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Uma causa incomum de tumefacção mandibular e diagnóstico diferencial
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Uma tumefacção mandibular é uma apresentação inespecífica que pode ter inúmeras etiologias. Aqui é apresentado um caso de etiologia incomum numa adolescente de 17 anos que, para o diagnóstico diferencial, necessitou de articulação entre várias especialidades médicas e integração de conhecimentos de diversas áreas da Medicina. Com a atribuição inicial de diagnóstico de abcesso dentário e instauração de antibioterapia dirigida, observou-se agravamento, com aumento das dimensões da massa até atingir 6 cm de maior eixo e com surgimento de dor associada, o que motivou internamento no Hospital Beatriz Ângelo (Loures, Portugal) para esclarecimento etiológico. São aqui discutidas as diferentes etiologias que devem ser consideradas no estudo da natureza de uma tumefacção mandibular com estas características, incluindo infecção odontogénica, osteomielite, formação cística, crescimento celular benigno, neoplasia maligna ou metastização de tumor primário à distância.
A mandibular swelling is a non-specific presentation that may have several etiologies. Here is presented a case of unusual etiology in a 17-year-old girl that, in order to create a differential diagnosis, required articulation between several medical specialties and integration of knowledge from diverse areas of Medicine. With the initial assignment of the diagnosis of dental abscess and establishment of tooth infection-directed antibiotic therapy, a worsening was observed, with increase of the mass’s dimensions until reaching 6 cm of greater axis and with associated pain, which motivated hospitalization in Hospital Beatriz Ângelo (Loures, Portugal) for etiological clarification. Here are discussed the different etiologies that should be taken into account in the study of the nature of a mandibular swelling with these characteristics, including odontogenic infection, osteomyelitis, cystic formation, benign cell growth, malignant neoplasm or metastasis from a distant primary tumor.
A mandibular swelling is a non-specific presentation that may have several etiologies. Here is presented a case of unusual etiology in a 17-year-old girl that, in order to create a differential diagnosis, required articulation between several medical specialties and integration of knowledge from diverse areas of Medicine. With the initial assignment of the diagnosis of dental abscess and establishment of tooth infection-directed antibiotic therapy, a worsening was observed, with increase of the mass’s dimensions until reaching 6 cm of greater axis and with associated pain, which motivated hospitalization in Hospital Beatriz Ângelo (Loures, Portugal) for etiological clarification. Here are discussed the different etiologies that should be taken into account in the study of the nature of a mandibular swelling with these characteristics, including odontogenic infection, osteomyelitis, cystic formation, benign cell growth, malignant neoplasm or metastasis from a distant primary tumor.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2018
Palavras-chave
Tumefacção mandibular Actinomicose Osteomielite Diagnóstico diferencial Pediatria