Tratamento cirúrgico de osteoma periosteal em mandíbula – relato de caso

Abstract

Introdução: Os osteomas são proliferações de tecido ósseo, neoplasia benigna clinicamente consiste em massa bem delimitada que pode ser séssil ou pediculada, assintomática e que dependendo da sua localização e tamanho, pode acarretar danos a estruturas adjacentes, alterações funcionais e estéticos dependendo da sua localização. Objetivo: Discutir um relato de caso de osteoma periosteal compacto em região mandibular. Relato de Caso: Paciente N.B, do sexo feminino, 33 anos, foi atendida no Hospital da face (Recife – PE) queixando-se de aumento de volume endurecido à palpação em região submandibular esquerda. Ao exame físico, apresentava uma lesão endurecida, séssil e indolor, com tempo de evolução de aproximadamente 1 ano. Após exame clínico, foi solicitada a tomografia de face para avaliação complementar. A imagem tomográfica evidenciou a presença de uma lesão hiperdensa em região de corpo mandibular esquerda. Mediante o aspecto da lesão, optou-se pela excisão cirúrgica através de acesso extra-oral submandibular. Após excisão, a peça foi encaminhada para estudo anátomo-patológico que identificou a lesão como um Osteoma compacto. Discussão: A anamnese e exame físico são de suma importância para o diagnóstico do osteoma, por se tratar de uma patologia assintomática. A conduta inicial do tratamento é o acompanhamento, e caso o osteoma acarrete transtornos funcionais ou estéticos, o tratamento eleito é a ressecção cirúrgica. Conclusão: O osteoma é uma neoplasia benigna, que em alguns casos, a intervenção cirúrgica é necessária devido ao comprometimento estético e funcional, como relatado no presente caso.

Surgical treatment of extensive peripheral osteoma in the mandibular ramus: Case report

“…Conditions associated with the persistence of the embryonic periosteum have also been related to the development of the lesion, especially in cases in which researchers were unable to establish the relationship between the beginning of its Research, Society and Development, v. 10, n. 6, e4810615486, 2021 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v10i6.15486 development and the occurrence of trauma or previous inflammatory processes (Bullot, et al, 2010;Aires, et al, 2020). In the present case, the patient was not exposed to any inflammatory or traumatic episode in the mandible region.…”

“…Studies in the literature have shown that computed tomography is the ideal imaging test to determine the actual location and extent of the lesion, as it is a versatile test that produces detailed images of bone tumors, with good sensitivity and great specificity for abnormalities. Cone-beam computed tomographies also reproduce detailed images with high specificity but are obtained with a lower dose of radiation; such a characteristic must be taken into account when choosing the ideal exam (Shintaku et al, 2010;Bullot et al, 2010;Aires et al, 2020). In the case in question, conventional computed tomography was chosen, since in addition to the excellent image reproduction properties, it is an exam available in the Unified Health System, thus not generating additional costs for the patient.…”

“…There is no significant microscopic difference between osteomas and exostoses, therefore, the differential diagnosis is restricted to clinical characteristics (Marcondes de Castro Rodrigues et al, 2019). Exostoses, usually bilateral, are considered developmental hamartomas and tend to stop evolving after the end of puberty, while osteomas may show continuous growth even after the end of this period, indicating the neoplastic character of the lesion (Geron et al, 2017;De Bartoli et al, 2018;Aires et al, 2020). In the case in question, the development of the lesion was detected after puberty; besides, it was a solitary and unilateral mass, showing the classic characteristics of this bone tumor.…”

“…The etiology of osteomas, widely discussed in the literature, is still uncertain; it can be associated with conditions such as inflammatory reactions, embryological and genetic factors, continuous muscle action, osteogenic processes, and terminal stages of traumatic healing (Autorino et al, 2019, Aires, et al, 2020. In the craniofacial region, this lesion mainly Research, Society and Development, v. 10, n. 6, e4810615486, 2021 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v10i6.15486 affects the paranasal sinus and can also manifest in the mandible, external auditory canal, orbit, temporal bone, and pterygoid process (Fernandez et al, 2017;Castro et al, 2020).…”

“…The posterior portion of the body is the most affected region of the mandible, followed by the angle, condyle, branch, coronoid process, anterior region of the body, and mandibular notch (Neville et al, 2016;Aires et al, 2020). In general, osteomas are found in both sexes, with the female gender presenting higher treatment rates.…”