Osteochondromas are benign tumors that develop most commonly in the long bones of the extremities, but can also occur in the mandibular condyle or coronoid process. They are attached to the underlying skeleton by a bony stalk. Osteochondromas are associated with proliferation of the epiphyseal cartilage invading the surrounding tissues.
Present as slow-growing masses, which can be painful if they impinge on a nerve or if the stalk is fractured. They are mostly detected as an incidental finding. Most patients present with unilateral masses associated with the TMJ.
Patient clinical history:
- Absence of this lesion in other portions of the mandible, skull or facial bones confirm its development in the endochrondal bone; occur in males more than in females and are limited to the 2nd or 3rd decade ages. The lesion is slow growing and cause swelling and pain along the lines of the teeth and chin pointing toward the unaffected side.
- The lesion appears as an irregular “popcorn-like” radiopaque mass on the medial side of the condyle or it has replaced the coronoid process.
Lesions affecting the coronoid process are managed by a coronoidectomy with minimal removal of the attached temporalis muscle tendon. Lesions affecting the condyle are treated by condylectomy with a preauricular as well as a neck incision. Reconstruction procedures involve using costochondral grafts or an alloplastic condyle.
Reoccurrence is rare.