Chondroblastic osteosarcoma mimicking periapical abscess

Abstract

Lesions of non-endodontic origin may mimic periapical abscess. Osteosarcoma is a rare malignant lesion. Case report The present report describes a case of chondroblastic osteosarcoma in the periapical region of teeth #29, #30, and #31 of an 18-year-old male. Clinical history showed self-reported discomfort in the right posterior gingiva for over a month. Physical examination showed a small expansion and redness of the right mandibular buccal and lingual cortical plates, but no signs of pain or inflammation were observed. All the teeth responded positively to pulp sensibility. Periapical and panoramic radiographs showed slight periapical radiolucency in the roots of teeth #29 and #30, clear periodontal ligament space widening, and evident loss of lamina dura. Incisional biopsy was performed, and based on microscopic findings the diagnosis of chondroblastic osteosarcoma was confirmed.Conclusions Non-endodontic diseases associated with tooth root apex, such as chondroblastic osteosarcoma, should be included in differential diagnosis of jaw lesions that resemble periapical abscess.

Common Operative Procedural Errors and Clinical Factors Associated with Root Canal Treatment

“…It is important to consider that not all the periapical radiolucencies are associated with infected root canals (61)(62)(63)(64)(65). Periapical lesions of non-endodontic origin may lead to misdiagnosis and consequently therapeutic errors (61)(62)(63)(64)(65).…”

“…Periapical lesions of non-endodontic origin may lead to misdiagnosis and consequently therapeutic errors (61)(62)(63)(64)(65). The case selection must be well considered and planned.…”

“…Endodontics challenges begin when diseases from nonendodontic origin suggest a typical case of periapical lesion (61)(62)(63)(64)(65). Mandibular or maxillary areas surrounding the root apexes presenting radiolucent or radiopaque images may be a sign of non-endodontic disease.…”

“…Mandibular or maxillary areas surrounding the root apexes presenting radiolucent or radiopaque images may be a sign of non-endodontic disease. Thus, the differential diagnosis of diseases from endodontic or non-endodontic origin should be cautiously made to avoid misdiagnosis (61)(62)(63)(64)(65).…”

“…The doubtful cases (transition phase) between RCT success or failure during a follow-up may be associated with limitations of imaging exams (5) or lesions from nonendodontic origin (61)(62)(63)(64)(65). Wu et al (107) reported that the outcomes of RCT should be re-evaluated in long-term longitudinal studies using CBCT and stricter evaluation criteria.…”