Case History
A 62-year-old female presented at our department with swelling, pain, and numbness in the left mandible for more than 4 years. The patient had a history of hypertension and diabetes for many years. On clinical examination, the patient had hard, ill-defined, and painful distension at the left mouth angle. The skin in the region was pigmented, the left lower lip and chin skin were mildly numb, and the buccal cavity and shape were not obviously abnormal (Figure 1). An intra-oral examination revealed a nodular, poorly defined, hard, tender, sessile lesion, with texture similar to that of the adjacent mucosa. The nodule (1.5 cm in diameter) was located on the buccal region of the first and second left mandibular premolars (Figure 2). The crowns of the left mandibular first and second premolars were intact, painless, and showed no loosening. No significant enlarged lymph nodes were found in the neck.
Cone-beam computed tomography (CBCT) scans showed an enlarged left mandibular canal and a markedly distended mental foramen (Figure 3). A contrast-enhanced CT scan showed a locally widened left mandibular tube, with locally convex and a slightly enhanced soft tissue density shadow in the corresponding area (Figure 4).