RESUMO
OBJECTIVE: This article discusses the differential diagnosis of an unusual lesion found in the mandible of an adult male individual (late 19th to early 20th century). MATERIALS: A cranium from the Identified Skulls Collection Escolas Médicas of the University of Coimbra, Portugal. METHODS: Macroscopic analysis, conventional radiography. RESULTS: Macroscopically, a conspicuous osteolytic lesion was identified in the middle vestibular area of the mandible. The conventional radiography examination revealed a multilocular and non-expansive lesion, with undefined contours and irregular walls. CONCLUSIONS: These characteristics are compatible with a benign lesion, possibly an ameloblastoma or an odontogenic keratocyst. SIGNIFICANCE: The present work contributes substantially to the knowledge of the development of cystic and tumour lesions in the past and generates a broader body of knowledge about these lesions. LIMITATIONS: Destructive methods were not authorized. SUGGESTIONS FOR FURTHER RESEARCH: In the future, computed tomography scans and 3D reconstruction analysis, not performed in the current study, may add new and valuable information.
Assuntos
Ameloblastoma , Adulto , Ameloblastoma/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Portugal , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: To undertake a differential diagnosis of a large mass found in the left maxillary sinus of a cranium dated to the 16th-17th-century, and to expand knowledge of the diagnosis of osseous tissue formation in osteoarchaeological studies. MATERIAL: A cranium recovered from the cemetery of San Salvador de Palat de Rey church, León (Spain). METHODS: Macroscopic analysis, CT scanning. RESULTS: Macroscopic analysis indicated that the individual was probably a male over 30 years old with an ossified mass in the left maxillary sinus, measuring 24 × 19 × 24 mm, occupying approximately 27 % of the maxillary antrum. Computed tomography revealed a well-demarcated radiolucent unilocular mass with some radiopaque areas, with no communication with the alveoli of the premolars or molars. No erosive lesions or signs of inflammation were found. CONCLUSIONS: Neither the macroscopic, nor the radiological characteristics are compatible with inflammatory or malignant pathology, favoring a diagnosis of ossifying fibroma. SIGNIFICANCE: This case adds to the few reported cases in the osteoarchaeological literature, especially since there is limited relevant reference data to assist diagnosis. The CT scans and 3D reconstruction presented here facilitate differential diagnosis in future paleopathological studies. LIMITATIONS: Destructive methods were not authorized. SUGGESTIONS FOR FURTHER RESEARCH: In the future, micro-CT analysis, which was not performed in the current study, may add new and valuable information.