Concomitant cemento-osseous dysplasia and aneurysmal bone cyst of the mandible: a rare case report with literature revie
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CASE REPORT
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Concomitant cemento-osseous dysplasia and aneurysmal bone cyst of the mandible: a rare case report with literature review Han-Gyeol Yeom1 and Jung-Hoon Yoon2*
Abstract Background: Concomitant cemento-osseous dysplasia (COD) and aneurysmal bone cyst (ABC) are rare in the head and neck region. In our search of the English language literature, we found only one case report describing the simultaneous occurrence of COD and ABC in the head and neck region. Here, we report a case of COD associated with ABC. Further, we performed a systematic search of the literature to identify studies on patients with COD associated with nonepithelial lined cysts of the jaws. Case presentation: The patient was a 32-year-old woman who was referred from a private dental clinic because of a cystic lesion below the mandibular right first molar. She had no pain or significant systemic disease. After performing panoramic radiography and cone-beam computed tomography, the imaging diagnosis was COD with a cystic lesion, such as ABC or solitary bone cyst. Excisional biopsy was performed, which revealed concomitant COD and ABC. Conclusion: This case of ABC associated with COD provides insight for the diagnostic process of radiographically mixed lesions with cystic changes. Keywords: Aneurysmal bone cyst, Fibro-osseous lesions, Cemento-osseous dysplasia
Background Cemento-osseous dysplasia (COD) is a fibro-osseous lesion occurring in the tooth-bearing area of the jaws [1–3]. The etiology and pathogenesis are unknown, but it is thought to arise from the periodontal ligament because of the proximity of the lesions to the teeth and the formation of cementum-like calcifications [1, 3]. The lesions usually are asymptomatic, so COD is discovered in routine panoramic radiographs, and in most cases, no treatment is necessary [4]. Disease progression can be divided into three stages: osteolytic, mixed, and matured osteogenic [5]. Histopathologically, all forms of COD have a similar appearance; the lesion is not surrounded by a capsule, and * Correspondence: [email protected] 2 Department of Oral and Maxillofacial Pathology, Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, South Korea Full list of author information is available at the end of the article
the early osteolytic stage consists of fibrotic tissue rich in cells and vessels, with a little cementum-like deposits [3, 6]. As the maturation progresses over time, cementumlike calcifications and irregular trabeculae appear. In the final osteosclerotic stage, these structures connect to each other, and few cellular elements are visible [6]. The aneurysmal bone cyst (ABC) is a benign, osteolytic, rapidly growing, expansile lesion of the bone, which predominantly occurs in the metaphysis of long bones, such as the femur, tibia, and spine [7, 8]. Its occurrence in the jaws is uncommon [7]. Radiographically, ABCs are characterized by ballooned cortical expansion from unilocular to multilocular radiolucent lesions [8]. Histopathologically, ABCs are cha
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