Aggressive Late Recurrence of a Calcifying Epithelial Odontogenic Tumor: Surgical Refinements Based on New Technologies

J Craniofac Surg. 2024 Jul-Aug;35(5):e468-e469. doi: 10.1097/SCS.0000000000010337. Epub 2024 Jun 5.

Abstract

A calcifying epithelial odontogenic tumor is a rare, benign odontogenic neoplasm. Surgical treatment is the option, and late recurrence is very rare. Radiologically, the lesions are commonly present scattered calcifications. This case report details a 64-year-old female patient with a recurrence of a right mandibular calcifying epithelial odontogenic tumor 2 decades after successful initial surgical removal. A segmental mandibulectomy and immediate reconstruction were performed using a planned vascularized free fibula flap with virtual surgery, custom reconstruction plate, and intraoperative computed tomography. Modifications were made to the design of the reconstruction plate to improve the cervicofacial profile and subsequent rehabilitation with dental implants. Fully guided implant surgery with point-of-care manufacturing protocol was done to improve prosthetically driven implant planning. The case presented highlights the usefulness of new technologies for mandibular reconstruction with the free fibula flap and the concept of point-of-care with technical notes that increase precision and reduce morbidity in implant-supported rehabilitation.

Publication types

  • Case Reports

MeSH terms

  • Bone Plates
  • Female
  • Fibula / surgery
  • Fibula / transplantation
  • Free Tissue Flaps*
  • Humans
  • Mandibular Neoplasms* / diagnostic imaging
  • Mandibular Neoplasms* / pathology
  • Mandibular Neoplasms* / surgery
  • Mandibular Osteotomy / methods
  • Mandibular Reconstruction / methods
  • Middle Aged
  • Neoplasm Recurrence, Local* / surgery
  • Odontogenic Tumors* / diagnostic imaging
  • Odontogenic Tumors* / pathology
  • Odontogenic Tumors* / surgery
  • Skin Neoplasms
  • Surgery, Computer-Assisted / methods
  • Tomography, X-Ray Computed

Supplementary concepts

  • Calcifying Epithelial Odontogenic Tumor