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Referral details

Case 198904

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Referral category

Disease / syndrome / tumor / condition

Region of interest

4th Quadrant

Referral reason

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Canaray 198904

1. Benign tumor in posterior 4th quadrant

A well-defined, predominantly radiolucent entity with a unilocular overall appearance is present in the posterior fourth quadrant in the region apical to teeth 85, 46, and 47. The periphery of this entity is delicately corticated. Mild lingual expansion of the alveolar process has occurred. Small dehiscences are visible within the lingual cortical plate adjacent to the entity. The inferior alveolar nerve canal appears to have been slightly inferiorly displaced by the entity. The border of the canal is not clearly defined, but this is the case along the entire course of the canal, not just in the region that abuts the lesion. The roots of teeth 46 and 47 have not been affected by the entity. One unique radiographic feature of this entity is the appearance of a localized "flow-around" effect at the border between the lingual cortical plate and the periosteum. This feature, in particular, is not characteristic of simple bone cysts and is more commonly seen in central giant cell granulomas. Internally, the entity is not completely radiolucent. Small low-density granular calcifications are visible, which is a second finding that is not characteristic of simple bone cysts.

This entity has many radiographic features of a simple bone cyst, as well as a few features that are suggestive of a central giant cell granuloma or possibly an odontogenic myxoma. The most likely diagnosis is a simple bone cyst with a slightly unusual presentation. However, due to the unusual presentation, a biopsy would be necessary for a definitive diagnosis.

Retained tooth 85 and congentially absent tooth 45

Tooth 85 is retained. Tooth 45 is congenitally absent. No significant root resorption is evident at tooth 85.