[Mandibular osteitis on a periapical granuloma mimicking an osteosarcoma: a case report].

R Ayachi, L Oualha, E Moussaoui, S Soufi, N Douki
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Abstract

Introduction: Osteitis is an inflammatory disease of bone tissue. Its clinical presentation varies according to the site, presence or absence of pus, duration and etiology. It represents one of the endo-periodontal diseases complication. We report the case of a mandibular osteitis having led to confusion with an ostesarcoma.

Observation: A 13-year-old boy was referred to our department for a right low swelling with suspicion of mandible osteosarcoma. The lesion’s evolution was 6 weeks. With the local aggressiveness and the speed evolution, the first diagnosis proposed was a mandibular osteosarcoma. Based on the clinical and radiological data established, the diagnosis of mandibular osteitis on a periapical granuloma was made and the treatment consisted on the causal tooth extraction with curettage of the periapical lesion associated to the prescription of macrolide (ERY®). The clinical follow-up was 6 weeks, a recovery with cessation of clinical signs were noticed.

Discussion: The differential diagnosis facing the clinical context is an osteitis on a periapical inflammatory cyst and especially mandibular osteosarcoma. For the therapy, it’s a 3 components treatment (etiology, medical and surgical) to obtain a recovery.

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[下颌骨炎在根尖周肉芽肿模拟骨肉瘤:1例报告]。
骨炎是一种骨组织炎症性疾病。其临床表现因部位、脓的存在与否、持续时间和病因而异。它是牙周内疾病的并发症之一。我们报告的情况下,下颌骨骨炎导致混淆与骨肉瘤。观察:一名13岁男孩因右下肢肿胀疑似下颌骨骨肉瘤而转介至我科。病变发展为6周。随着局部侵袭性和发展速度的加快,首次提出诊断为下颌骨骨肉瘤。根据已建立的临床和放射学资料,诊断为根尖周围肉芽肿的下颌骨炎,治疗包括拔牙和根尖周围病变刮除,并结合大环内酯(ERY®)处方。临床随访6周,临床症状消失,病情恢复。讨论:面对临床背景的鉴别诊断是骨炎在根尖周围炎性囊肿,特别是下颌骨骨肉瘤。对于治疗,它是一个三部分的治疗(病因,药物和手术)来获得恢复。
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