Left mandible with adamantinoma
Object numberGC.10594
TitleLeft mandible with adamantinoma
DescriptionMandible – Adamantinoma.
From a male aged 42 years. Eighteen years previously many teeth were extracted and he was supplied with a full denture. Soon thereafter he complained of pain in the lower left molar region. The denture was eased, but without relief and the lower denture was discarded. He now noticed a swelling. A local operation was done and a cavity which resulted, was packed weekly for three years. There was no pain but swelling increased, in size and became noticeable from the outside. During the next four years he was submitted to fifteen operations all under general anaesthesia. He then ceased to attend for treatment and when seen five years still later at the Edinburgh Royal Infirmary the swelling had begun to invade the cheek. A tentative diagnosis of adamantinoma was made and confirmed by biopsy. A course of radiotherapy was given. There was considerable pain and more than a year elapsed before healing occurred. Four years later pain recurred in the ascending ramus. Several biopsies were done and eventually residual adamantinomatous tissue was found. Due to severe pain the left half of the mandible was resected, Six months later residual tumour gave rise to a swelling in the temporal region and a further radical operation was done in which the whole of the temporal muscle and part of the masseter muscle were removed en bloc, From this the patient made a good recovery and later a bone graft was inserted said a denture was constructed which he wore with comfort.
The left half of the mandible, including the head, has been resected together with mucous membrane and soft tissue on the upper and outer aspect from the premolar region to a little below the neck. The mucous membrane is irregular and scarred and sear tissue extends into the attachment of the masseter muscle. Two portions have been removed for microsection. That from below the coronoid process where tumour was found in the preoperative biopsy does not reveal the presence of tumour tissue in several sections examined. There is round cell infiltration, scattered foreign body giant cells and considerable osteoclastic and osteoblastic activity in relation to the hone. The anterior portion ten from the site of the old lesion shows much fibrosis, Iymphatic infiltration, degenerate muscle bundles and vessels with well marked intimal fibrosis. A few isolated clumps and strands of epithelial cells typically adamantinomatous are present near the surface of the bone. The appearance is therefore of residual tumour embedded in tissue showing late reaction to irradiation.
Production date 1953
Object nameMandible, left
Object categoryAnatomical, specimen
Dimensions
- container Height: 10 cm
Length: 12 cm
Width: 8.4 cm