Differential Diagnosis

The patient is a 2-year-old Filipino female presenting with a mass on her right jaw, which has been increasing in size over the past few months. The following differential diagnoses are considered:

• Single most likely diagnosis
  • Ameloblastoma: This is a rare, benign (non-cancerous) tumor that occurs in the jaw. The patient's ultrasound and CT scan results showing an intraosseous soft tissue mass on the right mandible, along with the primary consideration of ameloblastoma by the ENT specialist, make this a strong possibility.
• Other Likely diagnoses
  • Tuberculous osteomyelitis: Given the patient's history of primary complex and exposure to TB, this is a possible diagnosis. However, the lack of systemic symptoms such as fever, weight loss, and night sweats makes it less likely.
  • Langerhans cell histiocytosis: This is a rare disorder characterized by an overproduction of Langerhans cells, which can cause lesions in the jaw. The patient's age and presentation make this a possible diagnosis.
  • Osteomyelitis: This is an infection of the bone, which can cause a mass or swelling in the affected area. The patient's history of antibiotic treatment and lack of improvement makes this a possible diagnosis.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Rhabdomyosarcoma: This is a rare, malignant tumor that can occur in the head and neck region, including the jaw. Although it is unlikely, it is a critical diagnosis to consider due to its aggressive nature and potential for metastasis.
  • Ewing's sarcoma: This is another rare, malignant tumor that can occur in the jaw. Like rhabdomyosarcoma, it is unlikely but requires consideration due to its aggressive nature and potential for metastasis.
  • Metastatic disease: Although rare in children, metastatic disease from other primary sites (e.g., neuroblastoma) can present with jaw masses. This diagnosis is critical to consider due to its potential impact on prognosis and treatment.
• Rare diagnoses
  • Cherubism: This is a rare, benign condition characterized by bilateral jaw lesions. Although it is unlikely, it is a possible diagnosis to consider given the patient's presentation.
  • Fibrous dysplasia: This is a rare, benign condition characterized by abnormal bone growth. It can cause jaw masses and is a possible diagnosis to consider, although it is unlikely.
  • Gorlin syndrome: This is a rare genetic disorder characterized by multiple jaw keratocysts, among other features. Although it is unlikely, it is a possible diagnosis to consider given the patient's presentation.