Case Presentation

Radiology D e pa r t m e n t

Presented and done by

Ahmed Zarif
Preliminary Clinical Diagnosis

A Patient came to the clinic with moderate swelling complaining

about mild pain related to lower right first and second molar 2 months
ago and a difficulty while eating
Case Info

Patient Name: Mai A**** H****

Age: 23 years
Nationality: Egyptian
Occupation: Teacher
Adress: Shubra
Phone Number: 010******903
Clinical Examination

Extraoral: some swelling in Intraoral : swelling related Slight pain on Palpation

the cheek to lower posterior area

Upon asking for Family history: history of malignancy related to the patient mother
Radiographic Examinatio
Radiographically

Moderately sized rounded, corticated cyst-like radiolucent

area with a well-defined margin present anterior to lower right
molars. leading to migration of teeth and slight root resorption of
the teeth resting on the mental and inferior nerve.

They can have a multilocular (honeycomb or soap bubble) appearance.

(With 53% showing scalloped margins.)

Definitive Treatment

-Biopsy for lab investigation is to be taken to know the defintive diagnosis and possible
treatment

-Excession of this lesion and extraction of lower 4&5&6 is required followed by fixation
plates and screws
Differential diagnosis:

1) Cyst
2) Giant cell granuloma
3) Ameloblastoma
4) Odontogenic keratocyst
(cheesy like material upon aspiration)
Definitive Diagnosis

Pathology report:
Central giant cell reparative granuloma with
surrounding woven bone
Central Giant Cell Granuloma

A benign condition of the jaws of localised non corticated fibrous tissue tumours which
contain osteoclasts, the exact cause is unknown, but it is believed to be a reactive process,
possibly secondary to trauma or inflammation.

CGCGs are more common in the anterior mandible, often crossing the midline and causing
painless swellings

However it erodes through bone including the alveolar ridge

Soft tissue swelling that is purple in colour
Paresthesia of the lip has also been observed
Resorption of tooth roots is seen in 37% of cases compared to displacement of teeth in 50%
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