PMC3886046_01
Photograph of a 9 year old girl with JOF showing unilateral
swelling extending from the right submandibular to the right
mandibular ramus and corpus region.
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fig1
Physical examination revealed a hyperaemic swelling about 6 x 8 cm in size, causing facial asymmetry in the region of submandibular area including right corpus and ramus of the mandibule (Figure 1).
Photograph of mandibular ramus and corpus region
showing clear lingual expansion of the mansoble (arrow).
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fig2
There was clear lingual expansion of the right mandible (Figure 2).
CT axial image shows a lesion involving submandibular area and
causing expansion and destruction of body and ramus of the right
mandible (arrow). Pharyngeal air column displaced to opposite
site.
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fig3
The tumour was occupied and destructed the right corpus and ramus of the mandible (Figure 3).
MRI axial image shows a large tumour which causes destruction of
body and ramus of the right mandible (arrow).
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fig4
It was hypointense on T1-weighted images and hyperintense on T2-weighted images (Figure 4).
MRI coronal image shows contrast retention in the tumour (arrow)
after gadolinium injection. Pharyngeal air column is displaced
to opposite site.
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fig5
Pharyngeal air column, hyoid bone and larynx were displaced to the opposite side (Figure 5).
Photomicrograph of tumour shows the presence of trabeculae of
fibrillar osteoid and woven bone (hematoxylin
and eosin stain, original magnification x40).
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fig6
Diagnosis was based on the presence of trabeculae of fibrillar osteoid and woven bone fragments (Figure 6).
Intraoperative photograph showing exposed tumour using a
transmandibular approach.
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fig7
Because of large size of the mandibular tumour, the resultant expansion and destruction of mandibular cortex, and the close adjacency to the temporomandibular joint, the patient underwent a right hemimandibulectomy using transmandibular approach (Figures 7,8,9).
Three-dimensional CT scan of the patient after right
hemimandibulectomy.
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fig10
No recurrence was observed during the 2 years of follow-up with three dimensional CT scan and MRI (Figures 10 and 11).
Three-dimensional CT scan shows good jaws relationship and
occlusion in the left side.
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fig11
No recurrence was observed during the 2 years of follow-up with three dimensional CT scan and MRI (Figures 10 and 11).
Photograph showing patient's postoperative appearance.
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fig12
Oral functions of the patient (chewing, eating and speaking) were appearing intact (Figure 12).