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Clinical Challenge
Radiology
September 2015

Mass of the Anterior Mandible

Author Affiliations
  • 1American Board of Oral and Maxillofacial Radiology, Lexington, Kentucky
  • 2Department of Oral Health Practice, University of Kentucky, College of Dentistry, Lexington
  • 3Chandler Medical Center, Lexington, Kentucky
JAMA Otolaryngol Head Neck Surg. 2015;141(9):849-850. doi:10.1001/jamaoto.2015.1456

A man in his 60s presented to the oral and maxillofacial surgery department with a 7-month history of a painless progressive swelling of the anterior mandible. The patient was completely edentulous. He reported numbness of the lower lip and difficulty on swallowing. There was no remarkable weight loss. His medical history was significant for hypertension and coronary artery bypass surgery. On intraoral examination, the mass was hard in consistency with relatively normal overlying mucosa. Computed tomographic (CT) images with bone window showed a grossly expansile, multilocular, low-attenuation lesion of the anterior segment of the mandible (Figure, A and B). The images demonstrated severe erosion of the facial and lingual cortices with a remarkable scalloping pattern, and multiple wispy, ill-defined intralesional septa. Soft-tissue CT images indicated a cystic and solid nature of the mass (Figure, C and D).

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