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Reprint requests: Karen A. Eley, MBChB, MRCS(Ed), PGCTLCP, FHEA, MSc, University of Oxford, Nuffield Department of Surgical Sciences, John Radcliffe Hospital, Level 6, Headley Way, Oxford OX3 9DU, UK
A 12-year-old boy presented to the Department of Oral and Maxillofacial Surgery with
a 2-week history of a mass in the lower right molar region. Over that period it had
rapidly enlarged, but was not associated with any discomfort. The first molar tooth
had been extracted 18 months before presentation for unrestorable dental decay. There
was no history of trauma or further dental symptomatology. His past medical history
was unremarkable, he was systemically well, and there was no family history of note.
Intraorally, there was a 4 × 2-cm nontender ulcerated mass centered at the first molar
socket (Figure 1) . The upper teeth occluded with the mass, and, extraorally, there was mild fullness
in the region, but no erythema. There was no palpable lymphadenopathy, and systemic
examination was normal. A full blood count, urea, electrolytes, liver function tests,
and calcium were all within the normal range. Panoramic radiography (OPG) demonstrated
developing dentition with absence of the lower right first molar tooth. There was
evidence of a soft tissue mass arising from this region, with an apparent underlying
lucency of the mandibular bone. A computed tomography (CT) scan of the region confirmed
destruction of the lingual cortex of the mandible with some periosteal new bone formation.
The soft tissue mass was poorly delineated, with evidence of calcification (Figure 2, A and B, Figure 3) . A 6-mm right submandibular lymph node and several small submental nodes were evident.
Fig. 1Clinical presentation of a well-defined nontender ulcerated mass centered on the lower
right first molar socket.
Fig. 2A and B, Axial CT scan demonstrating a mass in the lower right quadrant, with erosion of lingual
cortex. There is a Whitehead's varnish pack (antiseptic solution) in the tooth socket,
giving rise to an appearance of a calcified mass.
Treatment of localized nonorbital, nonparameningeal head and neck rhabdomyosarcoma: lessons learned from intergroup rhabdomyosarcoma studies III and IV.
Intraoral presentation of inflammatory myofibroblastic tumor (pseudotumor) at the site of dental extraction: report of a case and review of the literature.
