Imaging appearance of bone tumors of the maxillofacial region

The Profuse Bleeding Potential of Orbital Epithelioid Hemangioendotheliomas

Epithelioid hemangioendothelioma is a rare vascular tumor originating from vascular endothelial or pre-endothelial cells. We present the case of a 4-month-old male with a rapidly enlarging left zygomatico-orbital tumor causing mass effect on the eye globe. Examination revealed a large, nontender, solid lesion. CT angiography showed no major feeder or intralesional vessels. Complete surgical excision was performed, which was complicated by life-threatening intraoperative bleeding and successfully controlled with electrocautery. Microscopically, tumor cells exhibited varying morphologies. Immunohistochemistry confirmed the diagnosis of epithelioid hemangioendothelioma (positive for CD31 and CD34, negative for CK AE1/AE3). We also highlight 2 similar case reports with life-threatening bleeding complications. Surgeons should be aware of this condition and optimize surgical preparation, including blood products, to manage potential bleeding complications.

Maxillofacial challenge: Rare presentation of central giant cell tumor involving both maxilla and mandible

INTRODUCTION AND IMPORTANCE

Central giant cell tumor (CGCT) of bone is an uncommon yet locally aggressive neoplasm originating from undifferentiated mesenchymal cells in bone marrow. This case report explores a rare presentation in the maxilla extending to the mandible, emphasizing the complexity of CGCT management and the need for a multidisciplinary approach.

CASE PRESENTATION

A 35-year-old female presented with a progressively enlarging non-tender, firm swelling on the left maxilla and a similar mandibular swelling. Paraesthesia of the left lower lip and chin accompanied the mandibular swelling. CT scans and 3D reconstructions revealed expansive osteolytic defects affecting the maxilla and mandible. Biochemical tests supported a central giant cell tumor diagnosis. Histopathology confirmed spindle cell proliferation and multinucleated giant cells in both lesions. Surgical intervention involved excision and reconstruction. A five-month follow-up showed no recurrence, affirming the treatment's success.

CLINICAL DISCUSSION

Central giant cell tumors (CGCTs) of bone are primarily benign, arising from undifferentiated mesenchymal cells. While mostly benign, they carry a rare potential for malignancy. Diagnosis involves imaging (CT, MRI, bone scintigraphy) and confirmation through biopsy. Surgical resection is the standard treatment, with radiotherapy considered in challenging cases. Recurrence rates vary with the extent of surgical intervention. Alternative treatments like cryotherapy and chemotherapy show varying success.

CONCLUSION

This case emphasizes the necessity of precise histopathological diagnosis for CGCT management. The intricate nature of maxillary involvement, coupled with mandibular association, mandates a multidisciplinary approach. Surgery, while the primary treatment, should be judiciously determined based on tumor characteristics and recurrence.

Mandibular Chondroblastic Osteosarcoma: A Case Report

Osteosarcoma is primarily a long-bone disease that rarely affects the facial bones. Chondroblastic osteosarcoma is a subvariant of osteosarcoma. Its defining characteristics include the presence of malignant spindle and polygonal cells, as well as a thick layer of chondroid matrix and interwoven neoplastic tissue deposition. Mandibular chondroblastic osteosarcoma, in particular, is often overlooked and disregarded as a presumptive diagnosis at the time of initial presentation. This is mainly because of its rarity or inadequate lesion evaluation. Here, we present the case of a 47-year-old female patient with a rapidly growing swelling at the anterior mandible that was initially misdiagnosed as an ossifying fibroma of the mandible. The subsequent histopathological examination confirmed the diagnosis of chondroblastic osteosarcoma of the mandible. The patient requested a more extensive and aggressive excision, with the possibility of adjuvant radiation or chemotherapy. This article illustrates a rare case of mandibular chondroblastic osteosarcoma, with a focus on the clinical and pathological features of the tumor that should be taken into account when making a differential diagnosis for oral bone lesions.

Langerhans Cell Histiocytosis in the Nasal Bone: A Rare Case

Nasal bone involvement of Langerhans cell histiocytosis is rarely reported. Here we present a case of a 13-year-old boy with a palpable nasal mass. Ultrasonography revealed a hypoechoic mass on the left side of the nose. Both CT scanning and MRI showed an osteolytic mass. The lesion seen on MRI was well-defined mass with homogeneous enhancement. Histopathological examination of the resected specimen confirmed the diagnosis of LCH.

Headache Attributed to Disorder of the Cranium and Base of the Skull

The article describes the approach to imaging that clinicians should adopt in cases of headaches suspected to be secondary to cranial vault or skull-base disorder. As a rule, computed tomography (CT) is superior to MRI for most of the osseous lesions, and lesions of the middle and external ear. MRI provides a complimentary role to CT and is the modality of choice in a few conditions such as extraosseous neoplasms of the skull base.

Anatomy and Diseases of the Greater Wings of the Sphenoid Bone

The greater wings of the sphenoid bone (GWS) comprise the components of the sphenoid bone that make up most of the posterior orbital wall and form the anterior and medial parts of the floor of the middle cranial fossa. Many important skull base foramina, which transmit vital neurovascular structures, are present in these paired wings on either side of the central body of the sphenoid bone. A wide variety of diseases can affect the GWS, ranging from benign osseus lesions to malignant primary and secondary bone abnormalities. The complex three-dimensional curved (winged) shape of the GWS and the wide array of pathologic entities that affect this bone can make it challenging for the radiologist to report the imaging findings accurately, especially in relation to the important skull base foramina. The authors describe a systematic approach to understanding the three-dimensional anatomy of the GWS and review important diseases, with the aid of imaging examples. Useful imaging "pearls" that can help in making specific diagnoses are provided throughout the article. ^©RSNA, 2022.

Osteosarcoma of the Jaws: A Literature Review

Osteosarcoma of the jaws (OSJ) is a relatively rare disease, accounting for between 2% and 10% of all cases of osteosarcoma. It is morphologically and radiologically identical to the trunk and extremity variant, but distinct in several crucial aspects. The lesion is characterized by sarcomatous cells which produce a variable amount of osteoid bone. It arises centrally within the bone and can be subdivided into osteoblastic, chondroblastic and fibroblastic subtype, depending on the predominant cell type. Radiographically, these tumors display a spectrum of bone changes from well-demarcated borders to lytic bone destruction with indefinite margins and variable cortical bone erosion or, in some cases, images of sclerotic bone. Therapeutic options for OSJ include surgery, chemotherapy and radiotherapy, which are employed according to age of the patient, histological classification and localization of the tumor. Today, there is no general consensus in the treatment guidelines for the OSJ though surgery represents the key to the treatment. The main prognostic factor deeply influencing the patient's prognosis remains the complete tumor resection with negative surgical margins. The aim of the present review is to describe state of the art regarding diagnostic and surgical treatment aspects of the primary osteosarcoma of the jaws.

Bone-related disorders of the jaw: A clinico-radiological diagnostic algorithm

Bone-related disorders of the jaw (BRDJ) include a spectrum of non-neoplastic and neoplastic lesions of the maxillofacial region that have been recently classified into fibro-osseous lesions, giant cell lesions and osseous tumours. The histopathological features of BRDJ can be similar and overlie each other. Imaging is important in order to reach a specific diagnosis. However, the appearance of BRDJ on imaging is non-specific in some cases. Computed tomography (CT) and magnetic resonance imaging (MRI) are used for accurate localisation, characterisation of the tumour matrix, delineation of the lesion extension and establishment of the relation of BRDJ to the surrounding structures. Imaging is usually done to detect the relationship with the adjacent surrounding vital structures and to diagnose aggressive forms, malignant transformation and associated syndromes. The correlation of the demographic findings, the location and the clinical presentations with the imaging features are important for the diagnosis of BRDJ. The proposed clinico-radiological diagnostic algorithm with CT and MRI helps a specific diagnosis to be reached in some cases.

Osseous mass in a maxillary sinus of an adult male from the 16th-17th-century Spain: Differential diagnosis

OBJECTIVE

To undertake a differential diagnosis of a large mass found in the left maxillary sinus of a cranium dated to the 16th-17th-century, and to expand knowledge of the diagnosis of osseous tissue formation in osteoarchaeological studies.

MATERIAL

A cranium recovered from the cemetery of San Salvador de Palat de Rey church, León (Spain).

METHODS

Macroscopic analysis, CT scanning.

RESULTS

Macroscopic analysis indicated that the individual was probably a male over 30 years old with an ossified mass in the left maxillary sinus, measuring 24 × 19 × 24 mm, occupying approximately 27 % of the maxillary antrum. Computed tomography revealed a well-demarcated radiolucent unilocular mass with some radiopaque areas, with no communication with the alveoli of the premolars or molars. No erosive lesions or signs of inflammation were found.

CONCLUSIONS

Neither the macroscopic, nor the radiological characteristics are compatible with inflammatory or malignant pathology, favoring a diagnosis of ossifying fibroma.

SIGNIFICANCE

This case adds to the few reported cases in the osteoarchaeological literature, especially since there is limited relevant reference data to assist diagnosis. The CT scans and 3D reconstruction presented here facilitate differential diagnosis in future paleopathological studies.

LIMITATIONS

Destructive methods were not authorized.

SUGGESTIONS FOR FURTHER RESEARCH

In the future, micro-CT analysis, which was not performed in the current study, may add new and valuable information.

Fibrous Dysplasia, Paget's Disease of Bone, and Other Uncommon Sclerotic Bone Lesions of the Craniofacial Bones

Imaging studies of the brain, head and neck, sinuses, and dental computed tomography are among the most frequently performed procedures in radiologic departments. Systematic evaluation in the bone window may reveal common and uncommon sclerotic osseous abnormalities of the craniofacial skeleton.Most of these findings are incidental and unrelated to the initial clinical indications. Sporadically symptoms may arise due to lesional mass effect with compression on adjacent structures and neuroforaminal encroachment, resulting in proptosis, vision, or hearing loss. Other symptoms include craniofacial deformity, mandibular occlusion deformity, and local pain.This article reviews the most common disorders characterized by an increased bone density involving the craniofacial bones including fibrous dysplasia, Paget's disease of bone, meningioma with associated hyperostosis, and osteoma. Finally, typical examples of rarer sclerosing bone dysplasias are discussed as well.Emphasis is placed on imaging features and the differential diagnosis.

Anticancer Activity of Samarium-Coated Magnesium Implants for Immunocompromised Patients

The removal of tumors in the osseous tissue leads to functional disorders. To overcome this issue, biodegradable implants are used to replace the damaged part of the system. In the study, samarium oxide was coated on the anodic layer of AZ31 magnesium alloy. The potentiodynamic polarization, electrochemical impedance, and localized electrochemical impedance spectroscopy studies were carried out for the samarium-coated magnesium alloy. The corrosion resistance of the coating improved several folds than the bare alloy. The apatite formed on the 3rd day of immersion in the simulated body fluid showed cuboid and triangular structures, whereas on the 7th day, it exhibited a sea sponge-like appearance. The coating exhibited inherent anticancer and antibacterial properties. Our work suggests that the samarium coating is expected to be a promising orthopedic implant for preventing tumor relapse and metastasis.

Osteoimmunology of Oral and Maxillofacial Diseases: Translational Applications Based on Biological Mechanisms

The maxillofacial skeleton is highly dynamic and requires a constant equilibrium between the bone resorption and bone formation. The field of osteoimmunology explores the interactions between bone metabolism and the immune response, providing a context to study the complex cellular and molecular networks involved in oro-maxillofacial osteolytic diseases. In this review, we present a framework for understanding the potential mechanisms underlying the immuno-pathobiology in etiologically-diverse diseases that affect the oral and maxillofacial region and share bone destruction as their common clinical outcome. These otherwise different pathologies share similar inflammatory pathways mediated by central cellular players, such as macrophages, T and B cells, that promote the differentiation and activation of osteoclasts, ineffective or insufficient bone apposition by osteoblasts, and the continuous production of osteoclastogenic signals by immune and local stromal cells. We also present the potential translational applications of this knowledge based on the biological mechanisms involved in the inflammation-induced bone destruction. Such applications can be the development of immune-based therapies that promote bone healing/regeneration, the identification of host-derived inflammatory/collagenolytic biomarkers as diagnostics tools, the assessment of links between oral and systemic diseases; and the characterization of genetic polymorphisms in immune or bone-related genes that will help diagnosis of susceptible individuals.

Head and Neck Sarcomas: A Review of Clinical and Imaging Findings Based on the 2013 World Health Organization Classification

OBJECTIVE

Head and neck sarcomas are a complex, heterogeneous group of tumors that present a diagnostic challenge to radiologists because they have many overlapping imaging features. The purpose of this article is to review the imaging and clinical features and highlight distinguishing features of head and neck sarcomas.

CONCLUSION

An understanding of characteristic imaging and clinical features of head and neck sarcomas is important for the radiologist to narrow the differential diagnosis and help guide management.

A simple method to estimate the linear length of the orbital floor in complex orbital surgery

BACKGROUND

The orbital floor (OrF) and infraorbital rim (IOR) repair in cases of complete destruction is challenging mainly due to the fact that the defect length cannot be measured. The aim of the current study is to develop a method of calculating the Orf length by using the gender and the lengths of the medial, superior and lateral orbital walls (OrW) of the same orbit.

MATERIAL AND METHODS

Ninety-seven (59 male and 38 female) European adult dry skulls were classified according to age: 20-39, 40-59 and 60 years and above. The length of each OrW was measured by using the direct distance between the optic foramen and a landmark in each orbital rim.

RESULTS

A side asymmetry was detected for the lengths of the inferior, superior and medial OrW. Although a gender dimorphism was detected, no correlation with the age was found. Using the Stepwise multiple regression analysis two formulas were developed, one for the right and one for the left OrF with coefficient of determination R² 0.43 and 0.57, respectively.

CONCLUSIONS

The proposed formulas represent a simple, applicable and individualized method to calculate the OrF linear length in cases of complete destruction of the IOR and OrF, with accuracy and without the use of expertise material. Such data may improve the surgery planning of orbital floor fractures and complex orbital reconstructions.

Radiological review of skull lesions

Abstract

Calvarial lesions are often asymptomatic and are usually discovered incidentally during computed tomography or magnetic resonance imaging of the brain. Calvarial lesions can be benign or malignant. Although the majority of skull lesions are benign, it is important to be familiar with their imaging characteristics and to recognise those with malignant features where more aggressive management is needed. Clinical information such as the age of the patient, as well as the patient’s history is fundamental in making the correct diagnosis. In this article, we will review the imaging features of both common and uncommon calvarial lesions, as well as mimics of these lesions found in clinical practice.

Teaching Points

• Skull lesions are usually discovered incidentally; they can be benign or malignant.

• Metastases are the most frequent cause of skull lesions.

• Metastatic lesions are most commonly due to breast cancer in adults and neuroblastoma in children.

• Multiple myeloma presents as the classic “punched out” lytic lesions on radiographs.

• Eosinophilic granuloma is an osteolytic lesion with bevelled edges.

Treatment of cryotherapy and orthotopic transplantation following chondromyxoid fibroma of zygomatic bone: A case report

INTRODUCTION

Chondromyxoid fibrotherma (CMF) is a rare benign cartilage tumor that occurs more frequently in young males at the age of 20 to 30. It occurs more frequently on long bones, but rarely involves craniofacial bones.

CASE PRESENTATION

This study mainly introduced a 30-year-old male with CMF of zygomatic bone. Single tumor excochleation was conducted initially. However, CMF reoccurred, and then the following steps were adopted: firstly, the tumor was extensively excised; secondly, in vitro tumor excochleation was conducted; thirdly, the excised tumor bone was placed in liquid nitrogen for 3 cycles of cryoablation; finally, the orthotopic transplantation was performed to reconstruct the zygomatic appearance, with satisfactory follow-up efficacy obtained.

CONCLUSIONS

Orthotopic transplantation after tumorectomy and cryopreservation of tumor bone in liquid nitrogen could lead to excellent therapeutic efficacy and deserves to be widely applied in clinical practice in the treatment of a male patient with CMF of zygomatic bone, because it not only radically eliminates the tumor and kills tumor cells, but also provides bony skeleton for the growth of new bone, thus greatly promoting postoperative aesthetic degree and reducing the occurrence rates of complications.

Craniofacial Manifestations of Systemic Disorders: CT and MR Imaging Findings and Imaging Approach

Many systemic diseases or conditions can affect the maxillofacial bones; however, they are often overlooked or incidentally found at routine brain or head and neck imaging performed for other reasons. Early identification of some conditions may significantly affect patient care and alter outcomes. Early recognition of nonneoplastic hematologic disorders, such as thalassemia and sickle cell disease, may help initiate earlier treatment and prevent serious complications. The management of neoplastic diseases such as lymphoma, leukemia, or Langerhans cell histiocytosis may be different if diagnosed early, and metastases to the maxillofacial bones may be the first manifestation of an otherwise occult neoplasm. Endocrinologic and metabolic disorders also may manifest with maxillofacial conditions. Earlier recognition of osteoporosis may alter treatment and prevent complications such as insufficiency fractures, and identification of acromegaly may lead to surgical treatment if there is an underlying growth hormone-producing adenoma. Bone dysplasias sometimes are associated with skull base foraminal narrowing and subsequent involvement of the cranial nerves. Inflammatory processes such as rheumatoid arthritis and sarcoidosis may affect the maxillofacial bones, skull base, and temporomandibular joints. Radiologists should be familiar with the maxillofacial computed tomographic and magnetic resonance imaging findings of common systemic disorders because these may be the first manifestations of an otherwise unrevealed systemic process with potential for serious complications. Online supplemental material is available for this article. ^©RSNA, 2018.

Osteofascial Radial Forearm Free Flap Reconstruction of Midface Defect After Resection of Intraosseous Hemangioma

INTRODUCTION

Intraosseous hemangiomas of the midface are rare with few reported cases in the literature. Various reconstructive methods have been previously described, but none using vascularized bone graft secondary to the benign nature of the tumor and often relatively limited defect size.

CLINICAL REPORT

The authors present the case of a 47-year-old man with a biopsy proven enlarging right maxillary intraosseous cavernous hemangioma which was resected primarily, resulting in a large defect involving the entire zygomaticomaxillary buttress and a portion of the right orbital floor and malar prominence. Given the structural involvement and the significant bony defect size, this was simultaneously reconstructed using an osteofascial radial forearm free flap and orbital floor titanium implant with satisfactory outcome.

A Hemangioma of the Zygomatic Bone: Management Ensuring Good Reconstructive and Aesthetic Results

Hemangiomas are benign tumors representing only 0.7 to 1% of all bone tumors; those that arise in the zygomatic region are rarely described in the literature. Here, we describe the case of a 55-year-old woman with a mass in the right orbitozygomatic region. She was diagnosed on the basis of preoperative clinical manifestations, data from an earlier histopathological examination, and computed tomography (CT). The CT scan revealed a lesion in the right zygomatic region at the level of the cancellous component. This caused thinning and remodeling of the deformed cortex both medially and laterally. Surgery was performed. We describe the clinical characteristics of our case with an emphasis on surgical management of the lesion using a titanium grid prepared by reference to a stereolithographic model.

A comparison study on the design of mirror and anatomy reconstruction technique in maxillofacial region

BACKGROUND

The customized mandible reconstruction has been a challenging task in maxillofacial surgery. Designing an implant taking into considering the surrounding bone contours is really critical. Various computer aided design techniques have been used in the designing the customized reconstruction implants, but nevertheless study on the comparison between these techniques is rarely used.

OBJECTIVE

The objective of this study is to compare the mirroring and anatomical reconstruction design techniques used in the maxillofacial surgery and select the best design technique.

METHODS

The three mandible bone defects-small (< 20 mm), medium (20 to 40 mm) and large (41 to 53 mm) tumors are reconstructed using the two reconstruction design techniques and compared to their accuracy, using a 3 dimensional (3D) implant design evaluation and part to Computer aided design (CAD) comparison using a Co-ordinate measuring machine (CMM).

RESULTS

The analysis results indicate that the mirroring technique provides higher accuracy for the implant design as compared to the anatomical technique for the medium and large tumors at maxillofacial regions. In case of implant design in small tumors, the anatomical design provides perfect implant fitting.

CONCLUSIONS

Based on the results, it is recommended to select the anatomy design technique only for small tumor regions and mirroring technique for medium and large tumors.

Hemangioma of the Zygomatic Bone

Benign masses arising from facial bones have been reported several times in the literature. Hemangiomas are one of the uncommon benign tumors. In this study, the authors aimed to present a rare patient of zygomatic intraosseos hemangioma and their management. A 40-year-old woman with a mass in her left lateral cantus admitted to our clinic. Preoperative computed tomography and magnetic resonance imaging revealed an osseos mass in her left zygoma. The authors conclude that it should be kept in mind that although they are very rare benign tumors, intraosseos hemangiomas can cause facial masses. Meticulous radiologic examination can give important clues for differential diagnosis before the surgery.

Computed tomography and magnetic resonance imaging of maxillofacial lesions in renal osteodystrophy

PURPOSE

This study aims to describe the computed tomography (CT) and magnetic resonance (MR) imaging appearance of maxillofacial lesions in renal osteodystrophy.

PATIENTS AND METHODS

We retrospectively reviewed the CT and MR imaging of maxillofacial region in 9 patients (6 females and 3 males with mean age of 31 yr) with renal osteodystrophy. They presented with facial swelling (n = 6), facial disfigurement (n = 2), and oral cavity mass (n = 1). They underwent CT and MR imaging of the maxillofacial region.

RESULTS

Brown tumors (n = 6) were seen in the mandible (n = 4) and maxilla (n = 2). They appeared as mixed lytic and sclerotic (n = 4) and sclerotic (n = 2) lesions at CT. The lesions appeared as hypointense at T1-weighted images and of mixed signal intensity at T2-weighted images with intense contrast enhancement (n = 6). Uremic leontiasis ossea (n = 2) appeared at CT as diffuse hyperostosis with protruded maxilla and obliterated sinus. At MR imaging, there was expansion of the maxilla with obliteration of the maxillary sinuses and protrusion of the mandible. The lesion exhibited low signal intensity at T1-weighed images. At T2-weighted images, the lesion showed low signal intensity with small hyperintense lesions. Dystrophic calcification (n = 2) was seen in the parotid and the check.

CONCLUSION

We concluded that CT and MR imaging are helpful for diagnosis and treatment planning of maxillofacial lesions of patients with renal osteodystrophy.

Rare Presentation of Giant Cell Tumor in the Internal Auditory Canal: Case Report and Review of the Literature

Giant cell tumor (GCT) is a benign but locally aggressive bone tumor that usually involves the end of long bones. It is a relatively common neoplasm in patients, constituting 5 to 10% of all benign bone tumors. Approximately 2% of GCTs occur in the craniofacial skeleton with a predilection for the ethmoid, sphenoid, and temporal bones. The skull base location is unique and not commonly described. Hearing loss, headache, tinnitus, and subcutaneous masses are the most commonly reported symptoms in GCTs of the skull base. In this case report we present the first description of a GCT within the internal auditory canal causing cranial neuropathy and review the recent pertinent literature.

Intraosseous hemangioma as a rare differential diagnosis of intranasal bony tumor

Intraosseous hemangioma is a benign vascular tumor of the bone. The most common site of this tumor is the vertebral body, followed by calvarial bones. Intraosseous hemangioma of the nasal cavity is extremely rare. This lesion had en bloc been resected through the endoscopic approach without preoperative embolization, significant intraoperative bleeding, and postoperative events. We report a rare case of intraosseous hemangioma of the nasal cavity with distinctive radiologic findings. Clinicians should be well familiar with the radiologic findings and clinical features of this tumor, which would be helpful in making a correct diagnosis and management plan.

Pathological and clinical features of primary osseous tumours of the jaw

Primary bone tumors of the jaw are rare. The neoplastic cells in these tumors are the osteoblasts and osteoclasts. The gnathic bone tumors have also been referred to as borderline. The clinicopathologic approach towards these bony lesions have been reviewed.

Diffuse large B-cell lymphoma of the mandible with periosteal reaction: a case report

This report describes a rare case of a 63-year-old man with a lymphoma in the right mandibular ramus with periosteal reaction. Computed tomography (CT) images showed a soft tissue density (28 × 48 × 32 mm) around the right mandibular foramen. Bone-mode CT images showed diffuse bone destruction of the right mandibular ramus. Moreover, a periosteal reaction was seen on the lingual cortical bone of the right mandibular ramus. Histopathologic examination found a diffuse large B-cell lymphoma.

Chondromyxoid fibroma of the mandible: Case report and review of the literature

INTRODUCTION

Chondromyxofibroma (CMF) is exceedingly rare, accounting for 0.5% of the 10,065 bone tumors categorized by Unni and Inwards and 1.6% of their catalog of benign bone tumors. Only 2 of the 50 chondromyxoid fibromas included in their study occurred in the skull. Chondromyxoid fibroma of the maxillofacial region is typically seen in patients in the 2nd-3rd decade of life with slight female predominance. It is more commonly seen in the maxilla and is unusual in the sphenoid and ethmoid sinuses. The tumor is composed of hypocellular chondroid or myxochondroid tissue with multinucleated giant cells.

CASE REPORT

A 30 year old Nigerian house wife was seen at the Oral and Maxillofacial clinic of the Dental and Maxillofacial Department of the Federal Medical Centre Lokoja with a 4 year history of Rt mandibular swelling which was initially slow growing and painless and difficulty in eating. The whole lesion was removed and result confirmed the previous biopsy of chondromyxofbroma of the jaw.

CONCLUSION

Patients with CMF need close monitoring due to high rate of recurrence with cases of malignant transformation at rate of 1-2%, and this seems to have occurred following irradiation.

Unilocular anterior mandibular swelling

PURPOSE

To report a rare case of chondromyxoid fibroma, presenting as an unilocular anterior mandibular swelling, which is one of the least common tumours of bone comprising less than 1% of bone tumours and to review the differential diagnosis and literature for a better understanding of this disease as well as addressing the controversies in respect with its treatment.

MATERIALS AND METHODS

Previous reports about this lesion in literature were reviewed wherein data was recorded about the age, sex, race, location of pathology, presenting signs and symptoms, duration of pathology, size, radiographic findings, treatment and any recurrence on follow-up.

RESULTS

25 cases were studied and data compiled. Multisectional histopathological examination is advocated to differentiate it from osteosarcoma. Enucleation with or without curettage with long-term follow-up has been considered to be a satisfactory treatment modality.

CONCLUSION

The rarity of the lesion, limited data on the clinical presentation, histological dilemma and treatment options replete with controversies make it a tough predicament. A thorough understanding of the disease and treatment options is indispensable to treat such a case.