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Aneurysmal bone cyst located in the mandibular condyle.

Pelo S, Gasparini G, Boniello R, Moro A, Amoroso PF - Head Face Med (2009)

Bottom Line: A rapid growing mass, depicting soft tissue invasion, in the right condyle of the mandible was found.The ABC is an infrequent bone lesion which can only be found very rarely at the craniofacial skeleton.Therefore a functional device was used after surgery to overcome the lack of the condyle and to stimulate the growth of the ramus.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Catholic University of S, Cuore, A. Gemelli Rome, Via G. Moscati 31/33, 00168 Rome, Italy. siocmf@hotmail.it

ABSTRACT
A rare case of aneurysmal bone cyst (ABC) located in the mandibular condyle in a 10-year-old boy is presented. The patient came to our attention for a sudden swelling in the right temporomandibular region, the mouth opening was not reduced. A rapid growing mass, depicting soft tissue invasion, in the right condyle of the mandible was found. Clinically and radiographically it resembled to a malignant lesion. The surgical excision of the mandibular condyle allowed a complete removal of the lesion. The histological examination revealed a pseudocystic expanding osteolytic lesion containing blood-filled space separated by connective tissue and many osteoclastic giant cells, which was a conventional vascular ABC. The ABC is an infrequent bone lesion which can only be found very rarely at the craniofacial skeleton. There have been described about 160 cases of ABC originated in the molar region or in upper maxilla and even more rare is the location of this cyst in the mandibular condyle. Only 6 cases were reported in the literature to date. A complete surgical resection of this osteolytic lesion is the treatment of choice considering its high recurrence rate. The condyle was not replaced with any graft. Therefore a functional device was used after surgery to overcome the lack of the condyle and to stimulate the growth of the ramus.

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Intraoperative exposure of the thin, translucent lateral cortical plate overlying the mandibular cyst. Afterwards a low condylectomy, a coronoid process and mandibular ramus curettage were performed.
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Figure 7: Intraoperative exposure of the thin, translucent lateral cortical plate overlying the mandibular cyst. Afterwards a low condylectomy, a coronoid process and mandibular ramus curettage were performed.

Mentions: A posterior-anterior radiography of the skull was obtained revealing a radiolucent region in the condyle of the right mandible [Figure 2]. A three-dimensional CT reconstruction showed the presence of a radiolucent and multilocular lesion in the condyle region. It was possible to appreciate that the lesion had totally replaced the mandibular right condyle and part of the mandibular ascending ramus. The lesion substituted the bone marrow of these anatomical structures and the cortical bone was substantially expanded and perforated. The condyle was so ballooned that it was evident through extra oral examination. Part of the coronoid process was affected by the infiltrative osteolytic process [Figures 3, 4 and 5]. The magnetic resonant imaging (MRI) demonstrated a high-signal intensity within the lesion itself and a low-signal at the periphery [Figure 6]. The clinical presentation and the radiographic appearance of this lesion could have been associated to osteosarcoma, ameloblastma, myxoma or central giant cell granulomas therefore the decision for surgical excision was taken. The operation was performed under general anaesthesia. A preauricular incision was performed to identify the ATM joint capsule and thereafter the condyle. This structure appeared deformed and increased. The mandibular cortex overlying the cyst was noted to be thin and actually translucent in some places. Upon removal of the outer cortex of bone, thick greenish fluid was encountered, immediately followed by brisk hemorrhage which was difficult to control. Afterwards a low condylectomy was performed. The lesion underwent a complete surgical excision [Figures 7, 8]. The final histological diagnosis was aneurysmal bone cyst described as an expanding osteolytic lesion containing blood-filled spaces of variable size, separated by connective tissue constituted by bone trabeculae or osteoid tissue and many osteoclastic giant cells.


Aneurysmal bone cyst located in the mandibular condyle.

Pelo S, Gasparini G, Boniello R, Moro A, Amoroso PF - Head Face Med (2009)

Intraoperative exposure of the thin, translucent lateral cortical plate overlying the mandibular cyst. Afterwards a low condylectomy, a coronoid process and mandibular ramus curettage were performed.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2654878&req=5

Figure 7: Intraoperative exposure of the thin, translucent lateral cortical plate overlying the mandibular cyst. Afterwards a low condylectomy, a coronoid process and mandibular ramus curettage were performed.
Mentions: A posterior-anterior radiography of the skull was obtained revealing a radiolucent region in the condyle of the right mandible [Figure 2]. A three-dimensional CT reconstruction showed the presence of a radiolucent and multilocular lesion in the condyle region. It was possible to appreciate that the lesion had totally replaced the mandibular right condyle and part of the mandibular ascending ramus. The lesion substituted the bone marrow of these anatomical structures and the cortical bone was substantially expanded and perforated. The condyle was so ballooned that it was evident through extra oral examination. Part of the coronoid process was affected by the infiltrative osteolytic process [Figures 3, 4 and 5]. The magnetic resonant imaging (MRI) demonstrated a high-signal intensity within the lesion itself and a low-signal at the periphery [Figure 6]. The clinical presentation and the radiographic appearance of this lesion could have been associated to osteosarcoma, ameloblastma, myxoma or central giant cell granulomas therefore the decision for surgical excision was taken. The operation was performed under general anaesthesia. A preauricular incision was performed to identify the ATM joint capsule and thereafter the condyle. This structure appeared deformed and increased. The mandibular cortex overlying the cyst was noted to be thin and actually translucent in some places. Upon removal of the outer cortex of bone, thick greenish fluid was encountered, immediately followed by brisk hemorrhage which was difficult to control. Afterwards a low condylectomy was performed. The lesion underwent a complete surgical excision [Figures 7, 8]. The final histological diagnosis was aneurysmal bone cyst described as an expanding osteolytic lesion containing blood-filled spaces of variable size, separated by connective tissue constituted by bone trabeculae or osteoid tissue and many osteoclastic giant cells.

Bottom Line: A rapid growing mass, depicting soft tissue invasion, in the right condyle of the mandible was found.The ABC is an infrequent bone lesion which can only be found very rarely at the craniofacial skeleton.Therefore a functional device was used after surgery to overcome the lack of the condyle and to stimulate the growth of the ramus.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Catholic University of S, Cuore, A. Gemelli Rome, Via G. Moscati 31/33, 00168 Rome, Italy. siocmf@hotmail.it

ABSTRACT
A rare case of aneurysmal bone cyst (ABC) located in the mandibular condyle in a 10-year-old boy is presented. The patient came to our attention for a sudden swelling in the right temporomandibular region, the mouth opening was not reduced. A rapid growing mass, depicting soft tissue invasion, in the right condyle of the mandible was found. Clinically and radiographically it resembled to a malignant lesion. The surgical excision of the mandibular condyle allowed a complete removal of the lesion. The histological examination revealed a pseudocystic expanding osteolytic lesion containing blood-filled space separated by connective tissue and many osteoclastic giant cells, which was a conventional vascular ABC. The ABC is an infrequent bone lesion which can only be found very rarely at the craniofacial skeleton. There have been described about 160 cases of ABC originated in the molar region or in upper maxilla and even more rare is the location of this cyst in the mandibular condyle. Only 6 cases were reported in the literature to date. A complete surgical resection of this osteolytic lesion is the treatment of choice considering its high recurrence rate. The condyle was not replaced with any graft. Therefore a functional device was used after surgery to overcome the lack of the condyle and to stimulate the growth of the ramus.

Show MeSH
Related in: MedlinePlus