Biography
Biography: Lorenzo Azzi
Abstract
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 widespreading behaviour, 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 body’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 “salt-and-pepper” appearance. Eventually, an haematochemical analysis confirmed the final diagnosis of the pathology, which could have quickly caused the patient’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.