PMC3886077_01
Clinical photograph of the patient showing swelling on the right side of the
cheek (white arrow).
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fig1
Extraoral examination revealed single diffuse smooth swelling on the right side of the jaw, approximately 1 x 1 cm in size, with normal overlying skin (Figure 1).
Intraoral photograph showing unhealed extraction socket (encircled in
black).
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fig2
No discharge was noticed (Figure 2).
Intraoral periapical radiograph showing well defined radiolucency with
scalloped border (white arrows).
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fig3
Superiorly, it extended 0.5 cm from the crest of the edentulous alveolar ridge and presented with scalloped border, with incomplete septa running into the radiolucency (Figure 3).
Orthopantamogram showing multilocular radiolucency on the right body of the
mandible (white arrow) and multiple radio opacities in all the quadrants of
both jaws (yellow arrows).
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fig4
The radio opacities presented with a radiolucent halo around them (Figure 4).
Mandibular occlusal radiograph showing cortical expansion and internal
loculations (encircled in yellow).
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fig5
Mandibular occlusal view of the same region revealed expansion of the buccal and lingual cortical plates with presence of multiple internal loculations (Figure 5).
CT section showing a well defined expansile osteolytic lesion in the right
body of the mandible (yellow arrow).
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fig6
There is a narrow zone of transition (Figure 6).
Coronal CT section showing multiple patchy well defined hyperdense lesions
with hypodense rim were observed above the level of mandibular canal (yellow
arrow).
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fig7
Multiple patchy well defined hyperdense lesions with hypodense rim were observed in the body of mandible located above the level of mandibular canal, between the inter-radicular and inter-dental areas of maxilla and mandible (Figure 7 and Figure 8).
Sagittal CT section showing multiple patchy well defined hyperdense lesions
with hypodense rim (yellow arrows).
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fig8
Multiple patchy well defined hyperdense lesions with hypodense rim were observed in the body of mandible located above the level of mandibular canal, between the inter-radicular and inter-dental areas of maxilla and mandible (Figure 7 and Figure 8).
Postoperative orthopantamogram showing internal plate fixation (yellow
arrows).
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fig9
Internal titanium plate fixation was done to the lower border of the mandible to avoid pathologic fracture due to thinning of the cortex (Figure 9).
Hematoxylin and eosin stained histopathological section (original
magnification x10) of periapical bone and buccal cortex in the region of
teeth #45 and #46 showing immature bone with osteocytes.
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fig10
Blood vessels and chronic inflammatory cells in the form of lymphocytes were additionally identified (Figure 10).
Hematoxylin and eosin stained histopathological section (original
magnification x40) of cavity lining showing fibrocellular connective tissue
with osteiod areas within them (black arrow).
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fig11
Numerous capillaries and resting lines are also seen (Figure 11).