PMC9106244_01
Well-defined swelling in the lower anterior region of face giving facial asymmetry
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F1
Extraoral examination revealed well-defined swelling of approximate size 8 cm x 7 cm extending from right parasymphysis region to the body of mandible medio-laterally and supero-inferiorly from line joining the commissures to lower border of chin giving facial asymmetry [Figure 1].
Well-defined swelling on lower left alveologingival region obliterating both buccal and lingual vestibule
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F2
Overlying mucosa was normal [Figure 2].
Orthopantamogram showed multilocular mixed radiolucent radiopaque lesion in the mandible crossing the midline with thinning of lower border of anterior mandible giving soap bubble appearance
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F3
Orthopantamogram showed multilocular mixed radiolucent radiopaque lesion in the mandible extending from 37 to 43 crossing the midline with thinning of lower border of anterior mandible giving soap bubble appearance [Figure 3].
Cone beam computerized tomography showed mixed radiopaque radiolucent lesion causing expansion of buccal and lingual cortical plate
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F4
Cone beam computerized tomography showed perforation at multiple sites with respect to inferior border of mandible and buccal and lingual cortical plate [Figure 4].
MRI revealed well-defined heterogeneous multiloculated enhancing solid cystic alterd signal intensity lesion arising from the mandible with involvement of body of left hemimandible, symphysi, and the left mandibular canal
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F5
Magnetic resonance imaging revealed well-defined heterogeneous multiloculated enhancing solid cystic altered signal intensity lesion arising from the mandible with involvement of body of left hemimandible, symphysi and the left mandibular canal [Figure 5].
Angiography of head and neck revealed no feeding vessel to the tumor mass
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F6
Angiography of head and neck revealed no feeding vessel to the tumor mass [Figure 6].
Resected segment of mandible, grayish black in color with irregular and lobulated surface both buccal and lingual cortical plate expansion
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F7
On gross examination, resected segment of mandible was received of approximate size 8 cm x 9 cm extending from distal of 37 to distal of 45, grayish black in color with irregular and lobulated surface both buccal and lingual cortical plate expansion was evident [Figure 7].
Odontogenic epithelium showed proliferation in the form of interconnecting anastomosing strands and follicles with peripheral tall columnar cell and reversal of polarity, central areas of the follicles showed the presence of loosely arranged stellate reticulum like cell
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F8
This odontogenic epithelium also showed proliferation in the form of interconnecting anastomosing strands and follicles with peripheral tall columnar cell and reversal of polarity, central areas of the follicles showed presence of loosely arranged stellate reticulum like cell [Figure 8].
Increased vascularity seen as dilated endothelial lined vessels along with areas of red blood cells extravasation in the stroma and some of the follicles showed the presence of spindle cell proliferation
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F9
The increase in vascularity was seen as small and large dilated engorged endothelial lined vessels and as areas of extravasation of RBCs in the stroma and some of the follicles showed presence of spindle cell proliferation [Figure 9].