Actinomycotic osteomyelitis with proliferative periostitis arising in the mandibular ramus: an unusual case with spontaneous bone regeneration after coronoidectomy.
Actinomycotic osteomyelitis
Malignant bone tumor
Mandible
Proliferative periostitis
Spontaneous bone regeneration
Journal
Oral radiology
ISSN: 1613-9674
Titre abrégé: Oral Radiol
Pays: Japan
ID NLM: 8806621
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
31
05
2020
accepted:
18
06
2020
pubmed:
2
7
2020
medline:
20
4
2021
entrez:
2
7
2020
Statut:
ppublish
Résumé
Actinomycotic osteomyelitis is an aggressive and persistent disease capable of invading and destroying bone, and chronic osteomyelitis with proliferative periostitis represents new bone formation with periosteal reaction. We report a rare case of actinomycotic osteomyelitis with proliferative periostitis arising in the mandibular ramus and spontaneous bone regeneration after coronoidectomy. A 14-year-old girl was referred for swelling in the right parotid-masseteric region and severe trismus. Contrast-enhanced CT revealed that heterogenous enhancement of the right masseter muscle, and a reactive bone formation over the lateral cortex of the right mandibular ramus and osteolysis of the condyle were seen in plain CT. MRI showed that the mandibular ramus was a low-signal intensity and the reactive bone on the ramus was signal intensity similar to muscle on T1-weighted images. The lesion was clinically and radiologically diagnosed as chronic osteomyelitis of the mandibular ramus. However, a biopsy was performed intraorally under general anesthesia to rule out a malignant bone tumor, and pathological examination showed fibrous bone and Actinomyces druses. Finally, the lesion was diagnosed as actinomycotic osteomyelitis with proliferative periostitis. She underwent image-guided intraoral removal of impacted right third molar and reactive proliferative bone on the right mandibular ramus under general anesthesia. To improve trismus, coronoidectomy also was performed. After the discharge, AMPC was administrated intraorally for 7.5 months. Postoperative panoramic radiograph and CT showed the right mandibular angle resorption and coronoid process regeneration. There was no recurrence of mandibular osteomyelitis 7 years after surgery.
Identifiants
pubmed: 32607939
doi: 10.1007/s11282-020-00462-x
pii: 10.1007/s11282-020-00462-x
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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