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We present a clinical case which deals with a 59-year-old female patient who presented at our Dental Clinic for a radiolucent
bony lesion of the mandible with an odontogenic cyst-like appearance, accidentally detected by an orthopantomogram. First
diagnosed as radicular cyst, after histological examination the lesion was identified as Central Giant Cell Granuloma (CGCG) of
the mandible. Its aggressive recurrence and locally wide spreading behavior, followed by multi-focal involvement of the mandible,
urged the oral pathologist to gather a multidisciplinary team of medical investigation and management, led by the dental practitioner
himself in the early stages. Despite the fact that consultation with pathologists led to a full immunohistochemical characterization
of the CGCG, the dentist suspected a more severe underlying condition than a CGCG of the jaw. Therefore he collected the X-rays
of other bodyâ??s areas prescribed in the meantime by other specialists. A careful image comparison revealed the presence of multiple
osteolytic lesions on the left knee. The cranial X-ray showed other bony lesions that gave the skull vault a â??salt-and-pepperâ? appearance.
Eventually, a hematochemical analysis confirmed the final diagnosis of the pathology, which could have quickly caused the patientâ??s
death. The aim of this case presentation is to put on emphasize the enhancement of the role played by dental practitioners, especially
oral surgeons and pathologists, during the diagnostic process in a multidisciplinary team of work. This presentation could be a
clinicopathological debate involving discussion about the clinical case with a review of the corresponding pathology.
Biography
Lorenzo Azzi is currently a PhD student of the “Biotechnology, Biosciences and Surgical Technology” course at University of Insubria. He is an Oral Surgeon and Oral Pathologist. He is also an Assistant Director of the Unit of Oral Pathology, Ospedale di Circolo Fondazione Macchi, Varese and is an active Member of the Italian Society of Oral Pathology and Medicine (SIPMO) and of the European Association of Oral Medicine (EAOM).