Imaging diagnosis
Case 333
【Progress】
He received surgical resection of cystic lesion of left mandibular bone.
Pathologic examination revealed odontogenic keratocyst.
【Discussion】
Solid and cystic lesions exist on mandibular bone. Solid lesions are divided into with calcifying component or without. Solid lesions without calcification include squamous cell carcinoma from gingiva or paranasal sinus (1). Osteomyelitis is also found with symptoms of inflammation such as fever, pain and swelling.
Cystic lesions of mandibular bone are often encountered when interpretation on dental imaging is served. Radicular cyst or dentigerous cyst is most experienced. These cysts are post-inflammatory emerging. The tooth adjacent to cyst, either around root or including tooth, is inactive (2-6). Other representative cystic lesions are melanoblastoma and odontogenic keranocyst (2-6). It is crucial to keep in mind that when cystic lesion on mandibular bone, four disease should be listed: radicular cyst, dentigerous cyst, odontogenic keratocyst and ameloblastoma.
In our case, the lesion is possibly diagnosed with amenoblastoma on panorama radiograph and CT. However, histologic examination revealed odontogenic keratocyst.
【Summary】
We presented a fifty-six-year-old male for health care check revealing he had a lesion with cystic components. It is borne in mind that there exists two common cystic lesions of radicular cyst and dentigerous cyst, and two uncommon cystic lesions of ameloblastoma (enamel epithelial tumor) and odontogenic keratocyte.
【References】
1.Dunfee BL, Sakai O, Pistey R et-al. Radiologic and pathologic characteristics of benign and malignant lesions of the mandible. Radiographics. 26 (6): 1751-68.
2.Scholl RJ, Kellett HM, Neumann DP et-al. Cysts and cystic lesions of the mandible: clinical and radiologic-histopathologic review. Radiographics. 19 (5): 1107-24.
3.Curé JK, Vattoth S, Shah R. Radiopaque jaw lesions: an approach to the differential diagnosis. Radiographics. 2012;32 (7): 1909-25.
4.Abrahams JJ, Rock R, Hayt MW. Embryology and anatomy of the jaw and dentition. In:, Som PM, Curtin HD, eds. Head and neck imaging, 4th ed. St. Louis, MO: Mosby, 2003:889–901
5.White SC, Pharoha MJ. Cysts and cystlike lesions of the jaws. In:, White SC, Pharoha MJ, eds. Oral radiology: principles and interpretation, 6th ed. St. Louis, MO: Mosby Elsevier, 2009:343–365
6.Lin LM, Huang GT, Rosenberg PA. Proliferation of epithelial cell rests, formation of apical cysts, and regression of apical cysts after periapical wound healing. J Endod 2007; 33:908–916
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