PMC6604494_01
Intraoral view demonstrating swelling overlying the alveolar ridge with associated expansion of the left buccal plate. (Note that the lower left first and second deciduous molars were extracted previously at the incisional biopsy).
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fig1
Intraorally, there was a localized swelling with expansion of the mandibular buccal plate extending from the left mandibular canine to the left first permanent molar (Figure 1).
Orthopantomogram showing a well-defined multilocular radiolucent lesion with a sclerotic border in the left body of the mandible. The second deciduous molar has been displaced distally and is supraerupted.
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fig2
Radiographically, an orthopantomogram (OPG) showed a multilocular, radiolucent lesion with scalloped margins affecting the left hemimandible (Figure 2).
(a-d) Computed tomogram demonstrates an expansile mass to the left mandible with small buccal and lingual perforation of the cortices.
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In some areas, the cortex appeared breached (Figures 3(a)-3(d) and 4).
H&E (x100) biphasic lesion with dominant stromal and smaller epithelial component.
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Histological sections (Figures 5, 6(a), and 6(b)) showed a soft tissue specimen consisting of cellular/fibroblastic fibromyxoid stroma resembling primitive mesenchyme or developing dental papillae.
(a) H&E (x200) stromal element is composed of bland spindle cells with no cellular atypia or mitosis; small islands and cords of markedly attenuated ameloblastic epithelium are seen at the bottom of the field. (b) H&E (x400) epithelial element with peripheral palisading and reverse polarization away from basement membrane (Vickers-Gorlin change).
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Histological sections (Figures 5, 6(a), and 6(b)) showed a soft tissue specimen consisting of cellular/fibroblastic fibromyxoid stroma resembling primitive mesenchyme or developing dental papillae.
The tumour cavity in body of mandible following enucleation and curettage.
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fig7
While the lesion was successfully enucleated (Figure 7), it was found to have perforated both the buccal and lingual (posterosuperiorly adjacent to the molar teeth) cortices.
Gross pathological specimen.
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Gross pathological analysis showed an irregular mass of white rubbery tissue measuring 30 x 25 x 15 mm (Figure 8).
Postoperative OPG demonstrating satisfactory healing in the left body of the mandible with no evidence of recurrence.
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fig9
An OPG taken 10 months post-surgery shows good bone formation with no signs of tumour recurrence (Figure 9).