Osteoradionecrosis of the mandible

Case contributed by A.Prof Frank Gaillard

Presentation

Patient received radiotherapy for head and neck carcinoma.

Patient Data

Age: 60
Gender: Male
Modality: X-ray

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 vascularised 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 vascularisation 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 revascularisation.

PlayAdd to Share

Case Information

rID: 7239
Case created: 21st Sep 2009
Last edited: 5th Dec 2015
System: Head & Neck
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.