Osteochondroma of the palate: An interesting and an unusual case presentation

Abstract

A 40-year-old Indian male patient was referred to the Department of Oral and Maxillofacial Surgery with a slowly enlarging intra-oral, right-sided palatal swelling of one-year duration, with a previous diagnosis of osteochondroma. Extraorally, patient presented with a mild right-sided facial swelling. On intraoral examination, the palatal swelling was extending from the distal aspect of canine to the distal aspect of second molar with involvement of the maxillary tuberosity. The swelling was non-tender, bony-hard in consistency and covered by normal mucosa. The medical history was non-contributory with no relevant family history of any skeletal disease. Despite the attempt for complete removal of the tumor previously, it recurred within six months. The present article reports an extremely rare clinical case of endosteal (central) osteochondroma, manifesting itself as a radiopaque mass in the right posterior aspect of the palate.

Osteochondroma of the coronoid process

“…Osteochondroma, also known as osteocartilaginous exostosis, is classified by the WHO as an osteocartilaginous lesion [3]. The two names given to the lesion reflect the controversy in its pathogenesis, where osteochondroma implies a benign tumor and osteocartilaginous exostosis implies a reactive lesion.…”

“…Involvement of the coronoid process is exceedingly rare, and, to our knowledge, there are only 62 histologically proven cases in the English medical literature [4]. A few other cases have been reported in the base of the skull, zygomatic arch, and maxillary sinus [3].…”

“…The most common location is the metaphyseal region of long bones, which develop through endochondral ossification [3]. The facial bones are rarely affected, because they develop through intramembranous ossification [2][3][4]. When osteochondromas occur in the maxillofacial region, they usually affect the condyle.…”

“…It accounts for 10-20% of all bone tumors [1,2]. The most common location is the metaphyseal region of long bones, which develop through endochondral ossification [3]. The facial bones are rarely affected, because they develop through intramembranous ossification [2][3][4].…”

“…Unilateral involvement (75%) is more common compared with bilateral involvement (25%) [3,4]. Treatment is usually surgical, with a preferred intraoral approach [2].…”