Odontogenic keratocyst with a misleading clinical and radiologic appearance.

This report describes the case of an 82-year-old woman who presented with the chief complaint of a mild pain and gingival swelling of 2-months' duration in the buccal aspect of her mandibular left premolar region. The condition was initially diagnosed as a periodontal abscess and was treated as such by the referring clinician. The initial periapical radiograph provided by the clinician demonstrated horizontal alveolar bone resorption associated with active periodontal disease, which appeared to be more severe between the 2 premolars adjacent to the swelling. After more detailed clinical evaluation of the area and examination of the adjacent teeth, including vitality testing, it was concluded that the condition was not related to dental or periodontal disease. Consequently, a biopsy specimen was taken, and the histopathologic examination of the lesion proved it to be an odontogenic keratocyst. The case is reported because of the unusual clinical and radiographic findings associated with this lesion. Early diagnosis and appropriate treatment of odontogenic keratocyst can reduce the possibility of recurrence. However, misinterpretation of such a condition as endodontic or periodontal disease may lead to incorrect treatment planning and possibly unnecessary complications.

Case report: B-cell lymphoma of the maxillary sinus.

The radiographic manifestation of malignant lesions of the maxillary sinus on dental radiographs may be nonspecific, making it difficult to differentiate the lesion from disease of odontogenic origin or more benign sinus pathoses. A radiopaque mass in the maxillary sinus, resulting from a malignant neoplasm growing within or extending into the sinus, can be easily confused with the mass of a mucous retention pseudocyst. Similarly, a malignant growth in the early stages of development can produce radiographic patterns in the alveolar process that may resemble inflammation of odontogenic origin. A case of B-cell lymphoma is reported. The lesion involved the maxillary alveolar process and sinus, producing such a radiographic pattern on the panoramic radiograph. Radiographic and clinical features that should be considered in establishing a differential diagnosis of malignant disease are discussed.

Mental nerve neuropathy: case report and review.

Mental nerve neuropathy (MNN) or "numb chin syndrome" is a rare neurologic symptom most often associated with malignancy. Patients typically develop paresthesia or numbness localized to the chin and lower lip and will often seek care at their local emergency department. Pain and expansion of the lower jaw may also be present. We report a case of MNN associated with a metastatic lesion in the mandible. The purpose of this article is to highlight the importance of recognizing MNN, a potentially life-threatening symptom of metastatic carcinoma, and enable clinicians to properly diagnose MNN, which may mimic other conditions that affect the mandible.

Undiagnosed multiple myeloma causing extensive dental bleeding: report of a case and review.

A case of multiple myeloma causing profuse bleeding during a minor dental surgical procedure is presented. The value of dental radiography in detection of bone changes associated with an undiagnosed case of multiple myeloma is highlighted. We show that the extensive bleeding during the dental procedure could have been prevented if the panoramic radiograph had been evaluated carefully before initiation of the treatment. In addition, we briefly discuss the etiologic factors responsible for the formation of hemostatic abnormalities in multiple myeloma and the value of imaging methods used in diagnostic assessment of the disease.