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Oral Pathology:  Bone Case #5

 

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Patient: 37 year old man

Chief Complaint:
Patient requests a routine examination.

Medical History:
No abnormalities are identified.

Dental History:
No abnormalities are identified.

Clinical Findings:
During routine radiographic examination, a radiolucent lesion with sharply defined, corticated borders is noted in the mandibular right body of the mandible. The lesion demonstrates radiopaque areas within the radiolucent region.

There are no clinical images available for this case.

Radiographs
radiograph radiograph

 

There are no lab reports available for this case.

There are no charts available for this case.

Summary:
This lesion is asymptomatic, well-defined, and generally radiolucent with focal radiopacities (a variable lesion).

Lesions to Include/Exclude:
Exclude diffuse lesions because they aren't well-defined.

Exclude strictly radiolucent cysts, benign odontogenic tumors, benign nonodontogenic tumors and "other" radiolucencies.

Exclude odontomas because of their characteristic appearance.

Exclude cementoblastoma because it is fused to the tooth root.

Exclude monostotic fibrous dysplasia because it is a diffuse lesion.

Include such lesions as: calcifying odontogenic cyst, adenomatoid odontogenic tumor, calcifying epithelial odontogenic tumor, ameloblastic fibro-odontoma, calcifying odontogenic cyst, periapical cemental dysplasia, ossifying/cementifying fibroma, chondroma, osteoma, and hemangioma as these cannot be satisfactorily eliminated.

Management:
Treatment for each of the lesions included above would require enucleation at the least. Upon biopsy, this specimen was shown to be calcifying epithelial odontogenic tumor, which infiltrates surrounding bone. Removal of a thin rim of bone surrounding the site is required.

Prognosis:
This lesion has a higher recurrence rate than many of the localized lesions due to its capacity to infiltrate. Observation of the surgical site gives a deserved excuse for patient recall.