■与牙源性病变相比,下颌骨的非牙源性骨性病变是相对罕见的实体。虽然后下颌骨不是一个常见的部位,这些骨性病变也不罕见,使诊断模棱两可,如果误诊导致不同的治疗方案。
方法:一名43岁的女性,表现为下颌骨后部硬组织病变,由于症状重叠,在另外两个中心被误诊为颌下腺的唾液腺结石,解剖复杂性,和不充分的调查。该病变后来被诊断为下颌骨后部骨瘤,并进行了进一步的检查,手术切除.组织病理学证实了诊断。
■已知各种硬组织病变发生在后下颌骨中,如颌下唾液石,骨瘤,下颌下钙化淋巴结,Phlebolith,和扁桃体。然而,由于该地区的结构复杂性,硬组织病变的定位可能并不总是直截了当的,即使有射线照片.此外,在有矛盾症状的情况下,在这种情况下,误诊的可能性更大。这种诊断挑战的原因是通过对下颌后部骨性病变的放射学检查来考虑的。还建议进行适当的调查,从而处理这些下颌后部骨性病变。
结论:这些下颌骨后部病变的误诊可能导致患者接受不必要的外科手术,因为不同的病变需要不同的处理。需要鉴别诊断和适当的调查方案。
UNASSIGNED: Non-odontogenic osseous lesions of the mandible are relatively uncommon entities compared to odontogenic lesions. Although the posterior mandible is not a usual site, it is not rare either for these osseous lesions, making the diagnosis ambiguous, and if misdiagnosed leading to different treatment protocols.
METHODS: A 43-year-old female presented with a hard tissue lesion of the posterior mandible, misdiagnosed as a sialolith of the submandibular salivary gland in two other centers due to overlapping of symptoms, anatomic complexity, and inadequate investigations. The lesion was later diagnosed to be an osteoma of the posterior mandible with added investigations, and surgically excised. Histopathology confirmed the diagnosis.
UNASSIGNED: A variety of hard tissue lesions are known to occur in the posterior mandible like Submandibular sialolith, Osteomas, Calcified Submandibular lymph nodes, Phlebolith, and Tonsillolith. However, due to the region\'s structural complexity, localization of a hard tissue lesion may not always be forthright, even with radiographs. Moreover, in cases with conflicting symptoms, as was in this
case there are more chances of misdiagnosis. The reasons for such diagnostic challenges are deliberated with radiological review of posterior mandibular osseous lesions. Recommendations are also suggested for proper investigations, thereby management of these posterior mandibular osseous lesions.
CONCLUSIONS: Misdiagnosis of these posterior mandibular lesions may lead to the patient undergoing unnecessary surgical procedures as different lesions require different management. Differential diagnosis and adequate protocol for investigations are required.