E1827. Not So Inci-”dental”: A Review of Cystic Lesions of the Jaw
  1. Redmond-Craig Anderson; LAC+USC Medical Center
  2. Phoebe Chang; LAC+USC Medical Center
  3. Jay Acharya; Keck Hospital of USC
  4. Anandh Rajamohan; Keck Hospital of USC
Cystic lesions of the jaw are commonly identified on routine neuroimaging either incidentally or through workup of suspected jaw mass. While most cystic lesions of the jaw are benign (often congenital) processes, a few entities may require further evaluation and/or management and should be recognized by the radiologist. In this review, we will discuss the differential considerations for cystic lesions of the jaw and the tools to make a successful diagnosis.

Educational Goals / Teaching Points
The purpose of this educational exhibit is to provide an approach for interpretation of cystic lesions of the jaw. Different lesion types will be discussed including imaging features and tools to make a successful diagnosis and/or differential. We will also briefly discuss the treatment options for different lesion types.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Cystic lesions of the jaw (involving both mandibular and maxillary bones) are most commonly benign etiologies associated with an odontogenic process, either congenital or infectious secondary to odontogenic disease. A systematic approach includes identification of: lesion location, osseous changes, presence or absence of soft tissue components, relationship to adjacent teeth and presence of infectious/ inflammatory signs. Periapical cysts are often incidental and related to periodontal disease. Dentigerous cysts are seen less commonly and are always associated with the crown of an unerupted tooth. Additional uncommon lesions such as keratogenic cyst, Stafne cyst, nasopalatine duct (incisive) cysts, and simple or aneurysmal bone cyst have defining imaging characteristics which will be discussed. Lastly, recognition of suspicious features, such as soft tissue components or destructive osseous changes should be sought to help exclude a malignant process, such as ameloblastoma or other primary malignancy of the jaw.

This educational exhibit will provide an approach to the evaluation of cystic lesions of the jaw and discuss treatment implications.