History of the present illness
This 51-year-old white male was referred by his general dentist in May 2007 for obvious mandibular asymmetry along the inferior border of the left mandible. The patient reported that the lesion had been there for at least 1 Ĺ years. He was vague as to why no biopsy or treatment had been rendered up to that point. At presentation, he was experiencing pain and periodic numbness in the left lip and chin. The panoramic radiograph showed a large multilocular and expansile radiolucency in the left posterior mandible involving most of the body of the mandible (Figure 1). The expansion involved the inferior border of the mandible, as well as the buccal alveolar ridge. The patientís past medical history is significant for Crohnís disease and tobacco use.  

 

Figure 1. This panoramic radiograph is taken at first presentation.  Note the large expansile multilocualr radiolucency involving most of the body of the mandible. 

Figure 2. Low power (x100) histology shows a two fragments of a cystic structure lined by uniformly thin and keratinized stratified squamous epithelium and supported by fibrous connective tissue wall.