Unusual mandibular condylar pathology: Aneurysmal bone cyst, a case report and review on reconstruction

Kar, Indu Bhusan; Mishra, Niranjan; Ukey, Rahul B; Chopda, Prashant

doi:10.4103/0975-5950.168221

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…ABC accounts for 1.5% of the nonodontogenic, nonepithelial cysts of the mandible [8]. It is found more frequently in the mandible than the maxilla (3:1) with preponderance for the body, ramus and angle of the mandible [11] and rarely affects the condyles [13,14].…”

Section: Discussionmentioning

confidence: 99%

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Recurrence of Aneurysmal Bone Cyst of the Mandible: A Case Report

Hristamyan¹,

Tsolov²

2021

JofIMAB

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Аneurysmal bone cysts are benign osteolytic lesions with rapid growth, thin walls containing numerous blood-filled cavities. They occur mainly in the pediatric population but are rarely diagnosed in the facial skeleton. Although benign, the condition can be locally aggressive and cause significant weakening of the affected bone structure. This case report presents a 14-year-old boy with Burkitt's tumor (Non-Hodgkin's lymphoma), previously diagnosed with an aneurysmal bone cyst a year ago. He was admitted for treatment at the Clinic of Maxillo-Facial Surgery of the University Hospital "St. George" Plovdiv due to pain and swelling in the left molar area of the mandibula, dating from 2 days. A recurrence of an aneurysmal bone cyst measuring 55/25 mm, which does not require resection of the mandible, was found. After a decision for surgical removal of the formation, under general anesthesia, and preparation of a three-cornered mucoperiosteal flap, the mandibular bone, which is lysed and thinned by the formation, was trepanned. The roots of the affected teeth were resected, and the formation was extirpated. A gauze drain was placed in the formed cavity, and the wound was sutured. Drug therapy included Cefotaxime 2x1.0 - 10 days, starting 3 days before surgery, and Paracetamol 2x1 – 3 days, 2 days before and 1 day after surgery. Prophylactic examinations were scheduled on day 3, 7, 10, 15 after the operation, as well as 3, 6, and 12 months post-op, due to the recurrent nature of the formation.

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Section: Discussionmentioning

confidence: 99%

“…ABCs have been classified as primary and secondary, where primary may be divided into congenital or acquired types [3]. Histopathologically, the vascular variant is more common and consists of about 95% of total cases of ABC, while the solid type is rare, occurring in only 5-8% of cases [7,13].…”

Section: Discussionmentioning

confidence: 99%

Recurrence of Aneurysmal Bone Cyst of the Mandible: A Case Report

Hristamyan¹,

Tsolov²

2021

JofIMAB

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“…An aneurysmal bone cyst (ABC) is an expansive osteolytic lesion consisting of blood-filled spaces and channels divided by connective tissue septa that contain osteoid-like tissue [ 13 ]. An ABC usually either presents asymptomatic or with acute onset of expansion and localized pain [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…An ABC usually either presents asymptomatic or with acute onset of expansion and localized pain [ 3 ]. In the current literature, this rare condition has been reported in the mandibular condyle less than twenty times [ 13 ]. An association between an ABC and fibrous dysplasia has been reported, wherein the exact relation remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Custom Made Replacement of the Mandibular Condyle in a Case of Fibrous Dysplasia with Cystic Degeneration; A Case Report

2016

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This paper describes a rare case of fibrous dysplasia with cystic degeneration in the mandibular condyle. Diagnostic and therapeutic considerations are discussed. A 40-year old woman presented with pain near the region of her right ear. Physical and radiographic examination showed no abnormalities besides the presence of a mixed radiopaque/radiolucent expansive lesion of the right condyle. Pathologic examination showed high bone-turnover with bone formation. Bone scintigraphy showed a monostotic active fibrous lesion in the right part of the mandible. Bisphosphonate treatment did not sufficiently treat the patient’s symptoms and physiotherapy to treat craniomandibular dysfunction as a factor in the pain was also unsuccessful. The patient later developed an acute external otitis due to a narrowed outer ear canal and had to be admitted to the hospital for treatment with intravenous antibiotics. Approximately two years after first presentation, resection of the affected bone (condylectomy) and reconstruction with a custom total joint prosthesis was indicated due to repeated functional deficits with considerable morbidity. Pathologic examination of the resected mandibular condyle showed increased bone formation including formation of neocortex and some cystic formation. This was diagnosed as fibrous dysplasia with cystic degeneration. Approximately two years after surgery, the patient functioned well.

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“…The need to reconstruct the condylar process of the mandible in a child or an adolescent is rare and in the literature especially described in the cases of ankylosis of the temporomandibular joint (TMJ) [1][2][3][4]. The destruction of the whole condylar process by a solid or an aneurysmatic bone cyst is even a rarity [5][6][7]. Solitary bone cysts are benign fluid-filled tumor-like bone lesions and more than 90% are located in the long bones, most commonly in the proximal humerus and femur [8].…”

Section: Introductionmentioning

confidence: 99%

Mandibular ascending branch and condyle reconstruction in adolescence by a costochondral rib graft with an observation period over 8 years

Scheller

Reich

et al. 2019

J Oral Med Oral Surg

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Introduction: The need to resect and reconstruct the condylar process of the mandible in a teenager is rare. Reconstruction strategy must be accurately assessed in terms of donor side morbidity, postoperative risks (ankylosis) and the possibility of sufficient development in a growing patient. Observation: A 14-year-old boy presented with the radiographic finding of a large cystic lesion of the right condylar process. There were no clinical symptoms as pain, a limitation of mouth opening or malocclusion. Pathohistological examination confirmed a solitary bony cyst. The resected ascending jaw and condylar process was reconstructed by a costochondral rib graft. Commentaries: Over 8 years the development of the reconstructed ascending jaw and condyle was observed. There was an undisturbed growth. The cartilaginous part of the costochondral graft remodeled to a sufficient condylar process without ankylosis, resorption or overgrowth. Conclusion: The reconstruction of the growing mandible and condylar process in an adolescent is a challenge. Observation over 8 years showed a sufficient reconstruction. Intraoperative the chondral portion of the graft has to be handled carefully to avoid a separating from the bony part. The growth potential of the costochondral rib transplant allows a functional reconstruction without substantial donor side morbidity in adolescent patients.

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Unusual mandibular condylar pathology: Aneurysmal bone cyst, a case report and review on reconstruction

Cited by 7 publications

References 9 publications

Recurrence of Aneurysmal Bone Cyst of the Mandible: A Case Report

Recurrence of Aneurysmal Bone Cyst of the Mandible: A Case Report

Custom Made Replacement of the Mandibular Condyle in a Case of Fibrous Dysplasia with Cystic Degeneration; A Case Report

Mandibular ascending branch and condyle reconstruction in adolescence by a costochondral rib graft with an observation period over 8 years

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