Proliferative Periostitis in the Mandibular Ramus:Uncommon Pediatric Case Report

Introduction: Proliferative periostitis of the mandible is a particular form of chronic osteomyelitis. Clinical and radiology features overlap with malignant tumors. Accurate diagnosis through histopathology examination is crucial to avoid unnecessary aggressive treatment. case presentation: An 11-year-old child presented with a four-month history of painless swelling in the right preauricular region. Imaging revealed an osteolytic lesion in the right mandibular ramus with cortical perforation, raising suspicion of osteosarcoma. However, histopathological analysis confirmed a diagnosis of proliferative periostitis. Results: The patient was treated with antibiotics, leading to complete clinical and radiological remission within six months. No recurrence was observed at one-year follow-up. Conclusion: The clinical presentation of extensive proliferative periostitis affecting the ramus of the mandible can be misdiagnosed as osteosarcoma. This case highlights the importance of histological confirmation to avoid unnecessary aggressive treatment in pediatric mandibular lesions.