Abordagem cirúrgica de osteoma em ângulo mandibular: relato de caso

Abstract

Peripheral osteomas are benign, slow-growing bone tumors that are usually asymptomatic but may cause facial asymmetry and esthetic impairment. The occurrence of these lesions in the mandibular angle region is considered uncommon. This study aimed to report a case of a peripheral osteoma located in the left mandibular angle, focusing on its clinical, imaging, histopathologic features, surgical treatment, and postoperative evolution. A 46-year-old female patient presented with mandibular swelling with approximately one year of evolution, without pain or functional alterations related to the lesion. Imaging examinations showed a well-defined hyperdense bone mass in continuity with the mandibular cortical bone. Due to progressive growth and esthetic impact, surgical removal under general anesthesia was performed through an extraoral submandibular approach (Risdon technique). The lesion was removed en bloc using a piezoelectric ultrasonic device, followed by osteoplasty to regularize the bone contour. Histopathological analysis confirmed the diagnosis of spongy osteoma, showing lamellar bone tissue, osseous trabeculae, and interposed bone marrow. Postoperative follow-up showed adequate healing, restoration of facial symmetry, absence of relevant esthetic complications, and absence of clinical and radiographic recurrence at six months. The case highlights the importance of computed tomography, individualized planning, and careful selection of the surgical approach. It is concluded that the extraoral surgical approach proved to be effective and safe for the treatment of osteomas in the mandibular angle, especially in large lesions or lesions with difficult intraoral access.