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Case 91956

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Disease / syndrome / tumor / condition

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4thQuad

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Canaray 91956

Odontogenic cyst or cystic tumor in posterior right mandible [Update on 22 October 2015: This lesion was histopathogically diagnosed as a fibrous myxoma]

A well-defined corticated radiolucent cystic entity is located distal to tooth 48 in the right mandibular posterior area. This entity has a scalloping border and has extended into the anterior border of the ramus. No external resorption on tooth 48 is evident. Thinning of the buccal and lingual cortices is evident, but no buccolingual expansion of the alveolar process has occurred. The inferior alveolar nerve passes through the inferior border of the lesion. No tooth displacement is present.

This radiographic appearance likely represents a benign odontogenic cyst or cystic tumor.

Axial views of the right posterior mandible

These axial cross-sectional images demonstrate broad endosteal scalloping of the buccal and lingual cortical plates of the mandible distal to tooth 48. No damage has occurred to tooth 48.

Mesiodistal views of the posterior fourth quadrant

These mesiodistal cross-sectional images demonstrate extension of the cystic lesion from the distal surface of the distal root of tooth 48 to the anterior border of the ramus. The presence of broad endosteal scalloping is apparent. The alveolar crest is intact distal to tooth 48.

Orthogonal views of relationship of left inferior alveolar nerve canal to lesion (with orange nerve overlay)

These orthogonal cross sectional images demonstrate the position of the inferior alveolar nerve canal at the inferior border of the fibromyxoma at site 48. The superior cortical border of the inferior alveolar nerve canal is not visible. An orange overlay is present in these images to identify the inferior alveolar nerve canal.

Orthogonal views of right inferior alveolar nerve canal (without orange overlay)

The superior border of the inferior alveolar nerve canal is not visible in the region adjacent to the fibromyxoma.

Mesiodistal views of site 48 (with orange nerve overlay)

These mesiodistal cross sectional images demonstrate the relationship of the inferior alveolar nerve canal to the fibromyxoma at site 48

Mesiodistal views of site 48 (without nerve overlay)

The absence of the superior border of the inferior alveolar nerve canal in the region adjacent to the five is myxoma is evident in these images.

Buccolingual views of fibromyxoma and right inferior alveolar nerve canal (with orange overlay)

These buccolingual cross sectional images demonstrate the position of the inferior alveolar nerve canal at the inferior border of the fibromyxoma.

Buccolingual views of fibromyxoma and right inferior alveolar nerve canal (without nerve overlay)

These buccolingual cross sectional images demonstrate the absence of any clearly defined boundary between the fibromyxoma and the inferior alveolar nerve canal at site 48.

1. Calcified stylohyoid ligaments

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