Biopsy-Confirmed Glandular Odontogenic Cyst on Follow-Up Evaluation of a Displaced Third Molar

A 63-year-old female was referred for evaluation of the relationship between the left mandibular canal and the roots of a displaced tooth #17 and its associated lesion. The lesion had been noted on a previous scan also reported by BeamReaders, at which time its presentation was most suggestive of a dentigerous cyst or odontogenic keratocyst, and biopsy subsequently confirmed a glandular odontogenic cyst. On comparison with the prior study, the radiologist identified a reduction in the size of the lesion, resulting in significantly less direct contact between the lesion and the mandibular canal. Significant direct contact between the canal and the roots of #17 remained, and the radiologist provided nerve tracing with incremental cross-sectional imaging to give the treating doctor the information needed to plan a successful surgery while reducing the risk of complications. The radiologist highlighted this as a valuable teaching case, noting that glandular odontogenic cysts typically have a more aggressive growth profile, and that this case demonstrates lesions can present across a spectrum of appearances, with more aggressive lesions at times showing less aggressive features and vice versa.