A 38 year old female patient complained of swelling in the left lower region present since 5 months with no history of pain. History revealed that the swelling started as a small one extending from the premolar to the molar with no considerable change in size. Extraoral examination revealed facial asymmetry with diffuse swelling of about 2 × 2 cm, extending anteroposteriorly. swelling is non tender and hard. clinical picture and opg is attached please diagnose and discuss management.

7 Likes

LikeAnswersShare
Either this a uncystic ameloblastoma, but for this it should hv had scalloped margins, then it can b a cyst, as it has a even cystic wall shadow, better to aspirate n c for golden yellow aspirate for cyst, blood for central hemangioma or aneurysmal bone cyst, as there is absence of teeth in this region, history of mobile, impacted tooth, resorption of root, is missing, diagnose histopathologically n then go in for marsupilization, as the lower border width in the area of interest is less than 10mm, which is mandatory for continuity maintenance after any encleatuon, so marsupilization would continue till lower border of mandible is more than 10mm, the intra-cavity packing can be of iodophor + glycerine impregnated ribbon gauze, shorten the length of ribbon gauze every week or fortnightly. Observe n treat accordingly
In edentulous area necrotic tissue also prasent it consider someting or not?
0

View 2 other replies

residual radicular cyst in mand body region DDs Ameloblastoma(unicystic), KCOT, Odontogenic myxoma... Here pt has edentulous space might have undergone extraction of carious tooth and in long standing cysts ameloblastoma can arise from the cystic lining so suspecting ameloblastoma. go for FNAC and incisional biopsy.... n refer or treat accordingly....
OPG shows break in the superior alveolar margin which is becz of extraction... here the socket is not healed and has exposed the underlying lesion with secondary infection.... that is wht u r seeing clinically i feel.... better to put pt on antibiotics and analgesics before performing incisional biopsy(from the exposed socket region)
0

View 1 other reply

Suspect malignancy, advised incisional biopsy and histopathological examination before deciding treatment plan.
@Dr. Rajat Gupta Rabat ur views plz...
Radicular cyst.. Marsupialisation should be done..
Dr reema sharma, thanks for tagging me..
0
Any prior extraction ,ameloblastoma ??
Necrotic tissue is also seen , what it is consider?
0
FNAC and biopsy is needed
A close exam of opg shows a marked radioluscent area surrounded by radio opaque line and destruction of trabucular pattern.suggesting cystic growth.Advised to be nucleation under systemic use of medication and biopsy of any solid component encountered to rule out malignancy. Dr.Guljar Chand
more clinical and intraoral photographs are reqd. Looking at OPG., I feel that it can be residual cyst, lateral periodontal cyst to lower last molar, unicystic ameloblastoma, okc. Advice FNAC and then biopsy and then treatment according to histopath report.
go for biopsy of ulcerative area over ridge, n aspirate for cystic area, go for cbct to see bone pattern more clearly, according to me order of diagnosis would be. unicystic ameloblastoma, residual cyst, primary intraosseous squamous cell carcinoma,
Load more answers

Cases that would interest you