There is a 29 x 13 x 27 mm unilocular cystic slightly expansile lesion involving the body and angle of the left mandible, adjacent to the roots of the tooth 36 and 37 and to a lesser extent the unerupted mesially angulated 38. The lesion is not centred o the crown of 38. No dental caries or root absorption. The cortex is severely thinned inferiorly and posteriorly and there is a small region posteriorly where there is cortical breach. No periosteal reaction or pathological fracture.
The lesion extends to involve the left inferior alveolar canal near its origin.
No enlarged cervical lymph nodes.
No other destructive osseous lesion.
Small amount of bilateral maxillary sinus mucosal disease. Imaged lung apices are clear.
Conclusion
Cystic lesion of the body and angle of the left mandible. Based on location, appearances and the patients age, keratocystic odontic tumour is the favoured provisional diagnosis with a differential including unilocular ameloblastoma.