History of Present Illness
The patient reported that the lesion had been enlarging slowly for the past 21 years. The mass was not tender and the patient did not recall any history of trauma. No other information was available.
The patient’s medical history was unremarkable. He denied alcohol and tobacco use.
The clinical exam revealed a 3×2 cm “bony hard” swelling of the right mandible buccal to #27 and #28. The overlying mucosa was intact and no lingual extension was noted (Figure 1). The remainder of the oral cavity was within normal limits.
The periapical radiograph demonstrated a well-defined mixed radiolucent/radiopaque lesion that caused divergence of the roots without resorption. An occlusal radiograph also revealed buccal expansion and scattered opacifications (Figures 2 and 3).
On microscopic examination, the multiple sections examined revealed islands, strands, and sheets of polyhedral epithelial cells containing mildly pleomorphic nuclei set in a deeply eosinophilic cytoplasm (Figures 4-6).