[Oradlist] 36 yrs old male

[Emad Khan]

Dear Drs.,

Very valid points but I am still not completely convinced.
If the epithelial lining is not corticated and contiguous with the sinus air I 
would expect to see a "bulging" profile. Instead, I see a continuous curvature 
from the corticated area to the seemingly not corticated area which might 
represent a very thin cortex. The expansion and the hydraulic features are 
relative to the least resistance area.

If the "wait and see" approach with radiographic monitoring is chosen rather 
than surgery the complication might not be as serious. This may be related to 
the growth rate of the lesion.

I am wondering now how would a patient/dentist choose based on our radiology 
report? Is it an "informed" decision?

Thank you all for the very interesting cases and discussions.

Emad





________________________________
From: Susanne Perschbacher <sperschbacher at hotmail.com>
To: oradlist at lists.ucla.edu
Sent: Thu, September 2, 2010 5:24:09 AM
Subject: Re: [Oradlist] 36 yrs old male

 Dear Ebtihal,
Based on the images you have provided, I really feel this is an antral 
pseudocyst filling a loculation within the sinus. 
The images labelled "cys3", "cys4" and "softtissue" show that the cortication 
around the entity is incomplete and that the soft tissue is contiguous with the 
sinus air.
Also, despite the apparent round, cystic appearance from the parasagittal cuts, 
the cross-sectional views fail to reveal any expansion nor the hydraulic shape 
we would expect from a cystic lesion.

I would suggest not doing surgery and rather, monitoring the entity 
radiographically. 

Thanks for sharing all your interesting cases.

Regards,
Susanne Perschbacher
Oral and Maxillofacial Radiology
University of Toronto

________________________________
Date: Tue, 31 Aug 2010 11:40:13 +0300
From: ebtihalh at gmail.com
To: oradlist at lists.ucla.edu
Subject: [Oradlist] 36 yrs old male


Hi all
This is an incidental finding when patient came to the implant clinic, patient 
is not complaining of pain, the panoramic image shows a well defined corticated 
cyst-like lesion less than 2 mm within the maxillary sinus and not related to 
#16 and # 17 as seen from the coronal and sagittal sections, the fifth image 
(coronal view) shows less cortication resembling a soft tissue mass, or a cyst 
filled with fluid.
Differential diagnosis 
1. Maxillary sinus mucous retention cyst 
2. polyp in maxillary sinus

-- 
Ebtihal H. Zain Alabdeen, BDS, Msc
Oral and Maxillofacial Radiology
Ministry of Health
Riyadh, Saudi Arabia


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