Jacob’s disease or osteochondroma of the mandibular coronoid process, is a benign skeletal tumour that is rare in the oral and maxillofacial skeleton and even more rare in the coronoid process. Though first noted by Langenbeck in 1853 as an enlargement of the mandibular coronoid process, the first case report was described by J acob in 1899, who reported a pseudojoint between the coronoid and the zygomatic arch due to an osteochondroma formation of the coronoid process.

A review of the literature revealed only 39 histologically proved cases out of 50 reported cases ( Table 1 ). To the best of the authors’ knowledge this is the second case reported in India and it is the fifth typical mushroom-shaped Jacob’s disease; only four similar cases have been reported. The disease appears to involve males (63%) more often than females at a mean age of 30 years with an age range of 5–73 years. There is slight predilection for involvement of the left coronoid process. Initial signs and symptoms are a feeling of tightness in the joint region and gradual reduction in mouth opening. Later stages show a total trismus and appreciable swelling at the malar prominence. Pain is not a feature of the disease but deformity of the surrounding structures and facial deformity was found in most cases .

Table 1

Summary of the reported cases of osteochondroma of the coronoid process.

Case no	Authors	Year	Gender	Age	Side	Facial asymmetry	Mouth opening in mm	Surgical approach
1	S hackelford & B rown	1943	Male	15	Left	Present	12.5 mm	Extraoral
2	S hackelford & B rown	1943	Male	19	Right	Present	10 mm	Extraoral
3	S hackelford & B rown	1943	Male	38	Right	Present	Reduced	Extraoral
4	B randt	1949	Female	37	Right	Present	25 mm	Extraoral
5	B railsford	1952	Male	29	Left	Present
6	H olmes	1956	Male	36	Left		8 mm
7	L evine et al.	1957	Female	73	Left	Present	6 mm
8	D ingman & N atvig	1957	Male	27	Right		8 mm	Extraoral
9	A ntoni et al.	1958	Male	29	Left	Present	Adequate
10	P ap & F riedman	1958	Male	13	Left	Present	10 mm	Extraoral
11	L ebo	1961	Male	18	Left		14 mm	Extraoral
12	M ohnac	1962	Male	18	Right		18 mm	Extraoral
13	A llan & R eid	1967	Female	32	Right		16 mm	Intraoral
14	A llan & R eid	1967	Male	22	Left	Present	13 mm	Intraoral
15	M eyer	1972	Female	10	Right	None	20 mm	Intraoral
16	J ames et al.	1974	Female	52	Right	Present	5 mm	Extraoral
17	C ooper & F inch	1974	Female	43	Left	None	6 mm	Intraoral
18	T akeda et al.	1975	Female	14	Left	Present	10 mm	Extraoral
19	S inger & S chultz	1976	Male	64	Right	Present	5 mm	Combined
20	R amon et al.	1977	Male	45	Right	Present	Reduced	Combined
21	I to et al.	1981	Female	20	Left	Present	3 mm	Intraoral
22	I shii et al.	1983	Female	32	Left	Present	7 mm	Intraoral
23	I shii et al.	1983	Male	53	Right	Present	20 mm	Combined
24	R evington	1984	Male	24	Right	None	9 mm	Extraoral
25	T ucker et al.	1984	Male	16	Right	Present	22 mm	Intraoral
26	S chwartz & L iebel	1987	Male	15	Left	Present	18 mm	Extraoral
27	M acleod	1987	Female	46	Left	Present	5 mm	Intraoral
28	T otsuka et al.	1990	Female	37	Left	Present	2 mm	Intraoral
29	A sanami et al.	1990	Male	17	Left	None	8 mm	Combined
30	K erscher et al.	1993	Male	45	Left	None	14 mm	Intraoral
31	C onstantinides et al.	1997	Male	31	Right	Present	10 mm	Extraoral
32	C hen et al.	1998	Female	57	Left	Present	14 mm	Extraoral
33	M aganaro	1998	Female	26		Present
34	C hichareon et al.	1999	Male	5	Right	Present
35	H ernandez et al.	2000	Male	22	Left	Present	21 mm	Extraoral
36	R oychoudhury et al.	2001	Male	32	Left	Present	0 mm	Extraoral
37	E scuder i de la T orre et al.	2001	Female	24	Bilateral	Present	Reduced	Intraoral
38	E mekli	2002	Female	26	Right	Present	10 mm	Intraoral
39	E mekli	2002	Male	21	Right	Present	Reduced	Extraoral
40	C apote	2005	Female	23		Present	Reduced	Intraoral
41	V illanueva	2006	Female	44	Left	Present	30 mm	Intraoral
42	A kan & M ehreliyeva	2006	Male	24	Bilateral	None	15 mm	Intraoral
43	D ede	2007	Male	20	Bilateral	Present	6 mm	Intraoral
44	F erro M artín	2008	Male	28	Bilateral	Present	13 mm	Intraoral
45	G opikiran	2009	Male	15	Bilateral	Present	15 mm	Intraoral
46	D’A mbrosio	2009	Male	39			Reduced
47	E toz O sman	2009	Female	43	Right	Present	14 mm	Intraoral
48	Z hong et al.	2009	Male	28	Left	Present	13 mm	Intraoral
49	W aseem	2010	Male	15	Right	Present	10 mm	Intraoral
50	A hmet et al.	2010	Male	16	Right	Present	7 mm	Extraoral
51	K rishna (present case)	2010	Female	45	Left	Present	5 mm	Combined

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