A Rare Case of Peripheral Exophytic Osteoma of the Mandible Arising From an Extraction Site: Cone-Beam Computed Tomography (CBCT) Findings

Abstract

A benign osteogenic tumor made up of mature, well-differentiated bone tissue is called an osteoma. Jaw solitary peripheral osteomas are an uncommon occurrence. The mandible is affected more frequently than the maxilla, and the lingual side of the body, the angle, and the inferior border of the jaw are the sites of highest preference. Males are more likely than females to be impacted by osteomas, which can strike at any age. Patients with osteomas should be considered to have Gardner syndrome. This condition includes many embedded or supernumerary teeth, skeletal abnormalities such as osteoma and hyper calcification of the maxillary bones or skull, skin and soft tissue tumors, and gastroenteric polypus. Differential diagnosis is crucial since the development of gastroenteric polyps, which have a potentially malignant progression, occurs before oral and maxillofacial symptoms emerge. Mandibular osteomas are uncommon; even rarer is a massive osteoma with a prevalence of 0.01-0.04% of the population. That's the reason this is being discussed in this article. The primary differential diagnosis and pertinent clinical information from previously published literature are also included in this article.

Keywords: exophytic growths; gardner's syndrome; histopathological diagnoses; mandibular osteoma; osteogenic tumor; peripheral osteoma; radiographic findings; rare benign tumor.

Figure 1. A diffuse, oval swelling in the right retromolar region of size 2 x 1 cm approximately, with an elevated surface. The overlying mucosa over the swelling seems intact and the color is the same as that of the adjacent mucosa

Figure 2. CBCT findings of the bony growth seen in the right retromolar region

A: coronal view of the bony growth in the retromolar region; B: sagittal view of the bony growth in the retromolar region; C: axial view of the bony growth in the retromolar region; D: 3D reconstruction of the bony growth in the retromolar region CBCT: cone beam computed tomography

Figure 3. Sagittal view of CBCT revealing severe alveolar bone resorption and periapical rarefaction with 46, 47

CBCT: cone beam computed tomography

Figure 4. Exposed bony growth in the right retromolar region after raising the mucoperiosteal flap

Figure 5. Removed specimen of the bony growth directed for histopathological investigations

Figure 6. Under low power, histopathological examination of the lesional tissue shows matured osseous tissue without osteoblastic riming. The surrounding connective tissue is composed of fibrofatty tissue

A: matured lamellar bone; B: fibro-fatty connective tissue