions [2]. 3D reconstruction imaging has found varied applications [3]. But can we take this to mean that imaging modalities like dental panoramic radiographs have no role in the diagnosis of maxillofacial trauma? We found the answer is not clear-cut. A maxillofacial trauma patient was examined and found to have soft tissue wounds over the midface and swelling over the right angle of mandible with sublingual ecchymosis. Palpation also revealed an acute tenderness of left body of mandible. CT scan was performed and 3D reconstruction generated. The images depicted horizontally unfavourable fracture of right mandibular angle with clarity (Fig. 1). This image was superior to traditional 2D CT or panoramic radiograph. However, no mandibular body fracture was evident in the 3D CT reconstruction (Fig. 2). Due to continuing clinical suspicion of mandibular body fracture, a panoramic radiograph was made. It revealed undisplaced left mandibular body fracture (Fig. 3). Fig. 1 3D CT reconstruction depicting mandibular angle fracture Fig. 2 No evident fractures of mandibular body on 3D CT reconstruction Fig. 3 Panoramic radiograph depicts undisplaced left mandibular body fracture Accurate and detailed images of the facial skeleton in polytrauma patients can be obtained speedily with spiral CT scans. However, in 3D CT reconstruction, volume averaging and threshold errors may lead to misrepresentation. Regardless of the investigated structure, careful analysis of 2D axial and secondarily reconstructed coronal images is mandatory [2]. In addition to thorough clinical examination, the dental panoramic radiograph remains a most important imaging tool for fractures of the mandible. In conclusion, though 3D CT reconstructed images can be impressive, they cannot be the sole basis for surgical decisions.

Diagnosis and treatment of primary synovial cell sarcoma that occurred in the left mandible body: a case report and literature review

The authors describe a case of synovial sarcoma in the left mandible body. The primary tumor was investigated morphologically and immunohistochemically. The patient was treated with madibulectomy and lymph node dissection, which was followed by an immediate reconstruction of the left mandible with a revascularized osteomyocutaneous fibula free flap. The primary tumor was described as gingival sarcoma. The initial preoperative biopsy showed positive staining for cytokeratin, vimentin, smooth muscle actin, and desmin by immunohistochemistry. The definitive diagnosis of monophasic synovial sarcoma was established following postoperative excision biopsy. Antigens of S-100 and CD99 displayed positive staining but epithelial membrane antigen, Bcl-2, and CD34 were negative. Also, no metastasis or other bone swelling was observed by radionuclide survey suggesting the left mandible was the primary lesion of occurrence. Synovial sarcoma is an uncommon soft tissue malignant neoplasm. This is the sixth case of primary synovial sarcoma occurring in the jaw.

下顎骨に生じたＭａｓｓｉｖｅ ｏｓｔｅｏｌｙｓｉｓの１例 特にその臨床所見について

A case of Massive osteolysis affecting of the mandible was presented in a 46 years old female whose chief complaint was a depression on the left mandibular region. Radiographs revealed a large radiolucency of the left ramus of the mandible and histopathologically, the affected site consisted of only numerous dense connective tissues.The left mandible body was resected and reconstructed with autogenous bone and reconstruction metal plate.At the present situation, the prognosis is good for mastication and cosmetic form.