Case report on multiple solitary radiolucencies in the mandible - a diagnostic dilemma

Authors

DOI:

https://doi.org/10.5935/2525-5711.20200020

Keywords:

Primary intraosseous carcinoma, mandibular radiolucency, multiple solitary radiolucencies, digital panoramic radiography, cone beam CT

Abstract

Radiolucent mandibular lesions seen on panoramic radiographs develop from both odontogenic and non-odontogenic structures and represent a broad spectrum of lesions with a varying degree of malignant potential. Here, we report a case of a forty-five-year- old female patient with a complaint of pain and pus discharge from the left side of the face. Based on the characteristic clinical appearance, a diagnosis of chronic osteomyelitis was made. However, on digital panoramic radiography, a rather unusual radiolucent appearance in the ramus and coronoid process of the mandible was observed. Several laboratory investigations and advanced diagnostic imaging techniques were carried out to narrow down the differential diagnosis, which was crucial for the identification of this lesion which was diagnosed as Primary Intraosseous Carcinoma. The objective of this clinical case report is to highlight this unusual radiographic appearance to aid in future diagnosis.

Author Biographies

Valen Dela D'souza, A.J Institute of Dental sciences

A.J Institute of Dental sciences, Oral Medicine & Radiology - Mangalore - Karnataka - Índia

Prasanna Kumar Rao, A.J Institute of Dental sciences

A.J Institute of Dental sciences, Oral Medicine & Radiology - Mangalore - Karnataka - Índia

Raghavendra Kini, A.J Institute of Dental sciences

A.J Institute of Dental sciences, Oral Medicine & Radiology - Mangalore - Karnataka - Índia

References

Kramer IR, Pindborg JJ, Shear M. The WHO histological typing of odontogenic tumours. A commentary on the second edition. Cancer. 1992 Dec;70(12):2988-94.

Shambhulingappa P, Sheikh S, Puri N, Jindal SK. Primary intraosseous carcinoma of mandible: an update on review of literature with a case report. J Clin Exp Dent. 2010;2(2):e91-5.

Morrison R, Deeley TJ. Intra-alveolar carcinoma of the jaw. Treatment by supervoltage radiotherapy. Br J Radiol. 1962;35:321-6.

Willis RA. Pathology of tumors. St. Louis: The C. V. Mosby Company; 1948.

Shear M. Primary intra-alveolar epidermoid carcinoma of the jaw. J Pathol. 1969;97(4):645-51.

Pindborg JJ, Kramer IRH, Torloni H. Histological typing of odontogenic tumors, jaw cysts, and allied lesions. International Histological Classification of Tumors, no. 5. Geneva: World Health Organization (WHO); 1971. p. 35-6.

Waldron CA, Mustoe TA. Primary intraosseous carcinoma of the mandible with probable origin in an odontogenic cyst. Oral Surg Oral Med Oral Pathol. 1989 Jun;67(6):716-24.

Lin YJ, Chen CH, Wang WC, Chen YK, Lin LM. Primary intraosseous carcinoma of the mandible. Dentomaxillofac Radiol. 2005 Mar;34(2):112-6.

Lindqvist C, Teppo L. Primary intraosseous carcinoma of the mandible. Int J Oral Max Surg. 1986 Apr;15(2):209-14.

Nolan R, Wood NK. Central squamous cell carcinoma of the mandible: report of case. J Oral Surg. 1976 Feb;34(3):260-4.

Zwetyenga N, Pinsolle J, Rivel J, Majoufre-Lefebvre C, Faucher A, Pinsolle V. Primary intraosseous carcinoma of the jaws. Arch Otolaryngol Head Neck Surg. 2001;127:794-7.

Suei Y, Tanimoto K, Taguchi A, Wada T. Primary intraosseous carcinoma: review of the literature and diagnostic criteria. J Oral Maxillofac Surg. 1994 Jun;52(6):580-3.

Lin YJ, Chen CH, Wang WC, Chen YK, Lin LM. Primary intraosseous carcinoma of the mandible. Dentomaxillofac Radiol. 2005;34:112-6.

Punnya A, Kumar GS, Rekha K, Vandana R. Primary intraosseous odontogenic carcinoma with osteoid/dentinoid formation. J Oral Pathol Med. 2004 Feb;33(2):121-4.

González-García R, Sastre-Pérez J, Nam-Cha SH, Muñoz-Guerra MF, Rodríguez-Campo FJ, Naval-Gías L. Primary intraosseous carcinomas of the jaws arising within an odontogenic cyst, ameloblastoma, and de novo: report of new cases with reconstruction considerations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Nov;103(2):e29-33.

Thomas G, Pandey M, Mathew A, Abraham EK, Francis A, Somanathan T, et al. Primary intraosseous carcinoma of the jaw: pooled analysis of world literature and report of two new cases. Int J Oral Maxillofac Surg. 2001 Aug;30(4):349-55.

Hwang EH, Choi YS, Lee SR. Primary intraosseous carcinoma of the mandible. Korean J Oral Maxillofac Radiol. 2005 Dec;35(4):235-9.

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Published

2020-01-11

How to Cite

1.
D’souza VD, Rao PK, Kini R. Case report on multiple solitary radiolucencies in the mandible - a diagnostic dilemma. J Oral Diagn [Internet]. 2020 Jan. 11 [cited 2024 Nov. 15];5:1-4. Available from: https://joraldiagnosis.com/revista/article/view/83

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Case Report