Cystic lesions of the anterior mandible in young adults present a diagnostic challenge owing to the overlapping clinical and radiographic features of odontogenic keratocysts, unicystic ameloblastomas, central giant cell lesions, and traumatic bone cysts. A 25-year-old man presented with localized pain and swelling of the anterior mandible. The left mandibular first premolar was nonvital, and panoramic radiography revealed a 2 × 3 cm well-defined radiolucent lesion with sclerotic, scalloped margins and associated external root resorption. Fine-needle aspiration cytology did not yield any fluid (dry tap). Surgical exploration revealed an empty bone cavity with minimal straw-colored fluid and no discernible epithelial linings. Histopathological examination revealed fibrous connective tissue with chronic inflammation, dystrophic calcification, and focal multinucleated giant cells, but no epithelial lining. The final diagnosis was a traumatic bone cyst of the mandible. Surgical curettage with bleeding stimulation was performed. This case underscores the need for surgical exploration and histopathology to make a definitive diagnosis, as radiographic and cytological findings alone are insufficient to distinguish traumatic bone cysts from other cystic lesions.
Dudhe et al. (Mon,) studied this question.