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59 Y/O with Right Chin Numbness

Unilocular, expansile cystic lesion of body with lingual cortex erosion.  There is no soft tissue component and the lesion extends anteriorly to the mental foramen.

Roots of teeth minimally eroded, scalloping of cortex and unerupted 3rd molar tooth is within the posterior wall of the cyst.

Keratocystic odontogenic tumor (current name according to Brian’s boss).  Arises from remnants of dental lamina.  50% present with jaw swelling.  Associated with Marfan and Noonan synd.  If multiple, 50% have basal cell nevus syndrome (look for dural calcs).  Is there infection on the f/u?

Arrow:  irrigation drain.  New bone formation is visible along the margins, the unerupted tooth was resected.  The drainage of the cyst and irrigation is tx by marsupulization resulting in the cyst filling in over the next 6-12 mo.  Surgeon will likely enucleate after when a managable size.  High recurrence rate regardless of tx.