Osteochondroma (OC) of the Condyle of Left Mandible: A Rare Case

Abstract

A 36-year-old male patient presented with complaints of speaking and eating difficulties. He had a history of previous steroid injection to left TMJ a year ago for the management of internal derangement and from that time he slowly developed pain in the left TMJ associated with slight facial asymmetry [Table/ Fig-1]. Patient gave history of steroid injection (single dose) one year back due to lock jaw problem following which he developed pain and facial asymmetry. There was no history of trauma. Medical and family history was not significant. On clinical examination facial asymmetry was present and a localized swelling was present on left TMJ area which was diffuse, tender and hard in consistency. Tenderness elicited on TMJ area on opening and closing mouth and deviation of mandible on right side was present on mouth opening. Inter-incisal mouth opening was 30 mm. Radiographic examination revealed slight erosive lateral surface of left condyle and obliteration of left TMJ space on panoramic radiograph [Table/ Fig-2]. Clinic-radiographic correlation lead to following differential diagnosis: benign bone tumour of left condyle, fibrous ankylosis of left TMJ. As patient was not willing for advanced imaging, surgical exploration of joint was done where thick cartilaginous material was encountered at head of left condyle . Complete surgical excision of lesion was performed. On gross examination the specimen was measuring 1 × 0.5 cm in size, brownish white in color, firm in consistency. Postoperatively patient's mouth opening improved to 37mm.Microscopic examination revealed mono-nucleated, bi-nucleated and multi-nucleated cells having round to oval hyperchromatic nuclei within lacunae, suggestive of chondrocytes dispersed in hyaline ABStRACtOsteochondroma (OC) is one of the most common benign condylar tumours having both chondroma and osteoma. However, this tumour is most frequently found on the metaphyses of long bones and is unusual on the skull. When it affects the mandibular condyle, the cause could be due to trauma to the tempero mandibular joint (TMJ). Here, in this report we present a rare case of osteochondroma of left condyle region in a 36-year-old man. The patient had noticed pain in the left TMJ for six months. The lesion is surgically removed and histologically evaluated which composed of chondrocytes dispersed in hyaline matrix along with a rim of calcified bone at one end.matrix [Table/ Fig-4&5]. Areas of hemorrhage were also evident with minimal peripheral bony area. All these features confirmed the diagnosis of OC. Patient is on regular follow up. DISCUSSIoNThe World Health Organization defines the OC as a "cartilage-capped bony protrusion on the external surface of bone.'' It represents approximately 35% to 50% of all benign bone tumours and 8% to 15% of all primary bone tumours [1]. Though it is one of the most common benign tumours of the condyle, it is most frequently found on long bones and is uncommon on the skull [2]. OC of the mandibular condyle is thought to be a relatively rare lesion and o...

Mandible condyle osteochondroma: clinical case report

“…In addition, it is important to highlight that the treatment plan differs for both these conditions 1 . Radiographic appearance of osteochondroma of the mandibular condyle can be pathognomonic, appearing as an irregularly shaped, mixed density and expansile lesion 4 . Early diagnosis is essential in order to provide adequate treatment, which may affect the patient's quality of life 13 .…”

“…Although frequently found in the general skeleton, it is rarely seen to involve the facial bones [1][2][3][4] . It usually occurs early in life affecting young adults between 10-30years of age but the craniofacial Osteochondroma are frequently seen in older women 5 .…”