Mandible

Mesenchymal chondrosarcoma of the mandible: A rare malignant tumor

September 17, 2014     Rakesh Kumar Singh, MS; Saurabh Varshney, MS; Sampan Singh Bist, MS; Meena Harsh, MD; Nitin Gupta, MD
article

Abstract

Mesenchymal chondrosarcoma (MCHS) is a highly aggressive, malignant, cartilaginous tumor that represents about 1% of all chondrosarcomas. Only about 50 cases of MCHS of the jaw have been reported in the English-language literature; maxillary tumors are much more common than mandibular tumors. We present a new case of MCHS of the mandible that arose in a 22-year-old woman whose initial two biopsies did not reveal the features of the tumor. The diagnosis was made only after an incisional biopsy.

Keratocystic odontogenic tumor

September 17, 2014     Lester D.R. Thompson, MD
article

Bite-wing or orthopantomograph images reveal a well-defined, unilocular radiolucency with a smooth border, showing minimal bone expansion and even cortication.

Stylohyoid syndrome, also known as Eagle syndrome: An uncommon cause of facial pain

September 17, 2014     Erin L. Werhun, MD; Mandy C. Weidenhaft, MD; Enrique Palacios, MD, FACR; Harold Neitzschman, MD, FACR
article

Eagle syndrome is often a diagnosis of exclusion after other etiologies of pain are thoroughly investigated, and it can be determined via a physical examination and characteristic radiographic findings.

A rare case of ameloblastic carcinoma

September 17, 2014     Michael Yunaev, MBBS; Muzib Abdul-Razak, FRCS(Edin); Hedley Coleman, FFOP(RCPA); Yaroslav Mayorchak, MBBS; Ian Kalnins, FRACS
article

Abstract

Ameloblastic carcinoma is a rare type of ameloblastoma that has received little mention in the literature. While a number of cases have been published over many years, no institution has been able to produce a substantial case series. Ameloblastic carcinoma originates in the embryonic tooth components. It is believed to be an aggressive tumor that can metastasize; once metastasis occurs, the prognosis tends to be poor. Ameloblastic carcinoma is primarily a surgical condition that is best treated with resection; there has been little indication that other modalities are helpful. We present the case of a 40-year-old woman who was found to have a mandibular lesion by a dentist. After surgical resection, the tumor was found to be an ameloblastic carcinoma. The patient recovered without complication, and she was recurrence-free 18 months postoperatively. We also briefly review the available literature on the natural history of and management options for this rare tumor.

Endometrial carcinoma metastatic to the retromolar pad

September 18, 2013     Hisham Hatoum, DDS; Bruno C. Jham, DDS, MS, PhD; Karen Garber, DMD; Jaime S. Brahim, DDS, MS; Mark A. Scheper, DDS, PhD
article

Abstract

Metastatic carcinoma from the female genitalia to the oral mucosa is exceptionally rare, with only 11 such cases having been previously reported in the English-language literature. We describe a new case in a 65-year-old woman with a history of endometrial carcinoma who presented with swelling of the retromolar pad. Radiographic examination showed slight opacities and irregular trabecular bone in the left posterior mandible. Following an incisional biopsy, histologic examination and immunohistochemical studies revealed glandular adenocarcinoma with positivity for progesterone receptor, estrogen receptor, and cytokeratin 7. The patient was referred to her primary care physician for comprehensive treatment. This case illustrates the value of considering cancer metastasis in the differential diagnosis of an oral swelling, particularly in a patient with a history of cancer.

Pigmented villonodular synovitis of the temporomandibular joint

July 21, 2013     Helen Giannakopoulos, DDS, MD; Joli C. Chou, DMD, MD; Peter D. Quinn, DMD, MD
article

Abstract

Pigmented villonodular synovitis (PVNS) is a proliferative disorder that affects synovium-lined joints, bursae, and tendon sheaths. It appears in both diffuse and localized forms, depending on the extent of synovial involvement. PVNS rarely involves the temporomandibular joint (TMJ); when it does, it manifests clinically as a slowly growing and painless preauricular mass that resembles a parotid tumor. TMJ dysfunction, paresthesia, and/or hearing loss can result. We present a case of a large extra-articular PVNS of the TMJ, and we review the literature.

Osteosarcoma

July 21, 2013     Lester D.R. Thompson, MD
article

Osteosarcoma affects the mandible and the maxilla differently, with mandibular tumors tending to arise from the body of the mandible while maxillary tumors arise from the alveolar ridge and sinus.

Hepatocellular carcinoma metastatic to the mandible

February 25, 2013     Mia E. Miller, MD; Andrew A. McCall, MD; Guy F. Juillard, MD; Celina M. Nadelman, MD; Marilene B. Wang, MD; Vishad Nabili, MD
article

Abstract

We describe the case of a 55-year-old man with known multifocal hepatocellular carcinoma (HCC) who presented with a painful mandibular mass. Fine-needle aspiration cytology of the mass revealed the presence of bile canaliculi and bile formation, an extremely rare finding. Findings on immunoperoxidase staining of the aspirate were consistent with an HCC. Since the patient was known to have multiorgan metastatic disease, he was administered palliative radiation therapy to the mandibular metastasis for pain control, which was achieved. One year after presentation, the patient died as a result of disease progression. HCC rarely metastasizes to the mandible, as only about 70 such cases have been reported in the literature. We discuss the histopathologic appearance of HCC metastatic to the mandible, the radiologic findings, and the established treatment modalities.

Chronic focal Langerhans cell histiocytosis of the left mandibular condyle presenting as limited jaw opening: A case report

October 8, 2012     Juan F. Yepes, DDS, MD, DrPH; Mohd Khalaf, DDS; Larry Cunningham, DDS, MD, FACS; John Lindroth, DDS
article

Abstract

Temporomandibular joint (TMJ) disorders are common in the general population, with a particularly high prevalence among girls and women aged 15 to 25 years. The presence of chronic focal Langerhans cell histiocytosis in the mandibular condyle is rare, as only a few cases have been reported in the literature. We present the case of a 23-year-old woman who was referred to the Orofacial Pain Center at the University of Kentucky College of Dentistry with a chief complaint of limited jaw opening of 7 months’ duration. She had previously received a preliminary diagnosis of a TMJ disorder and had been treated conservatively, but she did not improve. An initial panoramic film revealed a suspicious radiolucent area at the head of the left mandibular condyle. She was eventually diagnosed on histopathology with chronic focal Langerhans cell histiocytosis. She was treated with condylectomy and surgical curettage of the lesion.

Mandibular condyle reconstruction with fibula free-tissue transfer

September 7, 2012     Eric J. Moore, MD; Steven S. Hamilton, MD
article

Abstract

We conducted a study to evaluate functional and cosmetic outcomes following reconstruction of the mandibular condyle with direct placement of a vascularized free fibula. We retrospectively reviewed the cases of all patients who had undergone hemimandibulectomy and condyle resection with immediate reconstruction at the Mayo Clinic in Rochester, Minn., between Nov. 1, 2005, and Jan. 31, 2007. We found 7 such cases, all of which occurred in men aged 32 to 61 years (mean: 50.7). Six of these patients had a malignancy and 1 had osteomyelitis. Postoperatively, 6 patients had no difficulty with occlusion, which was rated as “good” or “excellent” at their 6-month follow-up visit; the other patient had an open-bite deformity, but he was able to masticate solid food and maintain an oral diet. Cosmesis was generally satisfactory, and all patients maintained intelligible speech. We conclude that free fibula transfer with direct seating of the fibula into the condylar fossa followed by aggressive physiotherapy provides acceptable functional reconstruction of the mandibulectomy-condylectomy defect.

An expansile mandibular mass as the initial manifestation of hepatocellular carcinoma

February 1, 2011     J. Clinton Lasiter, MD, Benjamin D. Liess, MD, Robert P. Zitsch III, MD, and Jessica Wieberg, MD
article

Abstract

Hepatocellular carcinoma (HCC) is one of the most frequently encountered malignancies. Distant metastasis is a common sequela, occurring in approximately 50% of cases. Metastasis to the oral cavity is very rare. Careful immunohistochemical evaluation is critical in differentiating HCC from other metastatic malignancies. An understanding of the possibility that HCC may initially present as a mandibular metastasis is crucial to guide management. We describe the case of a 76-year-old man with a 3- to 4-month history of a painless, slowly enlarging, left-sided jaw mass. Biopsy findings were consistent with HCC. While the patient was a known hepatitis C carrier, the presence of HCC had been previously unknown. Additional workup revealed a large hepatic lesion. In view of his poor health, the patient elected to forgo chemotherapy, and he entered a hospice facility. This case provides an illustration that an isolated mandibular mass may represent the initial presentation of HCC. Subsequent identification of the primary tumor via radiographic and pathologic evaluations is important for the guidance of further management.

Malignant fibrous histiocytoma of the mandible

September 30, 2010     Lana E. Brahmakulam, DO and Bosco E. Noronha, MD, FRCS(Eng), FRCE(Ire)
article

Abstract

Malignant fibrous histiocytoma (MFH) of the mandible is rare. We describe a case of MFH of the mandible with metastatic disease to the lungs. To our knowledge only 30 cases have been reported prior to the present case. In previously reported cases, there was a strong tendency for the posterior portion of the mandible to be affected by MFH; ours is only the second reported case involving the anterior portion of the mandible. We review the diagnosis, pathology, and treatment of this rare malignancy.

Page
of 2Next