Clinical and Radiographic Findings

This patient had initially presented to his dentist with pain involving tooth #30 which was subsequently extracted. The extraction site remained swollen for almost four months post-extraction (Figure 1). During this time, in the lower spine there was detected a lytic lesion which initially did not seem to be related to the swollen right posterior mandible, the site of an earlier extraction site. The swollen right posterior mandible appeared mostly radiopaque on the panoramic radiograph (Figure 2). Tooth #31 was mobile and therefore was extracted along with incisional biopsy of the surrounding tissue, which was submitted for microscopic evaluation.

Figure 1 This is a clinical photograph at first visit to the Oral & Maxillofacial Surgeon demonstrating buccal swelling involving the vestibule in the right posterior mandible.

Figure 2 This is the panoramic radiograph taken at first visit to the oral & Maxillofacial Surgeon demonstrating diffuse radiopaque lesion interspersed with some radiolucency.