Iatrou I, Theologie-Lygidakis N, Leventis M. Intraosseous cystic lesions of the jaws in children: a retrospective analysis of 47 consecutive cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107:485-492 https://doi.org/10.1016/j.tripleo.2008.10.004
Tkaczuk AT, Bhatti M, Caccamese JF Cystic lesions of the jaw in children: a 15-year experience. JAMA Otolaryngol Head Neck Surg. 2015; 141:834-839 https://doi.org/10.1001/jamaoto.2015.1423
Patel M, Schultz K, Rosenfeld E. The earliest known reported occurrence of dentigerous cyst in a six-month-old child. Int J Oral Maxillofac Surg. 2022; https://doi.org/10.1016/j.ijom.2022.06.014
Robinson RA. Diagnosing the most common odontogenic cystic and osseous lesions of the jaws for the practicing pathologist. Mod Pathol. 2017; 30:(s1)S96-S103 https://doi.org/10.1038/modpathol.2016.191
Gallichan N, Albadri S, Dixon C, Jorgenson K. Trends in CBCT current practice within three UK paediatric dental departments. Eur Arch Paediatr Dent. 2020; 21:537-542 https://doi.org/10.1007/s40368-020-00526-w
Sahu B, Anand R, Kumar S A pattern-based imaging approach to pediatric jaw lesions. Indian J Radiol Imaging. 2021; 31:210-223 https://doi.org/10.1055/s-0041-1729767
Cystic lesions of the jaw in the paediatric population have been infrequently documented in the literature. The majority of these lesions are considered to be developmental in nature, as opposed to the commonly noted inflammatory lesions in the adults. Although asymptomatic, these lesions are associated with a high level of anxiety for parents. Early diagnosis and management help to allay anxiety. We present a case of 6-year-old boy who had a rapidly growing lucent lesion of the mandible that needed urgent intervention. The lesion was excised, analysed histopathologically, and confirmed as a dentigerous cyst. The management of paediatric cystic lesions can be difficult and vary significantly from those of the adult population. This can be amplified because cross-sectional imaging is seldom used in children owing to the risk associated with radiation. We present our experience of dealing with rapidly progressing lesion and the lessons learned in the process.
CPD/Clinical Relevance: The management of paediatric cystic lesions can be difficult and vary significantly from those of the adult population.
Article
A 6-year-old boy presented to the department of oral and maxillofacial surgery on an urgent pathway by his GP. There was a history of asymptomatic, but progressive swelling of the jaw for the previous 3 months. His past medical history was insignificant, and specifically there had been no weight loss, night sweats or pyrexia.
On examination, there was no obvious cervical lymphadenopathy. A visible and hard right-sided facial swelling was noted, with no overlying skin changes. Intra-oral examination revealed expansion of mandible around the LRC–LR6 region, with LR DE missing. There was no associated tenderness, discharge, ulceration or lesion on the mucosa. An orthopantogram (OPG) was taken at this visit, which showed a 36 x 25 mm, unilocular, well-defined radiolucency of the right mandible, extending from the apex of the deciduous canine to the first molar region. Additionally, the border of mandible adjacent to the lesion was very thin and susceptible to pathological fracture (Figure 1). In view of the above, an urgent surgery was planned to either marsupialize or enucleate the lesion under general anaesthesia.
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