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A localised soft tissue and bone enlargement in an infant mandible
Subhalakshmi Sen1, Abhay Kamath, Mukund Gupta
1Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Manipal, Karnataka, India.
Insights
Infantile cortical hyperostosis is a rare bone disorder causing mandibular swelling in infants. Early diagnosis relies on clinicopathological correlation to differentiate it from other conditions.
Area of Science:
- Pediatric Radiology
- Pediatric Pathology
- Pediatric Orthopedics
Background:
- Infantile cortical hyperostosis (ICH), also known as Caffey disease, is a rare, self-limiting condition of unknown etiology.
- It typically presents in the first few months of life with characteristic bone changes and irritability.
Observation:
- A 4-month-old infant presented with a rapidly growing, firm, and tender mandibular swelling.
- CT scan revealed cortical irregularity and masseter muscle hypertrophy.
- Histopathology showed reactive bone and inflamed fibrous marrow.
Findings:
- Clinicopathological correlation confirmed the diagnosis of infantile cortical hyperostosis.
- The case highlights the diagnostic challenges associated with this rare reactive bone dystrophy.
Implications:
- Accurate diagnosis of ICH is crucial to avoid unnecessary interventions.
- Understanding ICH aids in managing infants with unexplained bone swellings.
- This case underscores the importance of integrating clinical, imaging, and pathological findings.
Abstract:
A 4-month-old infant was referred by a paediatrician for a rapidly growing swelling on the right side of the mandible of 1.5 months duration. His medical and family history was unremarkable. Palpation divulged a firm and tender enlargement with the overlying soft tissue showing no significant alteration in colour. CT scan revealed cortical irregularity involving the ramus on the right side along with right masseter muscle hypertrophy. Routine haematological investigation yielded values within normal limits except for a raised erythrocyte sedimentation rate. Histopathological examination of the tissue submitted following an open biopsy procedure showed reactive lamellar bone and trabeculae with fibrous marrow exhibiting inflammation. The final diagnosis of infantile cortical hyperostosis was clinched based on the clinicopathological correlation. A rare reactive bone dystrophy which could pose a certain diagnostic dilemma is addressed herewith.
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