PMC3961933_01
Frontal view of the patient showing a well defined swelling on left side and diffuse swelling on the right side of the mandible
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F1
Gross facial asymmetry was noticed due to a swelling involving the middle and lower one third region of the face [Figure 1].
Intra-oral photograph shows an expansile swelling of the mandible with complete bucco-lingual cortical plate expansion and lingually displaced teeth
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F2
On intraoral examination [Figure 2], a diffuse swelling was seen extending from the left to right retromolar region.
Orthopantomogram reveals a massive high density, mixed radiopaque-radiolucent lesion exhibiting cotton -wool appearance. Demarcation between the lesion and normal bone with bowing of the inferior border of mandible is appreciable
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F3
Panoramic radiograph [Figure 3] revealed a well defined mixed radiopaque and radiolucent lesion, extending from left ramus region to the right angle of the mandible, measuring about 11 x 7 cms.
Lower occlusal radiograph shows irregular bucco- lingual cortical plate expansion
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F4
Occlusal radiograph [Figure 4], revealed irregular expansion of both bucco-lingual cortical plates and lingual displacement of involved teeth.
Posterior Anterior mandible view reveals an expansile mixed radiolucent radiopaque lesion extending from the ramus of left side to the right angle of the mandible
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F5
Posterior-Anterior (PA) mandible view [Figure 5] revealed a mixed radiopaque, radiolucent lesion involving the left ramus region and extending up to the right angle of the mandible.
Axial CT scan view shows a large lobulated bone density mass involving both right and left body and left ramus of mandible, which exhibits mixed sclerotic and lucent areas. Central low-density areas (arrow) are seen
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F6
Image of 3D-CT scan shows a large expansile swelling within the mandible, which involves both right and left body and left ramus of mandible, which exhibits mixed sclerotic and lucent areas measuring 11.8 x 7.0 x 7.3 cm3
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F7
Photomicrography shows several spherical masses of a cellular calcified material resembling cementum were seen throughout the fibrous tissue (H and E stain x250)
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F8
An incisional biopsy was performed and the tissue was sent for histopathological evaluation [Figure 8] which irregularly shaped bony trabaculae interspersed in connective tissue stroma which is fibrocellular.