On 5th Of October 1999, a 45 year old female patient
Chandra came to our hospital with a chief complaint of painless swelling on right
mandibular region with accompanied respiratory distress on bending her neck down. History
revealed that the lesion started as a nodule in canine region and progressively increased
over past 2 years to attain its enormous size.
Past Medical history revealed that patient was a known diabetic under medication.
Extraoral
examination revealed a large swelling extending anteriorly across the midline till the
opposite side corner of the mouth and posteriorly till anterior border of the
sternocleidomastoid muscle, superiorly from lobule of right ear extending 1.5cm across the
midline and inferiorly 1cm above the superior border of the clavicle. I/O
examination revealed marked buccal and lingual cortical expansion.
Radiographs taken were OPG, PA Skull, True Lateral and Computerised tomographic scan. They
revealed a massive RL-RO lesion eroding the lower border of the mandible. CT scan ravealed
the exact size of the lesion as 28X18 cms with no displacement of adjacent structures.
Photomicrographs showed sheets of polyhedral epithelial cells and hyaline material..
Correlating clinical, histopathological and radiological features
we came to a final diagnosis of Calcifying epithelial odontogenic tumor ( Pindborg's
tumour)
Surgery performed was hemimandiblectomy with tumour excision and reconstruction was
carried out with reconstruction plate and soft tissues were reconstructed with
deltopectoral flap.
