Osteomas of the facial bones are a rare entity and very few cases have been reported in the literature. Osteomas are benign neoplasms, often asymptomatic and consist of well-differentiated matured bone. There are three varieties of osteomas- the central type arising from the endosteum, the peripheral type arising from the periosteum, and the extra-skeletal soft tissue osteomas which usually develops within the muscle. In the facial bones, both central and peripheral osteomas have been described. Peripheral osteomas have been described to occur in the frontal, ethmoid, and maxillary sinuses, but are not common in jawbones. We describe a rare case of symptomatic peripheral osteoma of mandible in a middle-aged female patient.
Ameloblastic carcinoma is a rare malignant lesion with characteristic histologic features and behavior that dictates more aggressive surgical approach than that of a simple ameloblastoma. However, reliable evidence of its biologic activity is currently unavailable due to the scarcity of well-documented cases. It occurs primarily in the mandible in a wide range of age groups; no sex or race predilection has been noted. It may present as a cystic lesion with benign clinical features or as a large tissue mass with ulceration, significant bone resorption and tooth mobility. Because the lesion is usually found unexpectedly after an incisional biopsy or the removal of a cyst, a guide to differential diagnosis is not usually useful. The identifying features of ameloblastic carcinoma must be known and recognized by dental practitioners. The tumour cells resemble the cells seen in ameloblastoma, but they show cytologic atypia. Moreover, they lack the characteristic arrangement seen in ameloblastoma. Direct extensions of the tumour, lymph node involvement and metastasis to various sites (frequently the lung) have been reported. We present a case of ameloblastic carcinoma of the mandible with a clinical course of typical aggressiveness and extensive local destruction in a 27 year old male patient.
Ameloblastoma is a slow-growing benign neoplasm that has a strong tendency to local invasion and that can grow to be quite large without metastasizing. Rare examples of distant metastasis of an ameloblastoma in lungs or regional lymph nodes do exist. It has an aggressive and recurrent course and is rarely metastatic. Radiographically it shares common features with other lesions such as the giant cell tumor, aneurysmal bone cyst, and renal cell carcinoma metastasis; a definitive diagnosis can only be made with histopathology. Basal cell ameloblastoma is believed to be the rarest histologic subtype in which the tumor is composed of more primitive cells and has even fewer features of peripheral palisading. Till date, only few cases of basal cell ameloblastoma have been reported in the literature. Considering the rarity of the lesion, we report here an interesting and unique case of basal cell ameloblastoma of the mandible occurring in a very old patient.
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