Mandibular osteoradionecrosis

Case contributed by Dr Paul Simkin

Presentation

Previous radiotherapy for right palatoglossal sulcus squamous cell carcinoma. New right mandible pain and serous discharge.

Patient Data

Age: 65
Gender: Male
CT

Since the previous CT new permeative destruction of the right mandibular body is evident. There is a 17 mm cortical defect involving the buccal aspect, with a very small cortical defect on the lingual aspect. A 5 mm rounded lucency on the alveolar surface was present on the previous CT. No further osseous destruction is seen within the mandible, maxilla or other imaged osseous structures.

There is soft tissue thickening within the adjacent intervertebral sulcus, measuring up to 13 mm in thickness, without evidence of collection or abscess. No cutaneous fistula/sinus demonstrated. No collection or abscess within the deep spaces of the neck.

The prominent submental and left level 2 lymph node are unchanged in size. No new lymphadenopathy.

A 10 x 7 mm right upper lobe nodule is stable. Centrilobular emphysema.

Conclusion:

Destructive changes within the right mandible body is consistent with radionecrosis and superimposed osteomyelitis. No collection or fistula demonstrated.

CT

Prior study for comparison

Prior comparison study shows intact right mandible body.

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Case information

rID: 32954
Case created: 22nd Dec 2014
Last edited: 17th Dec 2015
System: Head & Neck
Inclusion in quiz mode: Included

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