PMC3341771_01
Pre-operative intraoral view shows buccal and lingual expansion in the posterior mandible
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F1
(a) Panoramic radiography shows an ill-defined radiolucent lesion with scattered foci of calcified material that contained several radioopaque bodies of varying sizes and shapes and an impacted fi rst molar (right side) (b) Occlusal view shows expansion and thinning of the buccal and lingual cortical plate
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F2
The orthopantomogram revealed a well-defined radiolucency measuring about 4.5cm x 2.5cm, associated with the impacted molar [Figure 2].
(a) Computed tomography shows an expansile lesion of the right mandible (b) Tomographic reconstruction image shows the extent of the lesion
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F3
Minute calcifications were evident within the lesion [Figure 3].
(a) Microscopic appearance of the lesion (hematoxylin and eosin). Islands of odontogenic epithelium with peripheral cells resembling ameloblasts and central cells resembling the stellate reticulum (arrows) of the enamel organ amid highly cellular loose connective tissue, similar to the dental papilla (stars) - x40 original magnification (b) Dental hard tissue formation adjacent to the epithelial island, x200 (c) Abundant dentinoid matrix - x40 original magnification
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F4
A fibrillar pattern reminiscent of dentinal tubules was noted in the focal area as marked [Figure 4].
(a) Condensation of ectomesenchymal tissue juxtaepithelialy with marked increase in cellularity - x100 (b) x200 - ectomesenchymal cells exhibiting mild pleomorphism (c) Pleomorphic ectomesenchmal cells - x400
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F5
The most striking finding was the presence of increased cellularity with mild pleomorphism of the dental papilla-like cells in few areas [Figure 5].
(a) Surgically excised tumor mass (segmental mandibulectomy) (b) Post resection reconstruction of the mandible using titanium plates
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F6
Reconstruction of the mandible was performed following resection [Figure 6].