At presentation, the patient was not in any acute distress. He had obvious mandibular asymmetry with increased fullness along the inferior buccal alveolar ridge. An oral exam noted an intact dentition with multiple carious teeth, though these were firm and not mobile. No submandibular adenopathy was noted. A firm, non-tender, non-fluctuant swelling was noted in the buccal vestibule extending from the left angle of the mandible to the left parasymphysis area. In addition, a firm fullness was noted on the lingual left mandibular alveolar ridge. His oral hygiene was fair. Both the panoramic and CT scan demonstrated a large multilocular radiolucency of the left mandible with possible lingual bony perforation.