PMC4178360_01
Orthopantomograph showing a unilocular radiolucent lesion in the ramus of left jaw. The inferior border of the lesion is scalloped
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F1
Examination revealed a unilocular radiolucent lesion, with a scalloped inferior border [Figure 1].
Orthopantomograph showing the reconstruction plate repairing the defect in the left jaw
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F2
A partial mandibulectomy was performed and a reconstruction plate with a mini plate at the anterior region along with a fibular graft in the jaw was inserted to repair the defect [Figure 2].
PMC4178360_02
Photomicrograph confirming the presence of granulomatous lesion (H and E, x40)
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F3
Histopathological examination revealed it as a granuloma [Figure 3].
PMC4178360_03
Extra oral swelling of the left lower jaw
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F4
A year later, the patient now 24 years old, was referred to the Department of Oral Surgery with the complaint of pain and recurrent swelling of the left jaw [Figure 4].
Intra oral photograph depicting exophytic growth in the junction of the left pterygomandibular fossa region and buccal mucosa
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F5
It had a smooth surface with no fluctuation on palpation [Figure 5].
CT scan showing the extent of the lesion during the second recurrence
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F6
Medially, the lesion led to mild pressure erosion with thinning of the buccal cortex of the left maxillary tuberosity and bulged against the left medial pterygoid muscle [Figure 6].
Photomicrograph showing giant cells in a vesiculated fibroblast connective tissue stroma (H and E, x40)
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F7
The connective tissue was minimal with vesiculated fibroblast proliferation [Figure 7].
Photomicrograph showing presence of giant cells near the condylar region (H and E, x40)
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F8
Even the bone graft attached to the condyle showed the presence of tumor giant cells [Figure 8].
Post-operative follow up OPG verifying the absence of lesion
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F9
No recurrence was noticed in post operative follow-up phase of 3 years [Figures 9 and 10] and further reconstruction of mandible using iliac crest graft is intended.
Post-operative intraoral view
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F10
No recurrence was noticed in post operative follow-up phase of 3 years [Figures 9 and 10] and further reconstruction of mandible using iliac crest graft is intended.