Giant Osteoma of the Mandible: Report of a Rare Case with Review of Literature

Abstract

Osteoma is a slow growing, asymptomatic, benign bony tumor composed of compact and cancellous bones. Central, peripheral, and extra skeletal osteomas are the three types based on the site of origin. They are mostly observed on routine radiographic screening, mostly in the paranasal sinuses. Gnathic involvement is an uncommon occurrence, and if present, mandibular involvement is more frequently seen. Mostly, osteomas are small asymptomatic lesions and very rarely they become symptomatic and acquire larger size. Multiple osteomas are a feature of Gardner's syndrome; however, solitary osteomas are non-syndromic. Oral health professional may be the first to diagnose Gardner's syndrome as the osteomas may be initial manifestation of the disorder. Treatment protocol of osteomas varies based on the associated signs and symptoms. Small, asymptomatic cases are treated conservatively by periodic clinical and radiographic evaluation. However, larger, symptomatic lesions require surgical intervention. Herby, reporting an unusual case of Giant peripheral osteoma of the mandible. Our case is unique in few aspects because of its unusually large size (5 × 4 cm) and involvement of lingual aspect of the mandible in the region of sublingual fossa, with compression of the floor of mouth.

Keywords: Gardner’s syndrome; Giant osteoma; Mandible; Osteoma.

Fig. 1

a Extraoral swelling in the submental region. b, c Intraoral extent of the swelling in the floor of mouth

Fig. 2

Mandibular cross-sectional occlusal radiograph, lateral oblique & OPG depicts a well-defined homogeneous radiopaque mass in the right mandibular body

Fig. 3

Axial and coronal CT shows the extent of homogeneous radiopaque mass

Fig. 4

a Macroscopic resected specimen. b Osteomatous element seen beneath the surface epithelium with interspersed thin fibrous layer in between. H&E 100 × (c)