PATHOLOGIC QUIZ CASE 1
Henry F. Frierson, Jr, MD, Stacey E. Mills, MD, Charlottesville
A 69-year-old man was seen with a "lump in the mouth" of unknown duration. There was no history of exposure to radiation, trauma, or previous disease of the jaw.
On physical examination a hard, exophytic, 10 x 10 x 12-cm mass was noted in the buccal, gingival, and alveolar areas of the left mandible. The skin of the left cheek was eroded over the body of the mandible. Although the jugulodigastric area had been obliterated by tumor, no discrete lymphadenopathy was present.
Serum calcium and phosphorus levels were normal. Serum alkaline phosphatase was only minimally elevated. A presumptive diagnosis was made based on the clinical and roentgenographic findings, and a subtotal mandibulectomy was performed. The specimen roentgenogram (Fig 1) and gross photograph (Fig 2) illustrate these features. Figures 3 and 4 are representative microscopic sections.
What
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