Osteochondroma of the mandibular coronoid process: Report of two cases

P22-8 Diagnos~ofneopNsm Between 1976 and 1996, 16 cases of oral VX were histopathologically diagnosed. The ages of the patients at biopsy ranged from 26 to 72 years, with a mean age of 51.3 years. The VXs were found mainly in middle aged persons, as 11 cases (68.8%) occurred in the fifth to seventh decades of life. Five patients were male and 11 were female. The known duration of the lesion ranged from one day to eight years from the time the patients had first noticed the lesion. The most common site was the gingiva or alveolar ridge, with nine cases (56.3%) three of which were expanding to the mucobuccal fold, followed by the buccal mucosa (3 cases), the palate and tongue (2 each). 13 patients (81.3%) were asymptomatic, two patients had an uncomfortable feeling on the oral mucosa and one complained of painful ill-fitting of the denture. The diameter of the lesions ranged from 2 to 20 mm in size. 10 lesions were white, 4 were yellowish red and 2 were yellow. It is noteworthy that the appearance of VX is often similar to that of papilloma and there seem few definitive clinical features to distinguish between them. The clinical features and findings of both lesions will be compared for the more accurate differential diagnosis of papillary or granular lesions of the oral mucosa.

229

ing, but with a severe deviation of the mandible to the left during opening. Plain radiographs did not show any abnormal findings. Initial diagnosis of possible internal derangement of the left TMJ was made. However, the patient did not show up at recall. One year later, the patient appeared once again with the same complaint as before. New radiographs including CT scan showed a vague image of a bony structure inside the coronoid process. A bony mass resection was performed through an i n t r a o r a l approach. After surgery, maximal mouth opening increased to 50 mm without the deviation of the mandible. Pathological examination revealed osteochondroma. A 21-year-old woman presented at our department with progressive reduction of maximal mouth opening. She had been treated for trismus by splint therapy and intraarticular injection of steroid i n other hospital. The patient could open her mouth 13 mm without pain. A CT scan showed a large bony mass medial to the zygomatic arch, fixed to the apex of the coronoid process. 3D-CT scan showed clearly impingement of a bony mass. A coronoidectomy was performed through an intraoral approach. After surgery, interincisal opening was 45 mm without clicking. On radiological documents, we are attempting to present the possibilities of false reading on routine X-ray for these two cases.

12. A Case of Solitary Xanthogranuloma of the Oral Cavity

Matsumoto, E, Fukazawa, H. Yuri Nokyo General Hospital, Department of Oral and Maxillofacial Surgery, Japan Xanthogranuloma (nevo-xantho-endothelioma) is characterized by the predominance of polygonal and fusiform histiocytes, varying numbers of Touton giant cells, fat-laden histiocytes, and infiltration by lymphocytes and eosinophils. This lesion is typically a benign, spontaneously regressing, granulomatous dermatosis of infants and children who have no major visceral lesions. It rarely occurs in the oral cavity and only a few cases have been reported in the past. We present a case of xanthogranuloma, arising in the gingiva of the mandible in a 63-year-old male with no abnormalities of serum lipids and no other lesions.

13. Osteochondroma of the Mandibular Coronoid Process: Report of two cases

Mizutani, H., Senga, K., Asahina, T., Ueda, M. Department of Oral Surgery, Nagoya University School of Medicine, Nagoya, Japan This paper describes two patients with osteochondroma of the mandibular coronoid process. A 13-year-old boy presented to our department with a chief complaint of limitation of opening his mouth. On examination the patient was able to open his mouth 25 mm without pain and click-

14. A Case Report of Chronic Recurrent Multifocal Osteomyelitis Showing Clinical Improvement with Glucocorticoid Treatment

Nakayama, K., Furuta, L, Sado, T., Ito, S., Koizumi, E, lwamoto, S., Swazaki, S., Sugiyama, E. Department of Oral and Maxillofacial Surgery, Second Department of Pathology, First Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan Chronic recurrent multifocal osteomyelitis (CRMO), the etiology of which is unknown, is an uncommon entity characterized by multiple osteomyelitic-type bone lesions, with sclerosis over a course of several months to years. The disease onset is usually in children and young adults. We present a case of a 22-year-old female with CRMO. She was admitted to our hospital because of recurrent fever and pain due to a swollen left mandible with trismus in September, 1995. She had a 7-year history of chronic osteomyelitis of the right leg, and had undergone several surgical treatments. Histological findings of biopsies and resected materials were characterized by chronic osteomyelitis with osteolytic lesions around a few small abscesses. Laboratory data on admission showed white blood cell counts of 6.060/mm 3, a hemoglobin level of 9.7 g/dl, a Creactive protein level of 11.8 mg/dl, and ALP 307 IU/L. Galium scintigraphy showed strongly increased uptake in the left jaw. Cultures of a portion of the jaw biopsy were all negative for bacteria and fungus. Antibiotic treatment for 5 months