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Tooth in a cyst - Is it always a dentigerous cyst?
Neelam Vaid1, Ajay Kothadiya, Sushama Adwani
1K.E.M. Hospital, 2, National Hsg Soc, Baner road, Aundh, Pune, Maharashtra 411 007 India.
Summary
An unerupted tooth in the maxillary sinus, initially suspected as a dentigerous cyst, was diagnosed as an odontogenic keratocyst. This case highlights the importance of accurate diagnosis, as not all cysts containing teeth are dentigerous.
Area of Science:
- Otorhinolaryngology
- Oral and Maxillofacial Surgery
- Pathology
Background:
- Unilateral nasal obstruction can be caused by various pathologies within the sinonasal tract.
- Cystic lesions in the maxillary sinus, particularly those associated with unerupted teeth, require careful diagnostic consideration.
- Dentigerous cysts are the most common type of developmental odontogenic cyst associated with an unerupted tooth.
Purpose of the Study:
- To report a case of an 18-year-old female presenting with unilateral nasal obstruction due to a cystic lesion in the maxillary sinus.
- To highlight the diagnostic challenge in differentiating between a dentigerous cyst and an odontogenic keratocyst when an unerupted tooth is present.
- To emphasize the importance of histopathological examination for definitive diagnosis.
Main Methods:
- A case report of an 18-year-old female with unilateral nasal obstruction.
- Computed tomography (CT) scan for imaging the sinonasal region.
- Endoscopic surgical removal of the cystic lesion and unerupted tooth.
- Histopathological analysis of the excised specimen.
Main Results:
- CT scan revealed an unerupted molar within a cystic swelling in the right maxillary sinus.
- Preoperative diagnosis was a dentigerous cyst.
- Surgical removal and subsequent histopathology confirmed the lesion as an odontogenic keratocyst.
- The presence of a tooth within the cyst did not confirm it as dentigerous.
Conclusions:
- Odontogenic keratocysts can occur in the maxillary sinus and mimic dentigerous cysts.
- Histopathological examination is crucial for the accurate diagnosis of sinonasal cystic lesions, especially when associated with unerupted teeth.
- This case underscores the need for vigilance in diagnosing cystic lesions in the maxillary sinus, as the presence of a tooth does not exclusively indicate a dentigerous cyst.
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