A 33-year-old male patient presented with a parasymphyseal mandibular basal region tumor on the right side for several years of evolution and slow growth.
His medical history included tuberous sclerosis and kidney transplantation after nephrectomy for renal angiomyolipoma.
She presented as symptoms of the disease the sebaceous adenoma of Pringle at the nasogenian level, hamartoma pigmentosa in the posterior fundus and fibrotic lesions at the cervical level.
Clinical examination revealed a hard lesion attached to the jaw, of approximately 2x2 cm in size, with mild pain at diameter.
In the skin of the lateral cervical region and in the neck, multiple small excrescent lesions of dark color and fibrotic appearance were observed.
The intraoral examination showed gingival hyperplasia that was discovered to the chronic anticonvulsant treatment with hydantoin to avoid the epileptic seizures typical of his baseline syndrome and that the patient had suffered from previous illness.
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Panoramic radiography showed an increase in bone density at the mandibular level in the parasymphyseal region, and CT showed a syndromic bone excrescence and a erosion of the right cortical bone at the blast level.
Radiographic differential diagnosis included: ameloblastoma, odontogenic myxoma, aneurysmal cyst, chondromyxoid fibroma, central hemangioma or eosinophilic granuloma.
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Under general anesthesia and using a cutaneous approach, the resection of the hard rounded lesion with a margin of safety in the mandible was performed.
In addition, cervical fibromas were excised during the same surgical procedure using CO2 laser.
The day after surgery the patient was discharged.
It was subsequently reviewed in outpatient clinics without presenting to date any signs or symptoms of recurrence of mandibular lesion for three years.
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The anatomopathological study of the resected mandibular bone lesion reported that it was a lesion formed by a small number and a stroma of hyalinized collagen.
Bone spicules were observed inside the bone without osteoid rib cage suggestive of bone voiding.
The lesion had spindle cells with elongated and uniform nuclei with scarce mitosis and no atypia, which gave them characteristics of benignity.
The study concluded that it was a demoplastic fibroma.
