Open AccessPrimary intraosseous mucoepidermoid carcinoma of the mandible: radiographic evolution and clinicopathological features
Author(s) -
Nicholas B. Abt,
Matthew E. Lawler,
Joseph Zacharias,
Edward T. Lahey
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-224612
Subject(s) - medicine , mucoepidermoid carcinoma , radiodensity , mandible (arthropod mouthpart) , lesion , differential diagnosis , odontogenic tumor , pathology , iliac crest , buccal fat pad , radiography , odontogenic cyst , dentistry , carcinoma , radiology , anatomy , buccal administration , botany , biology , genus
Mucoepidermoid carcinoma (MEC) can be rarely found as a primarily intraosseous lesion and mistaken for other intraosseous or odontogenic pathology. A 65-year-old man had a poorly defined radiolucency distal to the left mandibular second molar root. Periapical radiographs demonstrated a minor radiolucency from 2.5 years prior. An oral and maxillofacial surgeon felt the radiolucency represented periodontal disease, extracting tooth #18. The differential diagnosis of mixed radiolucent/radio-opaque mandibular lesions includes: (1) fibro-osseous lesion, (2) odontogenic and non-odontogenic cyst, (3) infection and inflammatory lesion, or (4) benign or malignant neoplasm (odontogenic, non-odontogenic, or metastatic). Histological analysis revealed low-grade MEC. A composite resection was performed with a 1 cm margin from first molar to ascending ramus. A buccal fat pad advancement flap covered the defect with an iliac crest bone graft placed later for a resulting osseous defect. Careful examination and diagnostic work-up for odontogenic cysts should be provided as they may harbour malignant tumours.