PMC5426157_01
(a and b) preoperative extraoral view of the patient showing swelling on the left side of face
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F1
Extraoral examination revealed an ill-defined, diffuse, and bony hard swelling of approximately measuring about 6 cm x 4 cm on the left side of the face, extending superior-inferiorly from left zygomatic arch till angle of the mandible and anteroposteriorly from nasolabial fold till tragus of the left ear with normal overlying skin [Figure 1a and b] Intraorally, swelling was solitary, slightly tender with the expansion of buccal and lingual cortical plates with no pathological changes to the overlying mucosa.
(a) Preoperative mouth opening, (b) postoperative mouth opening
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F2
There was reduce mouth opening measuring about 15 mm in the greatest dimension [Figure 2a]. Postoperative healing was uneventful; mouth opening was increased to the value of 30 mm [Figure 2b].
Preoperative panoramic view of the patient
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F3
Orthopantomogram revealed a large well-bordered, well-defined unilocular, circular, mixed lesion (calcification specks) approximately, 2 cm in size involving the ramus, coronoid, and angle of the mandible [Figure 3] posteroanterior view of mandible showed a well-defined, mixed lesion involving the coronoid process, ramus and the angle of the left side of the mandible [Figure 4].
Preoperative posteroanterior view of the patient
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F4
Orthopantomogram revealed a large well-bordered, well-defined unilocular, circular, mixed lesion (calcification specks) approximately, 2 cm in size involving the ramus, coronoid, and angle of the mandible [Figure 3] posteroanterior view of mandible showed a well-defined, mixed lesion involving the coronoid process, ramus and the angle of the left side of the mandible [Figure 4].
(a) Axial view of computed tomography, (b) sagittal view of computed tomography
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F5
Axial and sagittal view of computed tomography confirmed the routine radiographic features and further showed a heterogeneously enhancing mixed lytic-sclerotic lesion with a sclerotic rim extending into adjacent soft tissue measuring 5.12 cm x 3.83 cm with exterior and superior extension into the left infratemporal fossa and medial extension up to pterygoid muscle [Figure 5a and b].
Histopathological section
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F6
Peripherally bony trabeculae lined by osteoblast were also seen [Figure 6].
(a) Postoperative panoremic view of the patient, (b) postoperative posteroanterior view of the patient
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F7
The lesion was excised by segmental resection using transmandibular approach and reconstruction was done [Figure 7a and b].
(a and b) Postoperative extraoral view of the patient with intact facial symmetry
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F8
Postoperatively, the esthetics, oral function of the patient such as speaking, and chewing were intact and normal [Figure 8a and b].