History of the present illness

This is a 22-year-old Alaska Native male with history of 120 pounds of weight loss. He presented to Seattle Indian Health Board clinic for a routine dental visit. The head and neck examination was within normal limits. There is was no evidence of facial swelling or asymmetry or bony expansion. However, the panoramic radiograph (Figure 1) revealed a large, well-defined and corticated unilocular radiolucency of the left ramus extending and involving the condylar process and condylar head. The radiolucency of the condyle is multilocular.

Figure 1 Panoramic view at first presentation demonstrating large unilocular radiolucency with corticated border involving most of the ramus and an extension multilocular radiolucency of the condyle.