Presentation
Patient received radiotherapy for head and neck carcinoma.
Patient Data
Right hemimandible shows a lytic destruction.
Case Discussion
Osteoradionecrosis following radiotherapy for head and neck SCC.
Histology
Macroscopic
Three irregularly shaped fragments of mandible bone, one measuring 70x40x9mm and including ramus and head and neck of mandible, a triangular fragment 50x28x8mm and an irregularly shaped fragment 8x30x10mm including two attached teeth. The edges of each fragment are focally irregular and congested.
Microscopic appearance
Sections of the 3 bone fragments show the two larger ones to be viable bone with a vascularized marrow space and vascular fibrous tissue is seen on one end of both of them. Within the fibrous tissue, there are fragments of bone. The smallest fragment is non-viable, consistent with being osteoradionecrosis. There is some vascularization of marrow spaces at one end of the fragment.
Final Diagnosis
Right mandible: Viable bone and nonviable bone, consistent with being osteoradionecrosis. The viable bone shows revascularization.
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