A Rare Presentation of Radicular Cyst: A Case Report and Review of Literature

Abstract

The radicular cyst is the most common inflammatory odontogenic cyst in the jaws. It is a periapical lesion associated with non-vital teeth in the tooth-bearing regions of the jaws with a slight male predilection. A radicular cyst is typically asymptomatic, but if large or secondarily infected may cause swelling. The usual radiographic appearance of a radicular cyst is that of a periapical radiolucent lesion. This case report documents a rare case of 61-year-old male with a mixed-density periapical lesion diagnosed as a radicular cyst. The lesion presented as a well-defined, expansile, space occupying, corticated, sclerotic, hydraulic, unilocular, mixed density lesion, associated with the right mandibular second premolar that was predominantly radiolucent with scattered foci of radiopacities. Microscopic examination revealed fragments of lining epithelium along with small fragments of inflamed fibrous connective tissue, aggregates of necrotic cellular debris, and bacterial colonies intermixed with foci of dystrophic calcifications. The histopathological diagnosis was a radicular cyst with dystrophic calcification. Although rare, this entity should be considered in the differential diagnosis of mixed-density periapical lesions. Complete history and proper diagnosis is important in this type of rare cases as treatment varies between a radicular cyst and other odontogenic neoplasms.