This lesion was discovered during routine oral examination by the patient's pediatric dentist and was of unknown duration. It was expansile but otherwise asymptomatic. The patient was referred to the oral and maxillofacial surgeon for further evaluation and work up. A panoramic radiograph revealed a large mixed radiolucent/radiopaque lesion in the left mandible (Figure 1). A cone-beam CT scan was also performed to characterize the lesion as well as assess the surrounding structures and amount of surrounding bone present appropriate for the surgical procedure.
Figure 1 This is a panoramic view of the primary tumor taken at the initial presentation by the pediatric dentist. Note the inferiorly placed and impacted tooth #22 with miniature tooth-like structures associated with the crown of the tooth.