RESUMEN
INTRODUCTION: Unicystic ameloblastomas are a rare variant of ameloblastomas, which are characterized by slow growth and being relatively locally aggressive, with the main site of origin being the posterior portion of the mandible, it also refers to those cystic lesions that show clinical, radiographic, or gross features of a jaw cyst. PRESENTATION OF CASE: A 27-year-old female patient presented with a chief complaint of extensive mass of mandible along with severe swelling and numbness of right lips and chin. The oral examination revealed a swelling in the molar region of the right mandible with buccal plate expansion. The radiographic and histopathologic features were consistent with the diagnosis of unicystic ameloblastoma. Consequently, the lesion was surgically removed, and no clinical or radiological recurrence was detected during 5 years post-operative follow-up. DISCUSSION: While previous reports of unicystic ameloblastoma in the posterior portion of the jaw showed favorable prognosis lesions appeared as a unilocular entity, this case reports multilocular appearance and aggressive behavior of expansive unicystic ameloblastoma. Furthermore, while some studies linked the unilocular appearance of unicystic ameloblastoma to impacted tooth, our case suggests a possible traumatic link of preexisting lesion into multilocular unicystic ameloblastoma related to impacted tooth. CONCLUSIONS: This case presents a rare multilocular unicystic ameloblastoma appearance, notably with impacted tooth involvement. It also indicates the potential transformation of solid ameloblastoma into unicystic ameloblastom.
RESUMEN
Introduction and importance: Odontogenic keratocyst (OKC) is a distinctive form of developmental odontogenic cyst that deserves special consideration because of its specific clinical behaviour and histopathologic features. The clinical and radiographic features of OKC are indefinite; while some may be associated with pain, swelling or drainage, most of them are asymptomatic. This case reports rare radiographic and histopathological features of recurrence OKC. Case presentation: A 47-years-old male patient presented with a main complaint of a painful mass in the oral cavity with a history of previous lesions that occurred in the posterior portion of the mandible related to extraction of impacted third molar. The oral examination revealed a swelling in the molar region of the right mandible with lingual plate expansion. The radiographic and histopathologic were consistent with the diagnosis of OKC. Consequently, the lesion was surgically removed, and no clinical or radiological recurrence was observed during the 8-month postoperative follow-up. Clinical discussion: This case explained the clinical differences between OKC and other lesions and highlights the distinctive radiologic and microscopic features that a conflict with previous studies concerning the symptoms that may related to naevoid basal cell carcinoma syndrome, and revealed the proper treatment depending on the recurrence appearance and the treatment methods that used previously. Conclusions: This case highlights a rare multilocular appearance of recurrent OKC in the mandible with no naevoid basal cell carcinoma syndrome related, supports the marginal resection as an effective procedure in the management of recurrent OKCs cases.
RESUMEN
INTRODUCTION: Central Giant Cell Granuloma (CGCG) is a non-neoplastic benign lesion. It is primarily observed in the maxilla and mandible, with the mandible being the more reported site of the lesion. The lesion often manifests in the anterior regions of the mandible, extending occasionally across the midline. This case reports a rare presentation in the posterior portion of the mandible, in an edentulous area. PRESENTATION OF CASE: A 33-year-old female with a history of extraction of teeth 36 and 37 six months ago presented with a main complaint of a mass in the oral cavity. The oral examination revealed an expansive multilocular mass (4 × 3 cm) located on the alveolar ridge in the left posterior portion of the mandible, extending around tooth 33 with an intact masseter muscle. The histopathological findings were consistent with CGCG. Consequently, the lesion was surgically removed with no clinical or radiological recurrence observed during the 4-month post-operative follow-up. DISCUSSION: While previous reports of CGCG in the posterior portion of the jaw showed destructive lesions that caused mandibular ramus destruction along with swollen masseter muscle, this case reports no involvement of the masseter muscle. Also, while some studies linked CGCG to tooth-bearing regions, our case suggests a possible traumatic link even after extraction. CONCLUSIONS: This case presents a rare CGCG occurrence in the posterior jaw, notably without masseter muscle involvement. It also indicates that CGCG can manifest in edentulous regions.