Files (0)

Only logged-in users can see the full file list

Do you have an access code? Enter it below:

Referral details

Case 255317

Do you have an access code? Enter it below

Referral category

Disease / syndrome / tumor / condition

Region of interest

Right Mandible

Referral reason

[Only visible to logged-in users]

0 Files Info

Canaray 255317

Expansive mixed radiolucent-radiopaque/multiocular benign tumour in right mandible

There is an expansive mixed radiolucent- radiopaque moderately-defined entity in the right mandible, which extends from the root of tooth 43 to the roots of tooh 48, and from the alveolar crest to the inferior border of the mandible, which is partially captured in this image volume. The buccal and lingual cortical plates as well as the inferior border of the mandible are significantly expanded, thinned. The internal surfaces of the cortices exhibit small nibbling and scalloping as well as tiny septae. The buccal cortex may be partially dehiscent along the anterior aspect of the lesion. Tooth 43 is mesially displaced, and apical root resorption may be present on teeth 44, 45, and 46. Internally, the lesion exhibits possible foci, patches, and spicules of bone or calcified tissue. The definitive nature of these high density areas cannot be determined due to the filters that has been used on the image, such as metal artifacts removal. The right mandibular nerve canal is significantly dislaced in a buccal direction and appears compressed.

These radiographic features suggest a benign tumour possible with an odontogenic origin. The most likely diagnosis is calcifying epithelial odontogenic tumour (Pindborg tumour). The possibility of an ameloblastoma (desmoplastic type) or unusual cementifying-ossifying fibroma should also be considered as an alternative differential diagnosis. Biopsy and histopathologic correlation is recommended to make a distinction between these interpretations.

Mesiodistal views of the right mandible

These mesiodistal cross-sectional images demonstrate the buccal displacement of the mandibular canal as well as the probable dehiscence of the inferior cortical border of the right mandible. Also note the presence of a mixed pattern of the internal structure of the tumour and relatively well-defined borders, which suggests a benign tumour.

Axial views of the right mandible

These axial cross sectional images demonstrate the expansive lesion in right mandibular body and the buccal displacement of the right mandibular nerve canal. Note the small nibbling appearance along the remaining cortices, as well as the septae-like appearance.

Buccolingual views of the right mandibular body

These buccolingual cross-sectional images demonstrate that the inferior cortex of the right mandibular body has been partially captured, but appears expanded and may be dehiscent. The buccal and lingual cortices are thinned, and significantly expanded. The buccal cortex may be partially dehiscent. Note the absence of any periosteal bone formation. The mandibular nerve canal is buccally displaced.

Panoramic view of mandible

This panoramic reconstruction exhibits the extension of the lesion in the right mandible from the root of tooth 43 to the roots of tooth 48. The roots of the involved teeth exhibit apical resorption, but tooth 48. The root of tooth 43 is distally displaced.

1. Mucous retention cysts in both maxillary sinuses

Mucous retention cysts are evident along the floor of both maxillary sinuses. The ostiomeatal complexes appear patent otherwise. These mucus retention cysts will likely spontaneously resolve over time, and are non-significant incidental finding.

2. Osteoma in right frontal sinus

There is a smoothly contoured, pedunculated outgrowth of cortical bone located within the right loculation of the frontal sinus. These findings suggest the presence of an osteoma, which is a non-significant incidental finding. Continued follow up radiograph may be recommended.