Benign Mandibular Tumours: Two Case Studies From the Maya Lowland Site of Tikal, Guatemala
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This study presents a differential diagnosis of benign mandibular tumours identified in two adult burials from the precontact Maya city of Tikal, Guatemala. Both individuals were recovered from domestic structures that date to the Late Classic Period (AD 550-850). The osseous growths were interpreted as probable benign tumours based on evidence of localised growth, a circumscribed border, a dense texture and a lack of osteolytic activity or spiculate bone formation. Burial PTP-026A is a middle adult (35-50 years) of indeterminate sex with evidence of a small dense, circular mass extending laterally from the right mandibular corpus. Macroscopic and radiographic assessment of this lesion provided a diagnosis of osteoma, a true neoplasm, or alternately, hyperplasia (e.g. exostosis) or hamartoma, which are not true neoplasms. Burial PTP-017 is a probable young adult female (20-35 years) with a large osteoblastic lesion on the right anterior mandibular corpus. This dense, bony mass extends from the anterior margin of the mental canal, and shows a distinct boundary from the adjacent trabecular and cortical bone. The growth of the osseous mass displaced the right first premolar anteriorly. Radiographic assessment showed the presence of dense, radiopaque material, indicating significant calcification. This suggested a likely fibro-osseous origin for this lesion, with a probable diagnosis of ossifying fibroma, or possibly osseous dysplasia. Although not definitive, our differential diagnosis was able to exclude a number of neoplastic and non-neoplastic conditions that affect the jaws. This study provides the first reported cases of possible benign mandibular tumours in the ancient Maya. 2009 John Wiley & Sons, Ltd.
