Odontogenic keratocyst
CT features of a unilocular expansile lucent lesion of the maxilla with scalloped, well-corticated borders suggestive of odontogenic keratocyst (OKC)
On imaging, the main differential diagnosis should include:
-
ameloblastoma
- tend to be multilocular, more expansile, with a "soap-bubble" or "honeycomb" appearance
- tend to be more aggressive and cause more significant tooth resorption
- long-standing OKC may mimic ameloblastoma
-
dentigerous cyst
- tend to attach at the cementoenamel junction of teeth
-
radicular cyst
- centered at the apices of non-vital teeth
- does not scallop, does not exhibit septation, and is often more expansile
-
simple bone cyst
- exhibit minimal expansion, and spare the lamina dura as well as the periodontal ligament spaces
- OKC will tend to efface the lamina dura
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