A 55-year-old male presents with pain and swelling in the lower jaw. On clinical examination, tenderness is noted over the left angle and body of the mandible, along with mild bucco-lingual cortical expansion. An orthopantomogram (OPG) reveals the radiographic findings shown. What is the most likely diagnosis? 7
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Odontogenic keratocyst commonly occurs in posterior mandibleShows well-defined radiolucency with minimal bucco-lingual expansion.
Step 1: Analyze the clinical presentation.
The patient is middle-aged with pain and swelling in the mandibular angle and body regionThere is mild bucco-lingual expansionOdontogenic keratocysts commonly occur in the posterior mandible Step 2: Interpret radiographic features.
The OPG shows a well-defined radiolucent lesion in the posterior mandibleOdontogenic keratocysts typically present as well-corticated radiolucenciesThey may grow extensively in the anteroposterior direction with minimal cortical expansion Step 3: Evaluate the options. (A) Ossifying fibroma: Usually presents as a mixed radiolucent-radiopaque lesion with significant expansion (B) Ameloblastoma: Often shows multilocular "soap-bubble" or "honeycomb" appearance with marked expansion (C) Osteoblastoma: Typically produces radiopaque or mixed lesions and is less common in this location (D) Odontogenic keratocyst: Appears as a well-defined radiolucent lesion in posterior mandible with minimal expansionMatches the described features Step 4: Conclusion.
Based on posterior mandibular location, well-defined radiolucency, and mild expansion, the most likely diagnosis is odontogenic keratocyst
