History of the present illness

This is a 5-year-old white male who first presented for an initial routine dental examination by the pediatric dentist. Radiographs revealed a large radiopaque and radiolucent lesion associated with an impacted tooth #22 (Figure 1). The lesion was described to be approximately 2 cm in size and was expansile. The lesion displaced tooth #22 into the inferior border of the mandible. The lesion was otherwise asymptomatic; there was no pain or paresthesia. Clinical examination of the area showed an expansion at the left mandibular area overlying the lesion. The overlying and surrounding oral mucosa was unremarkable.

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.