Question

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?
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• A. Ossifying fibroma
• B. Ameloblastoma
• C. Osteoblastoma
• D. Odontogenic keratocyst

Hint:

Odontogenic keratocyst commonly occurs in posterior mandibleShows well-defined radiolucency with minimal bucco-lingual expansion.

Answer 1

The Correct Option is D

The clinical scenario involves a 55-year-old male with pain and swelling in the lower jaw, particularly over the left angle and body of the mandible. The OPG reveals specific radiographic findings.

To determine the most likely diagnosis, let's analyze each option:

1. Ossifying fibroma: Typically presents as a well-defined radiolucent lesion with mixed radiopaque areas. Usually, the lesion is not primarily cystic and is more common in younger individuals.
2. Ameloblastoma: Typically presents as a multilocular (soap-bubble) radiolucency. It often causes significant expansion and is commonly associated with an unerupted tooth. This does not match the typical presentation of a unilocular radiolucency without significant expansion in this case.
3. Osteoblastoma: Rare in the mandible and usually presents as a well-defined radiolucent lesion that may have some opacity. It frequently causes pain but does not fit the given radiographic description.
4. Odontogenic keratocyst (OKC): Known for presenting as a well-defined, unilocular or multilocular radiolucency. OKCs are often found in the posterior mandible and can cause cortical expansion. The clinical and radiographic findings align with an odontogenic keratocyst.

Conclusion: Based on the radiographic characteristics and clinical examination findings, the most likely diagnosis is Odontogenic keratocyst (OKC).