Traumatic bone cyst in the mandibular ramus - A diagnostic dilemma

Traumatic bone cysts (TBCs) are uncommon, nonneoplastic lesions occurring more commonly in the metaphysis of the long bones and contribute to only 1% of the cysts occurring in the jaws. Seen more commonly in the mandible between the canine and third molar, their occurrence in the ramus-condyle region is very rare. The radiographic appearance of this lesion is like odontogenic keratocyst (OKC) or ameloblastoma and, therefore, extremely challenging to diagnose. Misdiagnosis often results in aggressive treatment for an otherwise innocuous entity. The purpose of this article is to encourage the surgeon to consider the possibility of a TBC when encountering asymptomatic large lytic lesions in the ramus of the mandible especially in younger individuals to avert an extensive radical surgery.