EURORAD ESR

Case 10455

Desmoplastic fibroma of the mandible

Author(s)
Laura Serrano Velasco, Aida Ramos Alcalá, Isabel Pena Fernández, Lourdes Martínez Encarnación and Juan Jose de Haro.

H.G.U. Santa Lucía,
Radiologia; C/Ingeniero Cerón,
nº 12 30840 alhama de Murcia, Spain;
Email:laurasevel@hotmail.com
 
Patient
male, 15 year(s)
 
 
  • Figure 1
    Orthopantomography

    Orthopantomography shows a lytic lesion with cortical bone destruction in the left mandibular ramus.

     
    Area of Interest: Head and neck; Imaging Technique: Digital radiography; Procedure: Education; Special Focus: Neoplasia;
     
     
  • Figure 2
    Axial CT.

    Axial CT shows a soft tissue mass destroying the left mandibular ramus.

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Education; Special Focus: Neoplasia;
     
     
  • Figure 3
    Axial TSET1 MRI.

    Axial TSET1 MRI shows a large and hypointense soft tissue mass with well-defined contours invading the left mandibular ramus. There is no fat plane separating the parotid gland or pterygoid muscle.

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Education; Special Focus: Neoplasia;
     
     
  • Figure 4
    Axial TSET2 MRI

    Same mass showing mild heterogenous and high signal intensity in TSET2 sequences.

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Education; Special Focus: Neoplasia;
     
     
  • Figure 5
    Coronal STIR MRI.

    Coronal STIR MRI shows a hyperintense mass in masticator space that destroys the left mandibular ramus. The temporomandibular joint is affected.

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Education; Special Focus: Neoplasia;
     
     
  • Figure 6
    Axial diffusion MRI

    Axial diffusion shows a hyperintense lesion.

     
    Area of Interest: Head and neck; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Education; Special Focus: Neoplasia;
     
     
  • Figure 7
    CDA Map.

    CDA Map shows iso-hypointense homogeneous lesion that indicates moderate cellularity.

     
    Area of Interest: Head and neck; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Education; Special Focus: Neoplasia;
     
     
  • Figure 8
    Axial vibe T1 with contrast.

    Contrast-enhanced image shows a intense and homogeneous enhancement of the lesion.

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Education; Special Focus: Neoplasia;
     
     
  • Figure 9
    Coronal TSET1 with contrast.

    Same mass showing intense and homogeneous enhancement.

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Education; Special Focus: Neoplasia;
     
     
  • Figure 10
    Intraoperative image.

    Intraoperative image where we see the mass after dissection of skin and cellular subcutaneous tissue.

     
    Area of Interest: Head and neck; Imaging Technique: Experimental; Procedure: Education; Special Focus: Neoplasia;
     
     
  • Figure 11
    Macroscopic surgical specimen.

    Resected lesion.

     
    Area of Interest: Head and neck; Imaging Technique: Experimental; Procedure: Education; Special Focus: Neoplasia;
     
     
  • Figure 12
    Post-operative VR CT.

    VR CT shows surgical reconstruction of the jaw once the lesion was removed.

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Education; Special Focus: Neoplasia;
     
     
Orthopantomography shows a lytic lesion with cortical bone destruction in the left mandibular ramus.
 
Axial CT shows a soft tissue mass destroying the left mandibular ramus.
 
Axial TSET1 MRI shows a large and hypointense soft tissue mass with well-defined contours invading the left mandibular ramus. There is no fat plane separating the parotid gland or pterygoid muscle.
 
Same mass showing mild heterogenous and high signal intensity in TSET2 sequences.
 
Coronal STIR MRI shows a hyperintense mass in masticator space that destroys the left mandibular ramus. The temporomandibular joint is affected.
 
Axial diffusion shows a hyperintense lesion.
 
CDA Map shows iso-hypointense homogeneous lesion that indicates moderate cellularity.
 
Contrast-enhanced image shows a intense and homogeneous enhancement of the lesion.
 
Same mass showing intense and homogeneous enhancement.
 
Intraoperative image where we see the mass after dissection of skin and cellular subcutaneous tissue.
 
Resected lesion.
 
VR CT shows surgical reconstruction of the jaw once the lesion was removed.
 
 
 
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