PMC4203472_01
Swelling on left side of face extending from zygomatic arch to lower border of mandible superoinferiorly. Swelling was covering the whole ramus of the mandible anteroposteriorly.
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The swelling was covering the whole ramus of mandible anteroposteriorly (Figure1).
Intraoral examination shows obliteration of buccal sulcus and displacement of first and second deciduous molar and first permanent molar.
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Intraorally there was expansion of both buccal and lingual cortical plates and displacement of first and second deciduous molar and first permanent molar (Figure 2).
X-ray and CT scan show (a) large multilocular mixed radiolucent radiopaque lesion involving left side of mandible extending from mandibular, second deciduous molar. Superiorly it extends up to condylar and coronoid processes. Inferior margin showed multiple septae with thinning of the cortical plates, Anterior displacement of the tooth bud 37 was noted. (b) The CT sections show large severely expansile lesion in the left ramus of the mandible extending up to the cortical plates. (c) 3D CT shows expansion and thinning of cortical plates localised areas with perforation of cortical plates noted. (d) shows postoperative follow-up after two months with bony healing inferiorly.
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The inferior extent of the lesion showed hyperdense septae (Figure 3).
Cytological smears show spindle-shaped stroma with giant cells (40x).
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FNAC (Figure 4) showed blood-tinged fluid.
H&E stained section shows (a) both lesions, i.e., ABC and JOF, (b) psammoma bodies under higher magnification, (c) giant cells lining the sinusoidal spaces, (d) new bone formation at the periphery.
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Follow-up was done after two months. (Figure 5), which showed bony healing at the lower border of mandible (Figure 6).
Postoperative follow-up after two months (a) extraoral (b) intraoral.
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Follow-up was done after two months. (Figure 5), which showed bony healing at the lower border of mandible (Figure 6).