Expansile Radiolucency of the Mandible

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White Paper

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Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology





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A 27-year-old female presented for evaluation of an expansile lesion of the left posterior mandible. She reported that the swelling began several months prior and had progressively enlarged, now causing her intermittent pain. On further questioning, she denied paresthesia or significant compromises in function, including disruptions in eating, speaking, or swallowing. Extraoral examination revealed facial asymmetry attributed to a diffuse swelling of the left mandible. No compressibility or crepitus was noted on external palpation of the affected side, and the overlying skin was normal in appearance, without evidence of erythema. On intraoral examination, it was noted that the buccal and lingual cortices were expanded from tooth #18 to #23. The overlying gingiva and alveolar mucosa were pink, with no appreciable bruits or pulsations on auscultation. Examination of the associated teeth showed grade I mobility of tooth #18 and grades II and III mobility of teeth #24 and #23, respectively. All involved teeth tested vital with cold and electric pulp testing. The patient was edentulous in the regions of teeth #19, #20, #21, and #22 and teeth #28, #29, and #30. She stated that the left mandibular teeth had been extracted to treat an “abscess” 2 months prior. No history was provided regarding the missing right mandibular teeth. Examination of a panoramic radiograph revealed a large, multilocular radiolucency with well-defined borders extending from the mesial aspect of tooth #18 to the distal aspect of tooth #25 and encroaching on the inferior border of the mandible (Figure 1). The lesion enveloped the roots of teeth #23 and #24 and caused mild displacement of the teeth mesially. Distinct scalloping of the inferior mandibular cortex was seen. Internally, the lesion was predominately radiolucent, with focal evidence of radiopaque trabeculations.


Aneurysmal Bone-Cysts; Clinicopathological features; Jaws; Pathogenesis; Oncogenes; USP6





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