Cancellous osteoma of the coronoid process: a literature review and rare case report

Osteoma is a rare benign tumor primarily affecting the craniofacial skeleton. Coronary osteomas in the coronoid process are uncommon and asymptomatic until they affect mandibular function. This report presents a case of coronoid osteoma with its diagnosis, treatment and surgical approach. Osteoma is a benign tumor composed of well-differentiated bone tissue, with different origins: central, peripheral and extraskeletal. Mandibular coronoid osteomas are rare but important to consider in symptomatic patients. Mandibular osteoma frequency ranges from 22.8% to 81.3%, with a reported frequency of 15.28% in the maxilla. A 63-year-old female presented with facial deformation, limited mouth opening, and associated symptoms, such as intermittent dizziness and nasal congestion. Imaging revealed a well-defined radiopaque lesion in the coronoid process, displacing surrounding structures. Diagnosis confirmed coronoid osteoma. Surgical removal resulted in satisfactory recovery and improved mouth opening. Coronoid osteomas are rare, with limited reported cases. Osteomas are more prevalent in the mandible body than in other locations. Radiographic imaging and histopathological examination are crucial for diagnosis. Radiographic and histological features distinguish osteomas from other lesions. Etiology remains uncertain, with trauma, temporal muscle hyperactivity, or post-traumatic fibrosis as potential causes. Differential diagnosis involves distinguishing osteoma from osteochondroma, osteoblastoma, exostoses and osteosarcoma. Continued research and reporting are necessary to enhance understanding and management of this rare condition.

Osteoma; Benign tumor; Mandible; Mouth opening; Case report

[1] Iwai T, Izumi T, Baba J, Maegawa J, Mitsudo K, Tohnai I. Peripheral osteoma of the mandibular notch: report of a case. Iranian Journal of Radiology. 2013; 10: 74–76.

[2] Manjunatha BS, Nagarajappa D. Osteoid osteoma. Indian Journal of Dental Research. 2009; 20: 514–515.

[3] Shaw SE, Chan CH. Non-odontogenic tumors of the jaws. StatPearls: Treasure Island. 2022.

[4] Piattelli A, Scarano A, Di Alberti L, Piattelli M. Osteoma of the mandible. A case report. Acta Stomatologica Belgica. 1995; 92: 13–16.

[5] Das A, Saikrishna D, Jha C. Management of a case of osteoma of coronoid: a rare case report. National Journal of Maxillofacial Surgery. 2021; 12: 276–279.

[6] Ragupathy K, Priyadharsini I, Sanjay P, Yuvaraj V, Balaji TS. Peripheral osteoma of the body of mandible: a case report. Journal of Maxillofacial and Oral Surgery. 2015; 14: 1004–1008.

[7] Nayak V, Rao PK, Kini R, Shetty U. Peripheral osteoma of the mandible. BMJ Case Reports. 2020; 13: e238225.

[8] Kaplan I, Calderon S, Buchner A. Peripheral osteoma of the mandible: a study of 10 new cases and analysis of the literature. Journal of Oral and Maxillofacial Surgery. 1994; 52: 467–470.

[9] Lewars PH. Osteoma of the mandible. British Journal of Plastic Surgery. 1959; 12: 277–283.

[10] Ord RA, Rennie JS, MacDonald DG, Moos KF. Cancellous osteoma of the coronoid process: report of a case. British Journal of Oral Surgery. 1983; 21: 49–55.

[11] Plezia RA. Osteoma of the coronoid process. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology. 1984; 57: 111.

[12] Wesley RK, Cullen CL, Bloom WS. Gardner’s syndrome with bilateral osteomas of coronoid process resulting in limited opening. Pediatric Dentistry Journal. 1987; 9: 53–57.

[13] Kurita K, Kawai T, Ikeda N, Kameyama Y. Cancellous osteoma of the mandibular coronoid process: report of a case. Journal of Oral and Maxillofacial Surgery. 1991; 49: 753–756.

[14] Chen Y, Lin L, Lin C. Osteoma of the mandibular coronoid process. International Journal of Oral and Maxillofacial Surgery. 1998; 27: 222–223.

[15] Vashishth S, Garg K, Patil P, Sreenivasan V. An unusual cause for trismus caused by mandibular coronoid osteoma: a case report. Imaging Science in Dentistry. 2013; 43: 45–48.

[16] da Costa Araújo F, Melo Barbalho J, de Farias O, de Vasconcellos RH, do Egito Vasconcelos B. Pseudo-ankylosis caused by osteoma of the coronoid process. Annals of Maxillofacial Surgery. 2014; 4: 208–210.

[17] Gonzalez Y, Chwirut J, List T, Ohrbach R. DC/TMD Examination Protocol. MedEdPORTAL. 2014; 10: 9946.

[18] Sayan NB, Üçok C, Karasu HA, Günhan O. Peripheral osteoma of the oral and maxillofacial region: a study of 35 new cases. Journal of Oral and Maxillofacial Surgery. 2002; 60: 1299–1301.

[19] Jordan RW, Koç T, Chapman AW, Taylor HP. Osteoid osteoma of the foot and ankle—a systematic review. Foot and Ankle Surgery. 2015; 21: 228–234.

[20] Gurkan V, Erdogan O. Foot and ankle osteoid osteomas. The Journal of Foot and Ankle Surgery. 2018; 57: 826–832.

[21] Kopp WK. Benign osteoblastoma of the coronoid process of the mandible: report of case. Journal of Oral and Maxillofacial Surgery. 1969; 27: 653–655.

[22] Bilkay U, Erdem O, Ozek C, Helvaci E, Kilic K, Ertan Y, et al. A rare location of benign osteoblastoma: review of the literature and report of a case. Journal of Craniofacial Surgery. 2004; 15: 222–225.

[23] Wang GD, Zhao YF, Liu Y, Jiang L, Jiang XZ. Periosteal osteosarcoma of the mandible: case report and review of the literature. Journal of Oral and Maxillofacial Surgery. 2011; 69: 1831–1835.