[Enlargement of mandibular canal and lower lip hypoesthesia revealing non-Hodgkin’s lymphoma of the mandible].

Abstract

Introduction: Primary lymphoma of the mandible are rare and most often revealed by painless swelling. They are often confused with odontogenic lesions. Hence, their diagnosis is delayed. The authors report the case of an isolated mandibular lymphoma revealed by hypoesthesia of the lower lip and enlargement of the left mandibular canal.

Case report: A 35-year-old woman patient consulted for hemi-mandibular pain with episodes of left labial hypoesthesia. Clinically, we noted the presence of a vestibular tumor in front of tooth 34. A panoramic radiograph revealed that the left mandibular canal was widely enlarged, extending from the mandibular foramen to the mental foramen. The biopsy revealed a B-cell lymphoma. No other localization was found. After treatment with seven courses of a chemotherapy based on R-CHOP followed by local radiotherapy, the patient was in remission eighteen months after treatment.

Discussion: Primitive lymphoma of the mandible are rare; they represent about 0.6% of extra-nodal non-Hodgkin lymphoma. They occur at any age and mainly affect males. They most often come out as a painless swelling, sometimes ulcerated in the mouth. They are often misdiagnosed as a dental problem. Treatment combines variably radiotherapy and/or chemotherapy. The prognosis of bone lymphoma is more favorable than others malignancies bone, with a survival rate of 40-50% at five years.