Unusual osteoid osteoma of the mandible: report of case and review of the literature

Osteoid Osteoma of the Basilar Border of the Mandible: A Diagnostic Dilemma

Introduction. Osteoid osteoma is a benign osseous tumor characterized by an excessive formation of unmineralized bone matrix. The aim of this study was to present, through a case report, the clinical and radiological manifestations of osteoid osteoma affecting the left basilar border of the mandible. Observation. A 30-year-old male patient presented with left mandibular pain of unknown etiology. The chief complaint was mandibular pain accentuating mainly at night, originating in the left basilar border, and radiating to the whole mandibular hemi-arch. Extraoral examination revealed a small, bone-consistent, and slightly painful swelling. Computed tomography scan revealed a well-limited, infracentimetric, and mixed osteolytic image with central nidus and peripheral osteocondensation. Histological examination revealed osteoid osteoma. Surgical excision of the lesion was performed, and the pain stopped immediately. Discussion. This benign tumor presents many clinical and radiological features similar to other lesions. To differentiate osteoid osteoma from these other bone pathoses, practitioners should have a clear concept and keen observation skills. Confrontation of the clinical, radiological, and anatomopathological data is therefore essential to establish the correct diagnosis and to determine the appropriate treatment plan.

Efficiency and Safety of Dental Implantation in the Area of Hyperdense Jaw Lesions: A Narrative Review

Background. Mineralized lesions of the jaws are often found incidentally on radiographs and computed tomography. Most of them are benign, and only a few rare cases are associated with malignant transformation. However, there is little clinical data on successful rehabilitation with implants in patients with mineralized lesions. This narrative review aimed to study the efficiency and safety of dental implantation in the area of hyperdense lesions. Materials and Methods. A PubMed, Google Scholar, and Science Direct database search was carried out with keywords and manually. Results. The literature exploration identified 323 articles; only 19 of them matched the search criteria and reported cases about dental implantation in the lesion area. It has been shown that in 84.2% of described cases, dental implantation was successful: in the osteoid osteoma, odontoma, cementoblastoma, idiopathic osteosclerosis, and condensing osteitis areas dental implantation was performed without any complications. The possibility of lesion recurrence and implant failure limited the use of dental implants in the area of osteoblastoma and cemento-osseous dysplasia. Although most cases of dental implantation in hyperdense jaw lesions were successful and were not accompanied by complications, further research is needed.

Osteoblastoma and Osteoid Osteoma of the Mandible: Review of the Literature and Report of Two Cases

Osteoblastoma and osteoid osteoma are rare benign neoplasms of the jaws. We reviewed current literature surrounding the ongoing debate over similarities and differences of osteoblastoma and osteoid osteoma and present two cases. Both cases are well-demarcated mixed radiodensity mandibular lesions with histological features of osteoblastoma. They exhibit, however, distinctly unique and contrasting clinical and imaging characteristics suggesting that the first case is osteoblastoma and the second is osteoid osteoma. The first case of a 37-year-old male presents with a large, expansile lesion at posterior mandible, surrounded by a thick sclerotic band. Unusual features include significant buccal/lingual expansion, extensive new bone apposition, and soft tissue edema in the masseter muscle. This is in contrast to the second case of a much smaller lesion in a 17-year-old male with history of recent third molar extraction in the left posterior mandible. In this case, CT imaging revealed a circular, nonexpansile lesion with a sclerotic border surrounded by a radiolucent rim. Both patients underwent surgical excision of the lesion with extraction of the adjacent tooth. We discuss herein the distinct clinical and imaging features.

Osteoid Osteoma of the Maxilla Presenting as Dental Implant Pain

Osteoid osteoma (OO) is a benign osteogenic lesion, regularly noticed in young individuals. A solitary lesion most frequently appears in long bones but is extremely rare in jawbones. Pain is a distinguishing characteristic of this lesion. Herein, we report a rare case of an OO in the right maxilla of a 37-year-old male presenting as pain associated with dental implants. Clinical and radiographic features were indicative of a benign neoplasia of boney origin. An excisional biopsy and histological examination of the lesion confirmed the diagnosis of osteoid osteoma. Surgical excision was followed by immediate relief of most of the pain. His follow-up visits were documented; complete relief of symptoms with no complications was observed during the postoperative period. There was no evidence of recurrence at a two-year follow-up. Osteoid osteoma of the maxilla may present as pain related to dental implants, and careful radiographic assessment of the entire jawbone should be considered if diagnosis of dental implant pain is unclear.

Painless osteoid osteoma in the maxilla of an elderly female patient

Osteoid osteoma is an osteoblastic benign bone tumor more frequent in long bones of young male patients. It is the third most commonly diagnosed benign bone tumor and has distinctive symptomatology, nocturnal pain that relieves with nonsteroidal anti-inflammatory drugs. Nowadays, total resection is the preferred management. In the present paper, an unusual variant in the maxilla of a female elderly patient without previous symptomatology is exposed; it was surgically removed without signs of reappearance in 12 months of follow-up. Although it is not a common site of appearance, the manifestation of this tumor in the skull bones seems to be associated with a different pattern in contrast to the skeletal type as can be seen in the present case and others previously reported. The authors consider due to the clinical similarity between this and other tumors that it should be taken into consideration for future diagnosis dilemma.

Intra-articular osteoid osteoma of tempromandibular joint: A case report

•

Osteoid osteoma is a benign bone neoplasm, with significant nocturnal pain that responds to NSAIDs.

•

A case of an intra-articular osteoid osteoma involving the articular eminence and glenoid fossa of TMJ in a 46-years-old female is reported.

•

CT scan imaging is helpful in displaying the typical radiographic features and localization of the lesion.

Introduction

An osteoid osteoma is a benign bone neoplasm with limited growth potential, characterized by significant nocturnal pain that usually responds to non-steroidal anti-inflammatory drugs (NSAIDs). The tumor may occur in any part of the skeleton, most commonly in the lower extremities and vertebrae.

Presentation of case

A 46-year-old female was diagnosed with a rare case of an intra-articular variant of osteoid osteoma, involving the articular eminence and glenoid fossa of the temporo-mandibular joint (TMJ).

Discussion

The tumor presented as a painful progressive swelling in the right pre-auricular area that had lasted for more than 2 years and which had been previously treated as a TMJ disorder. Computed tomography revealed a well-defined heterogeneous nidus involving the articular eminence of the TMJ. Surgical excision was performed and histological examination confirmed the diagnosis. In this article, in addition to describing the case, all cases of osteoid osteoma of the jaws and TMJ reported in the English-language literature are reviewed.

Conclusion

Osteoid osteoma involving the TMJ is a rare presentation and may exhibit ambiguous symptoms, which could lead to misdiagnosis and delayed treatment.

Central Osteoma of Maxilla Associated with an Impacted Tooth: Report of a Rare Case with Literature Review

Osteomas are benign osteogenic neoplasms caused by proliferation of mature compact or cancellous bone. Clinically they may be classified as peripheral, central or extraskeletal. Osteomas usually involve the craniofacial region with mandible being the most common site. Central osteoma of the jaws is a very rare entity with only 13 cases reported in the literature till date of which only five cases occurred in the maxilla. Here we present a case of a large central osteoma of anterior maxilla associated with an impacted tooth, the first of its kind and a review of literature.

A case of benign osteogenic tumour in Homo naledi: Evidence for peripheral osteoma in the U.W. 101-1142 mandible

The reported incidence of neoplasia in the extinct hominin record is rare. We describe here the first palaeopathological analysis of an osteogenic lesion in the extinct hominin Homo naledi from Dinaledi Cave (Rising Star), South Africa. The lesion presented as an irregular bony growth, found on the right lingual surface of the body of the adult mandible U.W. 101-1142. The growth was macroscopically evaluated and internally imaged using micro-focus x-ray computed tomography (μCT). A detailed description and differential diagnosis were undertaken using gross and micromorphology, and we conclude that the most probable diagnosis is peripheral osteoma - a benign osteogenic neoplasia. These tumours are cryptic in clinical expression, though they may present localised discomfort and swelling. It has been suggested that muscle traction may play a role in the development and expression of these tumours. The impact of this lesion on the individual affected is unknown. This study adds to the growing corpus of palaeopathological data from the South African fossil record, which suggests that the incidence of neoplastic disease in deep prehistory was more prevalent than traditionally accepted. The study also highlights the utility of micro-computed tomography in assisting accurate diagnoses of ancient pathologies.

A large osteoid osteoma of the mandibular condyle causing conductive hearing loss: a case report and review of literature

Osteoid osteomas are benign skeletal neoplasms that are commonly encountered in the bones of the lower extremities, but are exceedingly rare in jaw bones with a prevalence of less than 1%. This unique clinical entity is usually seen in younger individuals, with nocturnal pain and swelling as its characteristic clinical manifestations. The size of the lesion is rarely found to be more than 2 cm. We hereby report a rare case of osteoid osteoma originating from the neck of the mandibular condyle that grew to large enough proportions to result in conductive hearing loss in addition to pain, swelling and restricted mouth opening. In addition, an effort has been made to review all the documented cases of osteoid osteomas of the jaws that have been published in the literature thus far.

[Osteoid osteoma of zygomatic bone: Case report and literature review]

INTRODUCTION

Osteoid osteoma is a benign osseous tumor affecting mainly young men. Although it develops essentially in long bones, some cases occurring in face, mainly in mandible, were related. To our knowledge, only one single case was described in zygomatic bone.

OBSERVATION

A 71-year-old man consulted for a right periorbital pain evolving since months with night recrudescence. The pain was not relieved by standard analgesics. Clinical examination was strictly normal. CT scan showed a low-density bone lesion surrounded by a peripheral osseocondensation line within the body of the right zygoma with intense uptake at bone scintigraphy. The patient benefited from surgical excision of the lesion. Pain stopped immediately. Histological examination assessed an osteoid osteoma.

DISCUSSION

Zygomatic localization and late occurrence are rare concerning osteoid osteomas. Many ways of management have been reported but surgical excision remains the gold standard.

A 5 year retrospective study of biopsied jaw lesions with the assessment of concordance between clinical and histopathological diagnoses

Introduction:

The jaw can be affected by several lesions that manifest in the oral cavity, but little is known about their distribution patterns in various populations.

Aims and Objectives:

This study presents the frequency and distribution of biopsied jaw lesions recorded in Faculty of Dentistry and gathers the information including provisional and final diagnosis of the lesions.

Material and Methods:

Biopsy of 1938 lesions (2008–2013) was reviewed and 1473 lesions were included in this study. The provisional diagnosis and histopathological validations of lesions were compared. Data on the location of the lesion, as well as patient demographics, were also evaluated. The lesions were divided into three major groups as 1 - developmental/reactive and inflammatory lesions of the jaw, 2 - cystic lesion and 3 - tumor and tumor-like lesions.

Statistical Analysis:

The variables were recorded and analysed using descriptive statistics.

Results and Observations:

Three hundred and ninety-six lesions were in Group 1 and periapical granuloma was the most frequent diagnosis. Seven hundred and eighty-nine lesions were in Group 2 and the radicular cyst was the most frequent diagnosis. Two hundred and eighty-eight lesions were in Group 3 and the keratocystic odontogenic tumor was the most frequent. Two hundred and ninety-one biopsied lesions were in disagreement with respect to the diagnoses on clinical and histopathological examination.

Conclusion:

Consequently, a provisional diagnosis of some of the malignant lesions was reactive, inflammatory, cystic or benign lesions, therefore the importance of evaluation of the specimen is emphasized.

Radiolucent rim as a possible diagnostic aid for differentiating jaw lesions

In this study, we formulate a new proposal that complements previous classifications in order to assist dental practitioners in performing a differential diagnosis based on patients' radiographs. We used general search engines and specialized databases such as Google Scholar, PubMed, PubMed Central, MedLine Plus, Science Direct, Scopus, and well-recognized textbooks to find relevant studies by using keywords such as "jaw disease," "jaw lesions," "radiolucent rim," "radiolucent border," and "radiolucent halo." More than 200 articles were found, of which 70 were broadly relevant to the topic. We ultimately included 50 articles that were closely related to the topic of interest. When the relevant data were compiled, the following eight lesions were identified as having a radiolucent rim: periapical cemento-osseous dysplasia, focal cemento-osseous dysplasia, florid cemento-osseous dysplasia, cemento-ossifying fibroma, osteoid osteoma, osteoblastoma, odontoma, and cementoblastoma. We propose a novel subcategory, jaw lesions with a radiolucent rim, which includes eight entities. The implementation of this new category can help improve the diagnoses that dental practitioners make based on patients' radiographs.

Central odontogenic fibroma (simple type) in a four-year-old boy: atypical cone-beam computed tomographic appearance with periosteal reaction

Central odontogenic fibroma (COF) is a rare benign tumor that accounts for 0.1% of all odontogenic tumors. A case of COF (simple type) of the mandible in a four-year-old boy is described in this report. The patient showed asymptomatic swelling in the right inferior border of the lower jaw for one week. A panoramic radiograph showed a poorly-defined destructive unilocular radiolucent area. Cone-beam computed tomography showed expansion and perforation of the adjacent cortical bone plates. A periosteal reaction with the Codman triangle pattern was clearly visible in the buccal cortex. Since the tumor had destroyed a considerable amount of bone, surgical resection was performed. No recurrence was noted.

Bone- and cartilage-forming tumors and ewing sarcoma: an update with a gnathic emphasis

Over the past decade, there have been remarkable advances in bone tumor pathology. Insights into the genetic basis and pathobiology of many tumor types have impacted diagnosis, classification, and treatment. However, because gnathic lesions may comprise only a small proportion of cases overall for many tumors, clinicopathologic features and management considerations specific to this subset may be overlooked. Here we provide a summary of recent developments in the following tumor types: osteosarcoma (OS), chondrosarcoma (CS), osteoid osteoma (OO), osteoblastoma (OB), and Ewing sarcoma (ES). In particular, we will give special consideration to cases arising in the jaws.