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Clinical Problem Solving: Radiology
March 2005

Radiology Quiz Case 1

Author Affiliations
 

R. NICKBRYANMDPATRICIA A.HUDGINSMD

Arch Otolaryngol Head Neck Surg. 2005;131(3):274. doi:10.1001/archotol.131.3.274

A 30-year-old multiparous woman who was in the last trimester of her pregnancy presented with a 6-month history of a painless progressive swelling in the right side of her jaw (Figure 1). Physical examination revealed a 3×2-cm nontender swelling in the buccal side of the right lower alveolus, extending from the canine tooth to the second molar tooth. The overlying mucosa was smooth, grossly thickened, and mildly congested. The last premolar tooth and the first molar tooth were missing. The patient did not complain of toothache, bony pain, pus discharge from the tooth socket, fever, dental intervention, or trauma. She stated that the last premolar tooth and the first molar tooth on the right side had become loose and had spontaneously fallen off 2 weeks earlier. She also had a few subcentimeter lymph nodes at levels Ib and IIa in the right side of her neck. A biopsy specimen revealed that the swelling was a submucosal spindle cell lesion rich in giant cells that did not express cytokeratin or epithelial membrane antigen on immunohistochemical analysis and showed no mitotic activity.

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