Surgical management of an infected aggressive florid cemento-osseous dysplasia. Report of a case.
Florid cemento-osseous dysplasia (FCOD) is a quite rare condition presenting in the jaws and is most seen in middle-aged black women, from the 4th decade of life on. The pathogenesis of the cemento-osseous dysplasias remains unknown; however, they seem to represent some kind of reactional or dysplastic process. We describe an aggressive case of infected florid cemento-osseous dysplasia (IFCOD) in a 47-year-old black woman. Extensive dysplastic lesions affected all jaw quadrants and radiographic features showed images of irregular radiopaque multilobular masses, peripherally lined by a radiolucent layer. We decided to keep the patient in the hospital in order to perform endovenous medication, hydration, drainage and general care. The surgery planning would be started as soon as regression of the acute feature was observed. Histopathologic analysis revealed the lesion was composed by osseous and cementoid tissues, being its diagnosis compatible with FCOD. The surgical procedure was accomplished with the patient under general anesthesia. It was opted for the excision of the lesion in all quadrants, with sequestrectomy and total dental extraction and remodelling of the alveolar ridges. After 9 months of follow-up the patient is still undergoing clinical control, presenting healing within the expected patterns. Symptomatic cases follow-up should be lasting and periodical, since there are reports of recurrence.
Martini
M Zillo
MZ
Division of Stomatology, Department of Oral and Maxillofacial Surgery, Hospital Municipal 'Dr. Carmino Caricchio' (HMCC) Tatuapé, São Paulo. SP, Brazil. martinifopunicamp@yahoo.com
de Carvalho Júnior
J Pereira
JP
Soares
H Arid
HA
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002485:Cementoma / Q000175:diagnosis / Q000601:surgery*; D002981:Clindamycin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008339:Mandibular Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D019647:Oral Surgical Procedures; D010019:Osteomyelitis / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D011862:Radiography, Panoramic; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D002981:Clindamycin