Management of giant osteoma in the mandible associated with minor trauma: a case report

Abstract

Background Osteoma is a benign tumor of the bones, which can be classified as central or peripheral. The occurrence in the jawbones is uncommon, but when it occurs, there is a greater prevalence of the mandible. The etiology is still unknown, and the hypothesis of its development is debated. Case presentation A 35-year-old Caucasian man presenting a tumor lesion in the right jawbone that had been growing for 8 years sought medical service complaining of speaking impairment. According to the patient, the tumor appeared shortly after a minor trauma caused by tooth extraction. The diagnosis of the lesion was made through clinical, radiographic, and histological methods, and the surgical treatment was successful and satisfactory for the patient as well as the surgical team, despite a short follow-up. Conclusion Etiopathogenesis of osteoma is not determined in the majority of cases. In the present report, it was possible to hypothesize the association between a minor trauma and the development of the tumor, reinforcing the reactive theory of tumor development. The uncommon location of the osteoma, as well the possibility of identifying the possible cause of the lesion, makes this case particularly interesting.

Rare Recurrent Giant Frontal Osteoma With Skin Multiple Keratinous Cysts and Multinucleated Giant Cell Granulomas

“…In addition, subperiosteal bleeding or edema resulting from the trauma caused by multiple surgeries and periosteal elevation due to muscle traction can also lead to an osteogenic response, which may also contribute to the recurrence of the frontal osteoma in case 2. 2 Although the osteoma was completely removed in the first 2 surgeries, the osteoma in case 2 still recurred. Consequently, at the third surgery, the patient requested that the frontal osteoma be removed first to restore the normal shape of the skull.…”

“…1,15 Its etiology is varied, such as infection, trauma, and genetics; however, the etiology is unclear in most cases. 2 Its clinical manifestation and symptoms depend on the location, extent, size, and growth direction of the osteoma. 15,18 As most osteomas are present asymptomatically, their detection is also mostly incidental.…”

“…34,35 X-ray examination shows round, oval, or irregularly shaped density reduction areas, while osteoma is an osteogenic lesion characterized by the proliferation of compact or cancellous bone. 2,34 Eosinophilic granulomas of the skin are predominantly characterized by eosinophilic granulomas and neutrophil infiltration, with a few areas where small numbers of lymphocytes and plasma cells can be observed. 36 Nevertheless, the skin lesion in case 2 was a multinucleated giant cell granuloma with lymphocytic infiltration, and no eosinophilic infiltration was seen.…”

“…More research is needed to verify this speculation. In addition, subperiosteal bleeding or edema resulting from the trauma caused by multiple surgeries and periosteal elevation due to muscle traction can also lead to an osteogenic response, which may also contribute to the recurrence of the frontal osteoma in case 2 2 . Although the osteoma was completely removed in the first 2 surgeries, the osteoma in case 2 still recurred.…”

“…Although eosinophilic granuloma can also involve bone and skin, eosinophilic granuloma of the bone is a bone-destructive lesion, and most patients have slight to severe pain, soft tissue swelling, and tenderness at the site of skin lesions 34,35 . X-ray examination shows round, oval, or irregularly shaped density reduction areas, while osteoma is an osteogenic lesion characterized by the proliferation of compact or cancellous bone 2,34 . Eosinophilic granulomas of the skin are predominantly characterized by eosinophilic granulomas and neutrophil infiltration, with a few areas where small numbers of lymphocytes and plasma cells can be observed 36 .…”