Giant osteoid osteoma of mandible in a 24-year-old female: a case report

Osteoid osteoma is a benign osteoblastic neoplasm characterized by the production of osteoid and immature bone within a highly vascularized, osteogenic connective tissue stroma. This lesion predominantly occurs in individuals during their second and third decades of life, with a male-to-female predilection ratio of 2:1 to 3:1. This report presents an uncommon case of a giant osteoid osteoma involving the mandibular ramus managed via complete intraoral surgical excision.

A 24-year-old female of Persian ethnicity presented with a 12-month history of a slowly progressive mass involving the right mandibular ascending ramus and coronoid process. The patient reported a 7-month history of intermittent pain and swelling in the right preauricular region, facial area, and submandibular region. The associated pain exhibited marked alleviation following nonsteroidal anti-inflammatory drug administration. Clinical evaluation, radiographic findings, and physical examination strongly suggested a benign lesion; therefore, surgical intervention was performed via an intraoral approach for complete excisional removal. Intraoperatively, an irregular, solid soft tissue mass measuring 3 × 2 × 0.8 cm was successfully resected in its entirety. Histopathological analysis demonstrated thick trabeculae embedded within a vascular connective tissue stroma, accompanied by scattered chronic inflammatory infiltrates and prominent blood vessels surrounding the nidus. The lesion exhibited multiple nidi with heterogeneous architecture, including a sclerotic network of bone trabeculae. These findings confirmed the diagnosis of osteoid osteoma.

In this case, a rare giant osteoid osteoma was effectively excised using an intraoral approach, resulting in significant improvement in both facial swelling and mouth opening, with no major postoperative complications.