BENIGN OSTEOBLASTOMA ASSOCIATED WITH AN ANEURYSMAL BONE-CYST OF THE MANDIBULAR RAMUS AND CONDYLE

This article reviews the clinical behavior, the histologic conditions, and the treatment of a benign osteoblastoma associated with an aneury smal bone cyst of the mandibular condyle and ramus. A 14-year-old boy, otherwise healthy, was referred for pain and enlargement in his right temporomandibular joint-cheek region. The swelling was firm and tende r, a slight facial asymmetry was present, and the mouth-opening capaci ty was reduced. During a 6-weeks period from the primary examination t o surgery the lesion expanded extensively, anesthesia appeared in the right inferior alveolar nerve and a lateral open bite developed on the affected side. Computed tomography displayed a total destruction of t he right mandibular condyle and ramus to the level of the mandibular f oramen. The lesion was radiolucent without distinct borders to adjacen t bone. Surgery revealed a bluish, well-vascularized predominantly cys tic tumor. The lesion included the temporomandibular joint disk but wi thout overgrowth to the temporal component. After resection of the les ion, the condyle and the mandibular ramus was reconstructed with the u se of an autogenous costochondral graft. The postoperative healing was uncomplicated. At follow-up 2 years after surgery the boy was free of recurrance with normal motor and sensory nerve function.