PMC7710432_01
Swelling present in the front of the preauricular region on the left side of the face.
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The swelling size was approximately 2 cm x 2 cm in diameter with diffuse periphery (Figure 1).
Panoramic radiograph view showed a well-defined radiopacity located at the left posterior ramus of the mandible region.
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Panoramic radiograph and paranasal sinus radiograph showed a well-defined radiopacity located at the left posterior ramus of the mandible region (Figures 2 and 3).
Paranasal sinus view showed a well-defined radiopacity located at the left posterior ramus of the mandible region.
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Panoramic radiograph and paranasal sinus radiograph showed a well-defined radiopacity located at the left posterior ramus of the mandible region (Figures 2 and 3).
Computed tomography axial section showed a well-defined osseous bony outgrowth arising from the posterior edge of the left ramus of the mandible. The lesion showed central medullary with sclerosed cortical bone at the periphery, continuing with the condyle leading to mild elongation and giving a mushroom-shaped appearance on the axial section.
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The growth showed central medullary with sclerosed cortical bone at the periphery, continuing with the condyle leading to mild elongation and giving a mushroom-shaped appearance on the axial section (Figure 4).
Magnetic resonance imaging scan showed continuity between the medullary cavity of the mandible and the outgrowth. It is isointense on T1 W images and hyperintense on T2 W images with the peripheral hypointense rim on the T1 W and T2 W images; these features are suggestive of the cartilage cap with mineralization.
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Mass effect was present over the facial nerve, after its existence from the stylomandibular foramen that led to the lateral displacement of the facial nerve (Figure 5).
Surgical exploration of the growth was performed through the Alkyth-Brameley preauricular and submandibular approach.
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Alkyth-Brameley preauricular and submandibular approach (Figure 6) and osteotomy, with the cut made at the angle of the mandible. After complete surgical excision of the growth, it exhibited a uniformly dense ossified area with few irregular soft tissues at the periphery (Figure 7).
On gross examination the lesion exhibited a uniformly dense ossified area with few irregular soft tissues at the periphery.
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Alkyth-Brameley preauricular and submandibular approach (Figure 6) and osteotomy, with the cut made at the angle of the mandible. After complete surgical excision of the growth, it exhibited a uniformly dense ossified area with few irregular soft tissues at the periphery (Figure 7).
H&E staining showed fibrocollagenous tissue overlying cartilaginous islands merging into bone trabeculae.
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The tissue section was decalcified, and H&E staining showed fibrocollagenous tissue overlying cartilaginous islands merging into bone trabeculae separated by fat marrow (Figure 8).
Postoperative panoramic radiography showing excision of the lesion and free of recurrence 1 year after surgery.
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The patient was kept under observation and was free of recurrence until one year after surgery (Figure 9).