Peripheral Osteoma: Unusual Presentation in the Mandibular Notch

This case report demonstrates an unusual presentation of a large peripheral osteoma affecting the left mandibular notch of a 42-year old female. Only five other cases involving this region have ever been reported in the English literature. The patient complained of a constant ‘contraction' like movement of her jaw over the course of one-year, with associated pre-auricular pain in the left temporo-mandibular joint region. Orthopantomographic investigation revealed a radiopaque mass related to the left mandibular notch with a subsequent cone beam computed tomography reporting a large pedunculated bony mass with a lobulated outline, extending into the infra temporal fossa. A working diagnosis of peripheral osteoma was reached, and surgery suggested to prevent further growth and to relieve symptoms. The patient declined treatment, and was therefore offered periodic clinical and radiographic follow up.