case_images: PMC11057601_01
case_images: (a) Image showing extraoral swelling of right side of the face (b) Intraoral features showing obliterated buccal vestibule with restricted mouth opening and dental caries in relation to 75,85
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case_images: The extraoral examination revealed facial asymmetry due to a diffuse swelling over the right side lower half of the face extending superiorly 3 cm below the lower eyelid, inferiorly 2 cm below the body of the mandible, medially to the lateral border of the nose, and laterally to the angle of the mandible [Figure 1a]. The right buccal vestibule was partly obliterated due to swelling, and there was no evidence of pus discharge noted [Figure 1b].
case_images: Orthopantomogram showing hazy moth-eaten appearance in body, ramus right subcondylar region
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case_images: The lower border of the mandible was discontinuous irt 85, 46 regions, and evidence of root resorption was seen in relation to 85 [Figure 2].
case_images: Computed tomography showing ill-defined osteolytic lesion with bony destruction
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case_images: Based on clinical and radiographic findings, a provisional diagnosis of osteomyelitis of right hemi-mandible with bony destruction was given [Figure 3].
case_images: Histopathology of incisional biopsy specimen:hematoxylin and eosin stained tissue section showing fibrocellular connective tissue stroma with numerous blood capillaries and inflammatory cells, osteoid lined by osteoblasts
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case_images: So, a diagnosis of chronic inflammation with respect to the received biopsy specimen was given [Figure 4].
case_images: Excisional biopsy showing hemi-mandibulectomy specimen of right mandible
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case_images: The ramus seems to be resorbed extensively, whereas the condylar head and coronoid process were submitted as separated bits, as there has been a pathological fracture due to osteolysis [Figure 5].
case_images: Histopathology of excisional biopsy specimen, showing decalcified bone with osteocytes within lacunae, bone resorption with scalloped margins, multinucleated giant cells adjacent to resorption areas
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case_images: Most of the marrow spaces show numerous blood vessels of varying sizes within a delicate connective tissue stroma along with inflammatory cells like lymphocytes, plasma cells, and acute inflammatory cells especially neutrophils and eosinophils [Figure 6].
case_images: Immunohistochemistry analysis for S 100 and CD1a (negative)
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