What is your differential diagnosis?
Differential for these findings would include a giant cell granuloma, adenomatoid odontogenic tumor, keratocystic odontogenic tumor, Langerhans cell histiocytosis, simple bone cyst, aneurysmal bone cyst, or other benign osseous tumor. The lesion appears separate from the incisive foramen. Biopsy will be required for a definitive diagnosis, but MRI could be considered for further preoperative tissue characterization.
There is an expansile lucent lesion within the left maxilla, measuring 30 x 29 x 35 mm AP by TR by CC. It is centered between the permanent left upper canine and first premolar with lobulated margins protruding into the floor of the left nasal cavity, left maxillary sinus, and left hard palate where there are areas of either frank osseous deficiency or extremely thin bone. The remaining osseous margins are sharply defined with nonaggressive borders. Lesional attenuation is misleading on cone beam CT though there is some suggestion that the lesion is more solid than cystic; no discrete lesional calcification/matrix.
No additional osseous lesion is identified within the maxillary field-of-view.
The lucent maxillary lesion occurs in the setting of a full complement of dentition for age, including partially erupted third molars. There is splaying apart of the roots of the first maxillary canine and premolar by the lucent lesion. There is otherwise normal alignment within each dental arch. There is normal molar occlusion and overjet/overbite. The temporomandibular joint is normally positioned.
There is protrusion of the lytic maxillary lesion into the left nasal cavity, left maxillary sinus, and left hard palate. The visualized nasal cavity and paranasal sinuses are otherwise clear.
Soft tissue structures of the face are not diagnostically evaluated due to low-dose technique.