Presentation
Right mandibular painless, hard swelling.
Patient Data
Expansile multiloculated lytic lesion centered on the right parasymphysael region of the mandibular body with cortical thinning. No cortical breach is seen. No soft tissue component or abnormal enhancement on the postcontrast sequence. No extension to the adjacent structures.
Case Discussion
CT features are most consistent with an ameloblastoma.
Ameloblastomas are the second most common odontogenic tumor (odontoma is the most common). They are locally aggressive benign tumors that arise from the mandible, or, less commonly, from the maxilla.
On imaging, the main differential considerations include:
dentigerous cyst: the relationship between ameloblastomas and dentigerous cysts is a controversial one; 20% of ameloblastomas are thought to arise from pre-existing dentigerous cysts
odontogenic keratocyst (OKC): usually unilocular with thin, poorly enhancing walls
odontogenic myxoma can be almost indistinguishable
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