PATHOLOGIC QUIZ CASE 1
Louis Gallia, DDS, MD, Jonas T. Johnson, MD, Pittsburgh
A 15-year-old boy was initially seen with an asymptomatic left maxillary mass of one month's duration. Physical examination disclosed firm palatal and buccal expansion of the left maxillary alveolus from the canine tooth to first molar; the overlying mucosa was normal. The teeth were aligned, immobile, and without caries; on vitalometer testing, the first premolar had a diminished response.
Polytomography (Fig 1) showed a 4-cm soft-tissue mass occupying the left maxillary sinus, with expansion of the buccal, palatal, and inferolateral nasal wall. A small dome-shaped mass of the opposite maxillary sinus, consistent with a mucous retention cyst, was noted. A periapical roentgenogram (Fig 2) showed external resorption of the canine tooth through first molar roots, most notably in the second premolar.
A Caldwell-Luc approach on the left side was used to remove a soft, friable, red-brown mass.
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