Monostostic fibrous dysplasia with nonspecific cystic degeneration: A case report and review of literature
A 40-year-old female patient reported to our college, with a chief complaint of swelling in the lower right and left posterior teeth region since 6 years. The swelling was asymptomatic. Her medical history was noncontributory. Extraoral examination revealed a swelling on the right posterior region of the mandible. The swelling extended anteroposteriorly 1.0 cm from the commissure to 4.0 cm in front of the angle of the mandible and superoinferiorly 1.0 cm above the lower border of the mandible to 0.5 cm from the commissural line and measured 4.0 × 3.0 cm in dimension. It was ill-defined, hard, and nontender; with overlying normal skin []. Intraorally, the swelling extended from the mesial aspect of 44 to the distal aspect of 47 with slight obliteration of the buccal vestibule. The lingual cortex showed slight expansion. The overlying mucosa was stretched but intact.\nExtraoral examination revealed a diffuse swelling on the left lower border of the mandible extending 2.0 cm behind the angle of the mouth to 5.0 cm from the angle of the mandible and measured 3.0 × 2.0 cm in dimension, was hard and nontender with overlying normal skin []. Intraorally, the swelling extended from mesial aspect of 34 to distal aspect of 37 with no obliteration of the buccal vestibule. The overlying mucosa was normal. Submandibular lymph nodes were palpable on both sides, solitary, mobile, and nontender.\nThe orthopantomograph showed a well-defined multilocular radiolucency with specks of radiopacity in the right and left posterior mandible. Radiolucency extended from 43 region to the ramus of the mandible on right side and from 34 to 37 region on the left side of the mandible, 36 was missing. The lower border of the mandible was intact [].\nOcclusal radiograph showed expansion of the buccal and lingual cortices on both right and left side of the mandible. Ground glass appearance of the mandible was visible []. Computed tomography (CT) scan revealed well-defined lytic lesion with radiopacities involving right and left posterior mandible region with buccal and lingual cortical expansion [].\nRoutine blood and urine investigations along with serum examination for alkaline phosphatase activity and calcium profile were performed and the values were within normal limits.\nUnder general anesthesia, a degloving incision was placed on the right side and the lesion was surgically recontoured. The lesional tissue did not separate out from the bone easily. The same procedure was followed on the left side and cystic cavities were seen which were empty [] and the lesion did not separate out easily. Hemostasis was achieved, betadine wash given, and primary closure was achieved. Specimens were submitted for histopathological examination with a clinical diagnosis of fibro-osseous lesion. Patient was kept under postoperative observation and recovered without any postsurgical complications. The healing was uneventful.