case_images: PMC5899802_01
case_images: (A) Panoramic radiography showing a well-defined unilocular radiolucent area in the right posterior portion of the mandible near to the angle and in close contact to the inferior border. (B-F) Coronal CT views demonstrating the bone concavity affecting the lingual and inferior aspects of the mandible.
case_images: jced-10-e88-g001.jpg
case_images: PMC5899802_01_jced-10-e88-g001.jpg
case_images: F1
case_images: The panoramic radiography of the patient revealed a well-defined unilocular image with sclerotic borders at the posterior body of the mandible, below the mandibular canal (Fig. 1A). SBD and help to exclude a possible metastatic lesion to the mandible, a bone window CT scan was requested (Fig. 1B-F). Sections of the exam revealed the presence of a round-shaped, hypodense and well-delimited concavity at the lingual aspect of the mandibular cortical bone with 8,7mm in its greater diameter (Fig. 2A).
case_images: (A) Axial CT view showing the lingual bone depression. (B) Multiple bone metastases evidenced by F-18 radionuclide (dark areas) in a total body bone scintigraphy. (C-D) Detail, showing the lack of hyperconcentration in the correspondent right posterior mandibular area of frontal and lateral cranium views.
case_images: jced-10-e88-g002.jpg
case_images: PMC5899802_01_jced-10-e88-g002.jpg
case_images: F2
case_images: SBD and help to exclude a possible metastatic lesion to the mandible, a bone window CT scan was requested (Fig. 1B-F). Sections of the exam revealed the presence of a round-shaped, hypodense and well-delimited concavity at the lingual aspect of the mandibular cortical bone with 8,7mm in its greater diameter (Fig. 2A). Total body skeletal radionuclide imaging with [18F] sodium fluoride (F-18), which was conducted for bone disease screening, revealed numerous osseous metastases in the skull base portion of the sphenoid bone, all segments of vertebral spine, sternum, bilateral ribs, scapulae, right humerus, pelvis and bilateral femurs, including the left femoral neck (Fig. 2B). However, no hyperconcentration of the radiopharmaceutical was evidenced in the jawbones including the mandibular defect (Fig. 2C-D).