case_images: PMC6699458_01
case_images: Right-sided Pre-auricular swelling.
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case_images: The overlying skin was normal in color (Fig. 1).
case_images: Coronal CT slice demonstrates a well-defined osteolytic lesion in the skull base (A). (B) Focused image shows a heterogeneous nidus contains multiple hyperdense masses with diffused sclerosis of the adjacent bone. (C) The lesion extends posteriorly into the glenoid fossa of the TMJ.
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case_images: A computed tomography (CT) scan revealed a well-defined and circumscribed hypodense lesion measuring 13 x 8.6 mm with multiple hyperdense foci, surrounded by endosteal sclerosis, involving the articular eminence of the TMJ, and extending posteriorly to the mandibular fossa (Fig. 2).
case_images: Micrograph shows irregular trabeculae of osteoid and woven bone lined by a rim of activated osteoblasts within a vascular fibrous stroma. (Hematoxylin and Eosin, 40x).
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case_images: Histological examination demonstrated anastomosing trabeculae of osteoid and woven bone, lined by a rim of benign plumped osteoblasts in a loose fibrovascular stroma, and numerous multi-nucleated giant cells embedded in vascularized, fibrous connective tissue stroma (Fig. 3).
case_images: Follow up CBCT one year postoperatively. (A) Relative hypodensity of the previous surgical site in the center of endosteal sclerosis involving the surrounding bones of the skull base. (B) The residual surgical defect in glenoid fossa.
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case_images: There was also evidence of sclerotic trabeculae having formed at the site of the nidus, along with a caudal cortical thickening (Fig. 4).