• Marina Kacarska Depratment of oral surgery, Faculty of Dentistry, Ss Cyril and Methodius University in Skopje, R.North Macedonia


Osteoid osteoma is an uncommon non odontogenic benign bone neoplasm that rarely occurs in the jaw bones. This article presents a rare case of osteoid osteoma in mandible mimicking a periapical inflammatory lesion. The patient reported without symptoms and in good general health. Intraorally, there was a swelling in the periapical region of the left mandibular first bicuspid. Vitality test was negative. Orthopantomography depicted a well defined unilocular periapical radiolucency incasing the apical third of the mandibular first bicuspid, with osteosclerotic rim on its distal prospect. Such clinical findings were appropriate for chronic periapical inflammatory lesion, so periapical surgery was scheduled. During surgery, apicoectomy was performed, the lesion removed and sent for histopathology. The result showed irregularly proliferated trabeculae with disrupted architecture and visible osteoid accumulations typical for osteoid osteoma. Periodic follow ups were scheduled.  No recurrence was noted. Although rare, osteoid osteoma in mandible can mimic a periapical inflammatory lesion. Surgical removal and histology contributed to proper diagnostics. Complete surgical removal prevented recurrence.

Keywords: osteoid osteoma, mandible, periapical inflammatory lesion, surgery, nonvital bicuspid, histology


1. H. Jaffe, “A benign osteoblastic tumor composed of osteoid and atypical bone,” Archives of Surgery, vol. 31,
p. 701–728, 1935.
2. S. Karandikar, G. Thakur, M. K. S. Tijare, K. Agrawal, “Osteoid osteoma of mandible,” BMJ Case Reports, vol.
2011, no. dec 05, 2011. bcr.10.2011.4886.indd (nih.gov)
3. C. Walia, P. Devi, V. B. Thimmarasa, and S. Jayadev, “Osteoid osteoma of the mandible: a rare entity,” Journal
of Indian Academy of Oral Medicine and Radiology, vol. 22, no. 3, pp. 162–164, 2010.
4. Manjunatha BS, Nagarajappa D. Osteoid Osteoma. Indian J Dent Res. 2009;20(4):514–5. Osteoid osteoma
Manjunatha B S, Nagarajappa D - Indian J Dent Res (ijdr.in)
5. Boscainos PJ, Cousins GR, Kulshreshtha R, Oliver TB, Papagelopoulos PJ. Osteoid osteoma. Orthopedics.
2013;36:792-800. http://m2.wyanokecdn.com/512102fb8ed227a778fd0e03c13cd979.pdf
6. Dorfman HD, Czerniak B, editors. Bone Tumours. St. Louis, MO: Mosby; 1998. Benign osteoblastic tumours;
pp. 85–127.
7. Atesok KI, Alman BA, Schemitsch EH, Peyser A, Mankin H: Osteoid osteoma and osteoblastoma. J Am Acad
Orthop Surg 19(11): 678-689, 2011. https://pubmed.ncbi.nlm.nih.gov/22052644/
8. Jones AC, Prihoda TJ, Kacher JE, Odingo NA, Freedman PD. Osteoblastoma of the maxilla and mandible: a
report of 24 cases, review of the literature, and discussion of its relationship to osteoid osteoma of the jaws.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102(5):639-50.
9. B. Rahsepar, A. Nikgoo, and S. A. Fatemitabar, “Osteoid osteoma of subcondylar region: case report and
review of the literature,” Journal of Oral and Maxillofacial Surgery, vol. 67, no. 4, pp. 888–893, 2009.
10. E. O. Kirwan, P. A. Hutton, J. L. Pozo, and A. O. Ransford, “Osteoid osteoma and benign osteoblastoma of the
spine. Clinical presentation and treatment,” Journal of Bone and Joint Surgery, vol. 66, pp. 21–26, 1984.
11. E. J. Gardner and R. C. Richards, “Multiple cutaneous and subcutaneous lesions occurring simultaneously
with hereditary polyposis and osteomatosis,” American Journal of Human Genetics, vol. 5, p. 139, 1953.
12. Mohammed I, Jannan NA, Elrmali A. Osteoid osteoma associated with the teeth: unusual presentation. Int J
Oral Maxillofac Surg. 2013;42(2):298-302.
13. Shafer WG, Hine MK, Levy BM. A textbook of Oral Pathology, 4th Edition, WB Saunders Company,
Philadelphia: Pennsylvania; 1993. p. 164-5.
14. Zulian MA,Vincent SK, Hiatt WB. Osteoid osteoma of the mandibular ramus. J Oral Maxillofac Surg. 1987; 45:
15. Shatz A, Calederon S, Mintz S. Benign osteoblastoma of the mandible. Oral Surg Oral Med Oral Pathol. 1986;
61: 189.
16. Mirra JM, Gold RH, Picci P. Osteoid Osteoma. In: Mirra JM, ed. Bone Tumors. Philadelphia, PA: Lea Febiger;
17. Schajowicz F. Bone-forming tumours 1.1.2 Osteoid osteoma and osteoblastoma. In: Schajowicz F, ed.
Histological Typing of Bone Tumours. Second Edition Berlin: Springer-Verlag; 1993:7–9.
18. Resnick DL, Kyriakos M, Greenway G. Tumors and tumor- like lesions of bone: imaging and pathology of
specific lesions. In: Resnick DL, ed. Diagnosis of Bone and Joint Disorders. Third Edition Philadelphia, PA:
Saunders; 1995:3629–47.
19. Ayala AG, Ro JY, Raymond AK. Bone tumors. In: Damjanov I, Linder J, eds. Anderson’s Pathology. Tenth
Edition St Louis: Mosby; 1996:2531–73.
20. Neville BW, Damm DD, Allen CM, Chi AC. Oral and maxillofacial pathology. 4th ed. St. Louis: Elsevier; 2016.
21. Liu CJ, Chang KW, Chang KM, Cheng CY. A variant of osteoid osteoma of the mandible: report of a case. J
Oral Maxillofac Surg. 2002;60(2):219-21. v1a19.pdf (gn1.link)
22. An SY, Shin HI, Choi KS, Park JW, Kim YG, Benavides E, et al. Unusual osteoid osteoma of the mandible:
Report of case and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116:e134–40.
23. Nair P.N. Pathogenesis of apical periodontitis and the causes of endodontic failures. Rev Oral Biol Med.
2004; 15: 348-381. Pathogenesis of Apical Periodontitis and the Causes of Endodontic Failures - P.N.R. Nair,
2004 (sagepub.com)
24. Oliveira L.D.Carvalho C.A.Carvalho A.S.et al. Efficacy of endodontic treatment for endotoxin reduction in
primarily infected root canals and evaluation of cytotoxic effects. J Endod. 2012; 38: 1053-1057.
25. Faitaroni L.A.Bueno M.R. De Carvalhosa A.A. et al. Ameloblastoma suggesting large apical periodontitis. J
Endod. 2008; 34: 216-219.
26. Nair PNR. Biology and pathology of apical periodontitis. In: Estrela C. Endodontic science. 2nd ed. São Paulo:
Artes Médicas; 2009. p. 285-347.
27. de Moraes Ramos-Perez F.M. Soares U.N. Silva-Sousa Y.T. et al. Ossifying fibroma misdiagnosed as chronic
apical periodontitis. J Endod. 2010; 36: 546-548.
28. Rodrigues C.D.Estrela C. Traumatic bone cyst suggestive of large apical periodontitis. J Endod. 2008; 34: 484-
29. White SC, Pharoah MJ. Oral radiology principles and interpretation. 6th ed., St. Louis, Mosby; 2009.
30. A Singh and MC Solomon. Osteoid osteoma of the mandible: A case report with review of the literature. J
Dent Sci. 2017 Jun; 12(2): 185–189. Osteoid osteoma of the mandible: A case report with review of the
literature (nih.gov)
31. Pieterse A.S., Vernon-Roberts B., Paterson D.C., Cornish B.L., Lewis P.R. Osteoid osteoma transforming to
aggressive (low grade malignant) osteoblastoma: a case report and literature review. Histopathology.
How to Cite
KACARSKA, Marina. A RARE CASE OF OSTEOID OSTEOMA IN MANDIBLE MIMICKING A PERIAPICAL INFLAMATORY LESION-case report. Journal of Morphological Sciences, [S.l.], v. 4, n. 2, p. 129-134, july 2021. ISSN 2545-4706. Available at: <https://jms.mk/jms/article/view/238>. Date accessed: 29 sep. 2021.