PMC6732594_01
(a) A 12-year-old girl with right mandibular and neck mass displacing teeth all the way. (b) Panorex view that shows massive destruction of half of her mandible with extension into condyle, neck, and medial of right of mandible. (c) Axial and (d) coronal CT scan of neck and soft tissue that shows multiple septations along with wall enhancement within the lesion. (e) Large soft tissue tumor was visible intraoperatively. Gross examination of large hemorrhagic soft tissue mass measures 6 x 6 x 3 cm (inset). (f) Postoperative panorex view of the patient which shows complete healing of her bony defect with significant resolution in her unique facial deformity that resembles sarcoma.
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This is a 12-year-old girl who was referred from an outside hospital as a case of right mandibular and neck mass, which was rapidly progressive for the last 3 months (Figure 1(a)). AP) involving the right side of the mandible, causing massive destruction of half of her mandible with extension into her condyle, neck, and medial side of the right mandible (Figure 1(b)). Areas of septations and bony erosions were seen peripherally. The enhanced study revealed multiple septations that contain wall enhancement within the lesion (Figures 1(c) and 1(d)). Upon reflection of the mucoperiosteum on the lingual and buccal side, a soft tissue tumor was visible (Figure 1(e)). Careful dissection of the tumor from the lingual mucosa was performed removing a large specimen of approximately 6 x 6 x 3 cm, which was submitted for histopathology examination (Figure 1(e) (inset)). The patient had complete healing of her bony defect with significant resolution in her unique facial deformity that resembles sarcoma (Figure 1(f)). 46 months of her last follow-up, the patient is healthy, alive with no recurrence.
Histopathology examination by hematoxylin and eosin stain (H&E). (a) Tumor is composed of spaces separated by septa (blood-filled cavities) (H&E; 4x). (b) Spindle cell proliferation with classification and osteoid formation (H&E; 10x). (c) Cellular components with osteoclast-like giant cells (H&E; 40x). (d) Numerous mitotic figures are seen (arrow head) (H&E; 40x).
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Histopathology examination revealed a tumor composed of spaces separated by septa (blood-filled cavities) (Figure 2(a)). The septa contained spindle cell proliferation with osteoclast-like giant cells and osteoid (Figures 2(b) and 2(c)). Also, we detected numerous mitotic figures reaching more than 10/10 high-power field (HPF) (Figure 2(d)).