Painless bilateral swelling of the face: think about cherubism

A 4-year-old Caucasian male child was referred to our padiatric clinic with bilateral facial swelling. When he was 3 years old, he had started to develop an enlargement of the cervical lymph nodes and of the jaw, which gave him a full-faced cherubic appearance. Clinical examination revealed swelling of both rami of the mandible with bilateral expansion of the mandibular angle extending to the molar and retromolar regions. Panoramic radiography showed generalised multicystic bilateral radiolucent lytic lesions affecting the mandible. CT scans with three-dimensional reconstructions confirmed extensive remodelling of the involved bone and showed displacement of some tooth germs in the maxillary arch