Surgical management of mandibular cherubism in an adolescent: integration of virtual surgical planning.

Cherubism, also known as familial fibrodysplasia of the jaw, is an autosomal dominant disorder with variable penetrance. The disease process is characterised by painless and progressive bilateral enlargement of the maxillofacial skeleton. We present an adolescent female with a family history of cherubism who presented to the Oral and Maxillofacial Surgery clinic with progressive bilateral swelling of the mandible. The diagnosis of cherubism was established through a thorough history which was confirmed with an incisional biopsy. The progressive swelling negatively affected her appearance and psychosocial well-being. The patient opted for surgical intervention after a course of conservative management. Although there is often resolution of these lesions into adulthood, surgical intervention may be considered when managing this condition in adolescence. Integration with virtual surgical planning can aid in obtaining desired postoperative outcomes.

Synchronous oral squamous cell carcinoma and a lymphoproliferative disorder in an adult: a challenge in diagnosis and management.

Synchronous primary malignancies present challenges in diagnosis, treatment sequencing and management. We present a rare case of a synchronous oral cavity and lymphoproliferative malignancy in a middle-age man. Our patient presented with a primary oral cavity squamous cell carcinoma and was subsequently found to have a secondary lymphoproliferative malignancy (chronic lymphocytic leukaemia/small lymphocytic lymphoma). The challenge of staging and sequencing of treatment is discussed. In addition, this case highlights the importance of multidisciplinary consultation, designing a personalised treatment plan that is coincident with the standard of care for each malignancy, and close follow-up.

Mandibular odontogenic myxoma in a paediatric patient.

Odontogenic myxoma (OM) are benign, locally aggressive tumours that are rarely found in the paediatric maxillofacial region. OMs derive from mesenchymal odontogenic tissue. We describe the management of a 3-year-old girl who presented with a large right-sided mandibular lesion. Her treatment included conservative excision, curettage and peripheral ostectomy. A literature review was performed which calls into question the dogmatic practice of resection with 1 to 1.5 cm margins. Treatment approaches to the OM could potentially be altered in the paediatric patient.

Septic arthritis of the temporomandibular joint in an unvaccinated adolescent.

Septic arthritis of the temporomandibular joint (TMJ) is a rare condition, particularly in the paediatric population. Our case involves a 15-year-old unvaccinated Amish man with acute pain and trismus of the TMJ. The diagnosis was reached after history, clinical examination, radiographic and laboratory examinations were performed. The patient improved after a minimally invasive surgical procedure and medical therapy. Failure to recognise and treat septic arthritis in a timely fashion can result in serious sequalae. Infectious aetiologies should be kept on the differential for any patient with acute TMJ pain.

Cervicofacial actinomycosis of the mandible in a paediatric patient.

Cervicofacial actinomycosis remains a rare pathogenic finding in the paediatric population. Diagnosis is challenging, as findings are often non-specific and Actinomyces species are generally difficult to culture. Treatment is a prolonged course of antibiotics, either intravenous and oral, often combined with a surgical procedure to remove the lesion. This patient had non-specific intermittent left mandibular pain for 8 months that was eventually attributed to an Actinomyces odontolyticus infection in the mandible. Diagnosis required incisional biopsy, and treatment involved 12 months of oral antibiotics.