Young adult with abnormal swelling over bilateral face and jaw

A 20-year-old child was brought to the emergency department with the chief complaint of dull aching, and non-radiating mild pain over the mental region with a history of tooth exfoliation of the lower anterior region. He was experiencing swelling over the bilateral sides of his face and jaw, which was initially less but eventually increased to the present size gradually, with blurred vision over the left eye and mild paraesthesia over the lateral to the right ala of the nose for the past 2 years (Figure 1). He went under surgical bone shaving, reencountering of the mandible, zygoma, and left orbital floor region under general anesthesia. This case describes the rarity of congenital genetic disorder presenting bilateral, symmetric, and painless swelling of the jaw and cheeks with premature loss or delayed eruption of teeth due to a history of occasional betel nut chewing (2–3 years approximately), submandibular lymph node enlargement, upward gaze of the eyes due to orbital involvement vision problems, or paraesthesia due to compression of central nerves. The histopathological examination that aided in final diagnosis of cherubism, computed tomography (CT) of brain revealed expansion of bony calvarium with intact cortex and loss of trabeculae giving homogeneous ground glass appearance to the mandible. Cherubism usually is a self-limiting, operative treatment that may not be necessary but are usually performed when the disease is quiescent. Aggressive lesions that cause severe functional problems, such as airway obstruction, justify early surgical intervention (Figure 2).