History of the present illness

This is a 17-year-old Hawaiian male whose chief complaint is of right facial swelling and asymmetry of six months’ duration. The patient has had regular dental and medical care. The patient was originally seen by an ear, nose and throat doctor who attributed the facial asymmetry to a large and expansile radiolucency of the right posterior mandible and ramus (Figure 1); this was confirmed by an oral surgeon. There was no evidence of pain, neurological abnormalities or malocclusion. The condyle and coronoid processes were not affected.

Figure 1 Cone Beam CT view at first presentation demonstrating large unilocular and expansile radiolucency with some generalized fine radiopacity involving most of the right posterior mandible and part of the ramus sparing the condyle and the coronoid processes.