Case 40-2005 -- An 18-Year-Old Man with a One-Month History of Nontender Left Mandibular Swelling

doi:10.1056/NEJMcpc059034

Volume 353:2798-2805		December 29, 2005		Number 26

Case 40-2005 — An 18-Year-Old Man with a One-Month History of Nontender Left Mandibular Swelling

Meredith August, M.D., D.M.D., Paul A. Caruso, M.D., and William C. Faquin, M.D., Ph.D.

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Presentation of Case

An 18-year-old man was referred by his dentist to the oral andmaxillofacial surgery clinic of this hospital because of leftmandibular swelling.

One month earlier, the patient first noticed gradual left mandibularenlargement without pain, fever, malocclusion, sensory changes,or trismus. There was no history of trauma or recent dentalwork. He had no illnesses or allergies, took no medications,did not use tobacco or alcohol, and reported no first-degreerelatives with cancer.

On physical examination, there was obvious facial asymmetry,with the left side of the jaw larger than the right (Figure 1A).A firm, nontender . . . [Full Text of this Article]

Differential Diagnosis

Odontogenic Cysts and Neoplasms

Nonodontogenic Tumors

Dr. Meredith August's Diagnosis

Pathological Discussion

Discussion of Management

Anatomical Diagnosis

Source Information

From the Department of Oral and Maxillofacial Surgery (M.A.) and the Department of Pathology (W.C.F.), Massachusetts General Hospital; the Department of Radiology , Massachusetts Eye and Ear Infirmary (P.A.C.); and the Departments of Oral and Maxillofacial Surgery (M.A.), Radiology (P.A.C.), and Pathology (W.C.F.), Harvard Medical School — all in Boston.