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Case 61148

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Referral category

Disease / syndrome / tumor / condition

Region of interest

left maxilla

Referral reason

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Canaray 61148

1. Benign, bone-forming neoplasm in left maxilla

A well-defined, delicately corticated, mixed radiopaque-radiolucent entity is present within the left maxilla, extending from the canine region to tooth 27 and from the alveolar crest to the sinus floor. Multiple foci of granular bone are dispersed throughout the central aspect of this primarily radiolucent entity. The roots of teeth 25 and 26 are splayed, but no resorption is present. The sinus floor has been elevated but remains intact, and the contiguous nasal floor is thinned.

This radiographic appearance is most consistent with a benign, bone-forming neoplasm. The possibility of an ossifying fibroma should be considered. Biopsy and histopathologic confirmation is indicated.

Axial views of maxilla

These axial cross-sectional images demonstrate the extent of the benign neoplasm in the left maxilla between teeth 23 and 27. The thinned and expanded buccal and palatal cortical plates are evident.

Coronal views of maxilla

These coronal cross-sectional images demonstrate the disorganized array of granular bone formation within the central aspect of the lesion in the left maxilla. A small focus of sclerotic bone is also noted adjacent to the inferolateral wall of the nasal cavity. The poorly organized internal structure is more suggestive of an ossifying fibroma than a central giant cell granuloma.

Sagittal views of left maxilla

These sagittal cross-sectional images demonstrate elevation of the floor of the left maxillary sinus. The overlying antral air space is clear. The roots of teeth 25 and 26 are splayed, but no resorption has occurred.

Developing wisdom teeth

The wisdom teeth 18, 28, 38 and 48 are developing normally. No evidence of pathology is associated with the adjacent teeth at this time. No resorption has occurred to the adjacent teeth.

2. Dense bone islands in mandible

Three small dense bone islands are present in the mandibular alveolar process, located interproximal to teeth 44 and 45, distal to tooth 34, and distal to tooth 35. This is an incidental finding with no clinical significance.

3. Pseudocyst in sphenoid sinus

A small pseudocyst is present in the sphenoid sinus. This is an incidental finding with no significance.

4. Concha bullosa

The right and left middle nasal conchae contain air. This represents bilateral concha bullosa and is an incidental finding with no clinical significance.

5. Right palatine tonsillolith

A tonsillolith is present in the right palatine tonsil. This is an incidental finding with no significance because tonsilloliths exfoliate spontaneously.

6. Calcified stylohyoid ligaments

The stylohyoid ligaments are partially calcified bilaterally. This is an incidental finding with no clinical significance.