AN ATYPICAL SIMPLE BONE CYST IN THE INFERIOR ALVEOLAR CANAL: A CASE REPORT

Objective The simple bone cyst is a benign intraosseous pseudocystic lesion without any epithelial lining. As most of simple bone cysts are asymptomatic, they are commonly first noticed as incidental radiographic findings. In the jaws, they are predominant in the mandibular premolar and molar region of young adults. We present a case of simple bone cyst of the mandible with atypical association with the inferior alveolar canal. Clinical presentation A 52-year-old female patient presented with a well-defined, finely corticated, unilocular, radiolucent lesion of unknown duration in the right ramus of the mandible, with no relevant past medical history. A benign odontogenic lesion was considered. However, given that the CBCT findings indicated the inferior alveolar canal as a possible epicenter, the differential diagnosis also included neural tumors and vascular anomalies. Incisional biopsy was performed, but no epithelial lining was noted. Microscopically, the specimen consists of variably dense fibrocollagenous connective tissue with small blood vessels and nerve bundles. S100 and CD31 immunohistochemistry showed expected positivity for nerve and vascular tissues. A microscopic diagnosis of simple bone cyst associated with the inferior alveolar canal was rendered. Conclusion This case represents an unusual simple bone cyst. Radiographically, the lesion appears to be associated with inferior alveolar canal. Even though simple bone cysts in the posterior mandible are not common, it is very unlikely to involve/arise from the inferior alveolar canal.