Not All Primary Osteolytic Mandibular Swelling Is Malignant.

ABSTRACT

Tubercular infection of the oral tissues can be primary or secondary. Primary lesions develop when tuberculosis bacilli are directly inoculated into the oral tissues of a person who has not acquired immunity to the disease. Here we present a case of 66yrs old non-smoker male presenting with a swelling in the left mandibular region (Lumpy jaw) over a period of last 1yr now presenting with weight loss, pain and trismus for 6month. No past history of tuberculosis or dental extraction. On examination there was a 6x5cm firm to hard nonfluctuant mildly tender swelling with trismus and no palpable cervical lymph nodes. Investigations revealed leucocytosis, ESR 45mm and Mantoux 24mm after 48hrs.PNG radiograph showed osteolytic lesion in angle & body of left mandible with CECT showing retro mandibular trigon extension. USG guided FNAC was consistent with tubercular osteomyelitis with Ziehl Neelsen stain positive for acid fast bacilli. He was started on antitubercular therapy for 9 month showing reduction in size and symptom.