PMC4353960_01
Preoperative OPT.
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A pretreatment radiograph (Fig. 1) OPT was ordered by the pediatric resident.
Intraoral clinical examination.
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Intraorally, a swelling related to a badly broken down lower left 1st molar which proved to have pulpal exposure was detected (Fig. 2).
Coronal CT cuts showing bucco-lingual extension and thin rim of inferior border remaining extension).
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The multi slice CT showed wide bucco-lingual extension with perforations through both the buccal and lingual bone plates (Figs. 3, 4, 5).
Axial CT cuts showing extensions of lesion buccolingually and the lesion multilocularity.
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The multi slice CT showed wide bucco-lingual extension with perforations through both the buccal and lingual bone plates (Figs. 3, 4, 5).
Axial CT cuts showing extensions of lesion buccolingually and perforation of lingual plate.
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The multi slice CT showed wide bucco-lingual extension with perforations through both the buccal and lingual bone plates (Figs. 3, 4, 5).
H&E section of pretreatment biopsy showing giant cell.
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Histological analysis depicted multinucleated giant cell most probably of fibroblast origin and extravasated erythrocytes and indicated that the lesion is giant cell lesion (Fig. 6).
Progress follow up (a) OPT pretreatment in May 2013, (b) OPT showing progress at July 2013, (c) OPT showing progress at August 2013, (d) OPT showing progress at September 2013 and (e) composite image showing pre and post treatment.
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The follow up monthly OPT starting showed gradual increase in the opacity of the radiolucent zone denoting bone apposition (Fig. 7a-e).
Showing progress of cushinoid appearance through the treatment (a) May 2013, (b) October 2013, (c) November 2013.
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This was associated with features coinciding with moon face appearance and Hirsutism associated with Cushing's disease (Fig. 8a-c).
H&E section of post treatment biopsy showing newly formed woven bone.
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