PMC5925163_01
Clinical picture: slight asymmetry with swelling on the right side of the face.
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This swelling has caused slight asymmetry of the face since 6 months, which gradually enlarged up to the present size (Figure 1).
PMC5925163_02
PMC5925163_03
Clinical picture: a bulbous mass of 4 x 4 cm in the vestibule on the right side, extending from the distal aspect of 44 to the 47.
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Intraoral examination revealed a 4.0 x 4.0 cm bulbous mass hard to palpation arising from the mandible and extending from the distal aspect of the lower right first premolar (44) to the second right molar (47) (Figure 2).
Panoramic radiography showing unilocular radiolucency close to the 46.
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fig3
Roots erosion of the relative tooth was noted (Figure 3).
Computed tomography scan: axial views showing multiloculated ground-glass ossification of the lesion.
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Biopsy specimen.
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PMC5925163_04
PMC5925163_05
PMC5925163_06
Parathyroid technetium scintiscan (99mTc Sestamibi; Technetium-99 MIBI; methoxy-isobutyl-isonitrile) showed increased uptake of the radiocontrast agent observed in the left lower parathyroid.
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Sestamibi; Technetium-99 MIBI; methoxy-isobutyl-isonitrile) was requisite and revealed left lower parathyroid adenoma (Figure 6). Skeleton exploration was done by technetium 99 scintigraphy and did not reveal any abnormally high uptake.
PMC5925163_07
Clinical and radiological control at the 6 month with good mucosal and bone healing.
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The patient was compliant and presented a favorable evolution (Figure 7).