Treatment

Under general anesthesia, an incision was made from approximately tooth #21 to tooth #25.  The mental nerve was retracted posteriorly and inferiorly.  The periosteum was carefully dissected off and the facial wall of the expanded area removed.  The lesion was then removed, as was the impacted tooth #22.  The cavity was copiously irrigated with saline solution and the rough and irregular margins smoothed.  The area was closed with chromic gut suture.  The area healed with no complications.

Incisional Biopsy

Histologic examination of the H & E section revealed multiple pieces of decalcified hard and soft tissue composed of a neoplasm of odontogenic epithelial origin and multiple tooth fragments representing sections of the impacted vital canine tooth.  The soft tissue component comprises the bulk of the specimen and is made up of a cystic structure with lining epithelium surrounded by connective tissue wall.  The lining epithelial is made up of spindle-shaped cells arranged in whorls and strands as well as lace-like structures (Figures 2 & 3).  The spindle epithelial cells are interspersed with duct-like structures lined by one layer of cuboidal epithelial cells (Figures 4 & 5). 

Figure 2 Low power (x40) histology shows an H & E stained section made up of a cystic structure with lining epithelium surrounded by connective tissue wall. The lining epithelial is made up of spindle shaped cells arranged in whorls and strands.

Figure 3 Higher power (100) histology shows an H & E stained section with a closer look at the spindle shaped epithelial cells arranged in whorls and strands.

Figure 4 Higher power (200) histology shows an H & E stained section with a closer look at the duct-like structures lined by one layer of cuboidal epithelial cells.

Figure 5 Higher power (200) histology shows an H & E stained section with a closer look at the many duct-like structures lined by one layer of cuboidal epithelial cells.