Central neurilemmoma (schwannoma) of the mandible. Case report

A neurilemmoma presenting as a central bone tumour is uncommon with less than 40 cases having been reported in the jaws. A further case of intraosseous (central) neurilemmoma arising in the posterior mandible of a 55 year old Vietnamese woman is presented with discussion on the incidence, clinical presentation, radiographic appearance, histology and treatment of this benign neurogenic tumour.     

Central leiomyoma of the mandible.

A case of central leiomyoma of the mandible is reported, along with ultrastructural confirmation of the diagnosis. The pertinent literature is reviewed. It is probable that this lesion arose from the smooth muscle in the walls of blood vessels. To the best of our knowledge, this is only the second report of a leiomyoma central in bone.     

Desmoplastic fibroma of bone. A case in the mandible.

A case of desmoplastic fibroma of the mandible in a 25-year-old white man, expanding from the first molar to the ramus, is presented. This is a rare primary central neoplasm. It grows expansively and may destroy the cortex. Few cases in the mandible have been reported. Its diagnosis is important because the experience reported by different authors has shown the tendency for recurrence when treatment consists of less than radical resection.     

Intraosseous angiolipoma of the mandible.

A case of intraosseous angiolipoma, one of the rarest benign tumors of bone, is reported. This tumor represents an example of an intraosseous neoplasm consisting of both blood vessels and fat. To our knowledge, such a tumor of the mandible has not been reported previously.     

Hemophilic pseudotumor of the mandible. Report of a case

Hemophilic pseudotumor of bone is a rarely encountered lesion associated with hemophilia. To date, only eight cases in the mandible have been reported in the literature. A rare case occurring in the mandible of a 2 1/2-year-old child required the fabrication of a customized wound obturator for postoperative wound care after surgical curettage. The literature is reviewed and the obturator described.     

Aneurysmal bone cyst of the jaws. Review of the literature and report of 2 cases

Strictly speaking, the aneurysmal bone cyst is not a true cyst. It is a lesion characterized by replacement of bone by fibro-osseous tissue containing blood-filled cavernous spaces. It is usually treated by surgical curettage, and access within the jaws may sometimes be difficult. We reviewed the world literature and found 63 cases of aneurysmal bone cysts involving the face, 22 reported in the maxilla, and 63 in the mandible. One was found in the zygomatic arch. Of the patients reported, 88% were younger than 30 years old; there was an equal sex distribution. Included in this report, are two cases of our own, one involving the maxilla and one the mandible.     

Bilateral fracture of the mandible in chronic lymphocytic leukaemia. Case report

The development of osteolytic bone lesions in patients with chronic lymphocytic leukaemia (CLL) is extremely rare and has not been reported to involve the mandible. A case of bilateral pathologic fracture of the mandible extensively involved with multiple bony deposits of CLL is reported.     

Osteosclerotic bone dysplasia (melorheostosis) of the mandible

Melorheostosis is a linear bone dysplasia of unknown origin that may be associated with soft-tissue alterations. Although any part of the skeleton can be affected, this condition is rarely observed in the craniofacial region. Only seven cases of melorheostosis with craniofacial involvement have been reported and cranial manifestation only is even rarer. To the authors' knowledge, manifestation in the mandible only has not yet been documented. A patient with isolated melorheostosis of the mandible with characteristic symptomatic bone pain is presented. The clinical, radiological and histological findings are described and possible therapeutic options are discussed.     

Massive osteolysis of the maxillofacial bones. Report of two cases

Two cases of massive osteolysis were encountered, one affecting the mandible and the other the maxilla and mandible. Only 13 cases have been reported so far in the existing literature for massive osteolysis of the mandible. It is indeed a rare disease. Our two cases were surgically treated and were clinically and histopathologically assessed.     

Reconstruction of mandibular defects by autogenous bone grafts: a review of 37 cases.

Thirty-seven cases of autogenous bone grafted to the mandible at the maxillofacial unit, Kaduna, Nigeria, were reviewed. The ilium was used in the majority of cases. In four cases where the recipient beds were vascular, the rib was used. The various techniques for restoring the central arch defects of the mandible are discussed and the methods we used are described. The superiority of autogenous bone grafts over homografts and heterografts is emphasized.     

Autosomal dominant osteosclerosis: report of a kindred.

Autosomal dominant osteosclerosis (ADO), a rare inherited craniotubular bone disorder, is a generalized hyperostosis that manifests itself as increased cortical thickening of the skull, mandible, metacarpals, metatarsals, long bones, vertebral bodies, ribs, and clavicles. Jaw abnormalities, which clinically resemble the widening and deepening of the mandible seen in cherubism, begin in childhood and have been reported to stabilize after puberty. Teeth and alveolar bone are normal. ADO must be distinguished from Van Buchem's disease, which is characterized by elevated serum alkaline phosphatase, neurologic complications, exopthalmos, periosteal excrescences, and an autosomal recessive pattern of inheritance, as well as from other craniotubular bone disorders such as osteopetrosis. We present clinical and radiographic documentation of members of a kindred representing 4 generations affected with ADO. At initial examination of the proband, a differential diagnosis included cherubism, fibrous dysplasia, osteopetrosis, and Paget's disease. Radiographic examination revealed extensive radiopacity of the inferior border and basal bone of the mandible. The proband's clavicles and humerus were also affected. All family members examined were similarly affected and had mandibular and palatal tori. Authors of a previously published report on the dental and dentoalveolar management of patients with craniotubular bone disorders have recommended prophylactic antibiotics to minimize risk of osteomyelitis in all such cases. The members of our kindred received extensive dental treatment before diagnosis, including extractions of severely carious teeth, preprosthetic dentoalveolar surgery, and endodontic therapy; there was no incidence of osteomyelitis or postsurgical complications. Therefore, the use of prophylactic antibiotics may not be warranted in patients with ADO who have otherwise normal medical histories.     

The use of fresh frozen allogeneic bone for maxillary and mandibular reconstruction.

The use of fresh frozen bone (FFB) alone, or in combination with autogenous bone (AB), for bony augmentation of the maxilla and mandible in preparation for dental reconstruction with endosseous implants has been studied. Ten patients received FFB +/- AB for augmentation of a severely atrophic mandible (n = 6) or for reconstruction of a jaw defect secondary to trauma or tumor resection (n = 4). Average follow-up was 26.3 +/- 5.4 months. At the time of implant placement, the bone grafts were found to be firm in consistency, well incorporated, and well vascularized in all 10 patients. Twenty-nine endosseous implants were placed an average of 8.3 +/- 3.1 months following bone grafting. One implant failed and was replaced, and one implant remains buried as a nonfunctional unit. All patients have been restored prosthetically by means of 28 of the 29 implants. This preliminary study indicates that FFB may be used alone or in combination with autogenous bone for augmentation or reconstruction of the atrophic maxilla and mandible. The resultant ridge is adequate to support loaded endosseous implants. A potential disadvantage is the minimal risk of disease transmission.     

Multiple Stafne bone cavities: a diagnostic dilemma

Salivary gland inclusions in the mandible are relatively uncommon. If defects occur they are generally unilateral, although bilateral cases have been reported. This article describes an unusual case in which the dental panoramic tomogram revealed three radiolucent areas in the mandible. The diagnosis of the two posterior radiolucencies was confirmed as Stafne's bone cavities but a definite diagnosis for the parasymphyseal lesion remained elusive, even after surgery. However, Stafne's bone cavities are known to occur in this region and this diagnosis remains the most probable.     

Aneurysmal bone cyst of the mandible--a case report

Aneurysmal bone cysts originating in the craniofacial region have seldom been reported in Taiwan. A case of aneurysmal bone cyst arising in the right mandible of a 15-year-old Chinese boy was presented with both the roentgenographic and microscopic findings. In view of the high recurrent rate and the large destructive mandibular lesion, segmental resection with immediate bone grafting for reconstruction and a conscientious follow up regimen was employed. The etiology and pathogenesis of this interesting lesion remained unclear but several theories were reviewed and the differential diagnosis of this lesion was also discussed. Furthermore, immunoperoxidase staining for Factor VIII related antigen was performed to help differentiate between the aneurysmal bone cyst and a central hemangioma and then to elucidate the pathogenesis of the former.     

Mandibular fracture caused by peri-implant bone loss: report of a case

BACKGROUND: A major complication related to excessive bone loss around implants is fracture of the mandible. This complication is most likely to occur in a very atrophic mandible. A 57-year-old woman presented with progressive pain and swelling that had been present for 5 days in the right frontal region of the mandible. An intraoral radiograph revealed a radiolucency around one of the implants in the interforaminal region. METHODS: Ten years earlier, 4 hollow-screw implants of 10 mm length had been inserted in the interforaminal region of the edentulous mandible. Throughout the 10-year postoperative period, no adverse clinical events were seen; however, during the last 7 years, no radiographic follow-up was performed. Mobility was tested after removal of the bar, on which one of the implants appeared to be mobile. The mobile implant was removed together with the fibrous tissue. RESULTS: At a recall visit 2 weeks later, a radiograph revealed a fracture of the mandible at the explantation site. Characteristic features of the hollow-screw implant are the hollow body and the transverse openings in the side walls of the implant. It has been reported that these characteristic features can enhance infection and rapid bone loss, but a case of mandibular fracture has never been described. CONCLUSION: Radiographs should be taken on a regular and perhaps more frequent basis to diagnose excessive bone loss, so that measures can be taken to prevent the risk of mandibular fracture.     

Central osteoma of the maxilla with involvement of paranasal sinus

Osteoma is an osteoblastic benign tumor characterized by the proliferation of either compact or cancellous bone. In the jaws, the most of cases reported in the literature presented as peripheral solitary lesions, involving preferably the posterior region of the mandible. However, central osteomas are quite rare, especially in the maxillary bone. The purpose of this article was to present the clinical, radiographic, surgical, and histologic features of a solitary central osteoma of the maxilla with involvement of the paranasal sinus and to review the literature for central osteomas located in the jaws. Our clinical report participates to literature as the 12th case of central osteoma in the jaws and the fourth case in the maxillary bone.     

Primary tuberculous osteomyelitis of the mandible. A case report.

A case of tuberculous osteomyelitis of the mandible in a 76-year-old woman is reported. The patient sought treatment for a periostitis of the left side of the mandible. A purulent discharge was evident. Roentgenographic examination of the mandible revealed bone destruction from the midmandible to the ramus on the left side. The diagnosis was made by microscopic examination of the specimen from the involved bone. This case proved to be primary tuberculous osteomyelitis caused by the absence of the primary focus.     

Desmoplastic fibroma (fibromatosis) of the jawbones. Report of a case and review of the literature.

Desmoplastic fibroma (fibromatosis) is rarely seen as a primary tumor of bone. Its occurrence as a central lesion in the jaws is even more uncommon. The case of a 26-year-old woman with a central desmoplastic fibroma of the body of the mandible is described. The lesion manifested as a painless swelling and radiographically appeared as a well-delineated radiolucency. On exploration, the tumor was found to have infiltrated through the lingual cortex. Microscopic examination revealed invasion of muscle. The clinicopathologic features of this case and of the twenty-five similar lesions previously described in the literature are analyzed and discussed.     

A rare location of benign osteoblastoma: review of the literature and report of a case

Benign osteoblastoma is a rare primary bone tumor that constitutes approximately 1% of all primary bone tumors. Its occurrence in the craniomaxillofacial region as also rare and represents only 15% of all osteoblastomas. The tumor shows a predilection for the male gender and constitutes less than 1% of all tumors of the maxillofacial region. In the maxillofacial region, the mandible is affected more frequently than the maxilla, and the coronoid process of the mandible is the area most rarely affected by osteoblastoma. Before this report, 53 cases have been reported in the literature. In this report, a rare location of osteoblastoma, namely, the coronoid process of the mandible, is described.     

Mandibular osteoma in the encephalocraniocutaneous lipomatosis.

INTRODUCTION: Encephalocraniocutaneous lipomatosis is a rare congenital disorder characterized by an abnormal development of adipose tissue, and is of unknown pathogenesis. Catherine Haberland and Maurice Perou first diagnosed this disorder in 1970. To our knowledge, approximately 25 patients have been reported with this diagnosis but so far, only 1 patient has been reported in Poland by Roszkowski and Dabrowski in 1997. At that time she was a 13-year-old girl, who was neurosurgically treated. CASE REPORT: The authors followed the same patient (now 21 years old), who was referred to the Department of Cranio-Maxillofacial Surgery of the Medical University of Lodz for osteoma of the mandible. Partial resection of the mandible was performed on account of the size of the lesion. The mandible was reconstructed by an iliac crest bone graft fixed by 2 titanium plates. The surgical procedure is described. CONCLUSION: Encephalocraniocutaneous lipomatosis is a very rare syndrome. Most of the cases described in the literature presented lipomas of the skin with neurological and ophthalmological disturbances. Only a few authors described jaw tumours and no information was found on such big osteomas to this syndrome.