Painful, rapidly growing mass of the mandible*********

CLINICAL PRESENTATION An 18-year-old Afro-Trinidadian girl presented with a painful swelling on the right side of her mandible that had resulted in significant facial asymmetry (Fig 1). The patient reported that she had first noticed the swelling 3 months previously, with subsequent rapid enlargement. The remaining head and neck tissues were unremarkable, with no palpable enlargement of regional lymph nodes. The mass was firm but slightly compressible and was exquisitely tender to direct palpation. The patient’s jaw opening was restricted. A partially ulcerated, fleshy, lobulated mass could be seen intraorally extending from the right mandibular premolar region to the right anterior ramus with marked buccal and lingual expansion (Fig 2). The right mandibular second and third molars were missing. Although the adjacent first molar and second premolar teeth appeared normal, both exhibited significant mobility. No evidence of abscess or purulent drainage was seen in the area.