Presentation
A long history of left facial swelling. Painless enlarging mass in the left jaw.
Patient Data
Large expansile lytic lesion replacing the left mandible. There is thin rim calcification with a bubbly appearance. An unerupted molar tooth is present within the posterior peripheral part of the mass.
Following surgical removal, the pathology report on the specimen was:
Microscopic: Sections show a hard and soft tissue specimen consisting of trabeculae of vital bone and droplets of cementum-like material seen in association with a variable cellular fibrous connective tissue stoma.
Comment: The histopathological findings, in conjunction with the clinical and radiographic presentation, are most compatible with cemento-osseous dysplasia variant expansive osseous dysplasia or gigantiform cementoma.
Final Diagnosis: Benign fibro-osseous lesion
Case Discussion
The patient presented late with a long history of left facial swelling. Cross-sectional imaging was not available.
The differential of the expansile lytic lesion would include the benign mandibular lesions as there are no aggressive features seen on plain radiographs; ameloblastoma, or fibro-osseous lesion, depending on where the lesion originated. The originating tissues cannot be ascertained from plain radiographs.
Following surgical removal, the pathology report gave a final diagnosis of a benign fibro-osseous lesion.
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