case_images: PMC10629850_01
case_images: a CT of the facial region with the bone window. b CT of the facial region with the soft tissue window. c MRI facial region showing enhancement. d MRI facial T2 with fat suppression. e PET scan with FDG uptake. MRI, magnetic resonance imaging; PET, positron emission tomography.
case_images: cro-2023-0016-0001-532014_F01.jpg
case_images: PMC10629850_01_cro-2023-0016-0001-532014_F01.jpg
case_images: F1
case_images: The lesion showed disruption of the cortical outline with periosteal elevation and a sublingual soft tissue extension (shown in Fig. 1a, b). Lymph node involvement was also identified inferior to the lesion (shown in Fig. 1c, d). A positron emission tomography scan with FDG update was performed, and the highlighted tumor is shown (shown in Fig. 1e).
case_images: a Bland-looking odontogenic epithelium with peripheral palisading with a spindle-to-pleomorphic "sarcomatous" component. b Benign-looking odontogenic epithelium with peripheral palisading mixed with a predominating malignant mesenchymal component and extensive tumor necrosis. c, d Higher magnification on the malignant mesenchymal component showing marked atypia and mitosis.
case_images: cro-2023-0016-0001-532014_F02.jpg
case_images: PMC10629850_01_cro-2023-0016-0001-532014_F02.jpg
case_images: F2
case_images: Histopathological examination revealed interspersed islands of benign odontogenic epithelium with peripheral palisading in a background of hypercellular spindle to pleomorphic "sarcomatous" component (shown in Fig. 2a). The pleomorphic sarcomatous component was predominating with necrosis (shown in Fig. 2b). Higher power magnification showed nuclear pleomorphism and hyperchromasia with abundant mitosis (shown in Fig. 2c, d).
case_images: A timeline schematic illustrating the patient's presentation, primarily with a left mandible swelling, which showed in radiology as a 6.5 cm mass, with soft tissue and lymph node involvement. On histopathology, the tumor showed benign odontogenic epithelium with a pleomorphic sarcomatous component. NGS was performed to check for genetic mutations.
case_images: cro-2023-0016-0001-532014_F03.jpg
case_images: PMC10629850_01_cro-2023-0016-0001-532014_F03.jpg
case_images: F3
case_images: Patient's schematic timeline is summarized in Figure 3.