Aneurysmal bone cyst associated with a dentigerous cyst in the mandible - A diagnostic challenge - case report

Sep 29, 2026

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Aneurysmal bone cysts (ABCs) are rare, benign, expansile jaw lesions frequently associated with odontogenic cysts such as dentigerous cysts, creating major diagnostic difficulty because their radiographic and histopathological appearances vary. This case report presents an ABC in the mandible associated with a dentigerous cyst that was initially misclassified as central giant cell granuloma (CGCG) after incisional biopsy. Panoramic imaging and CBCT showed a multilocular radiolucent lesion with aggressive features, while excisional biopsy confirmed ABC sinusoidal spaces with a dentigerous cyst component.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

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Case report

Imaging findings

Incisional vs excisional biopsy

Differential diagnosis and diagnostic significance

Radiology Ca s e Reports 21 (2026) 1104 – 1110 Available online [at](at www.sciencedirect.com)[ www.sciencedirect.com](at www.sciencedirect.com) journal [homepage:](homepage: www.elsevier.com/locate/radcr)[ www.elsevier.com/locate/radcr](homepage: www.elsevier.com/locate/radcr) | Case Report
Aneurysmal bone cyst associated with adentigerous cyst in the mandible: A diagnostic challenge—case report ✩
Fereshteh Hayatimotlagha, Mohammad Taghi Mashkouri Najafib, Bita Heydarzadeha, Saba Khorrama,∗
a Department of Oral and Maxillofacial Radiology, School of Dentistiry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
b Department of Oral and Maxillofacial Surgery, School of Dentistiry, Shahid Beheshti University of Medical Sciences, Tehran, Iran | | | --- | --- | | a r t i c l e i n f o | a b s t r a c t
Aneurysmal bone cysts (ABCs) are rare, benign, expansile lesions of the jaws, often associated with odontogenic cysts like dentigerous cysts, presenting diagnostic challenges due to their variable radiographic and histopathological features. This case report describes an ABC associated with a dentigerous cyst in the mandible, initially misdiagnosed as central giant cell granuloma (CGCG). A 19-year-old male presented with an asymptomatic semi-erupted right mandibular third molar (\#48), and panoramic radiography revealed a multilocular radiolucent lesion (22.9 × 46.5 × 20.4 mm) in the posterior mandible and ascending ramus, with features including curved and coarse septa, hazy bone pattern, possible root resorption, mild cortical expansion on CBCT, focal perforation, and posterior displacement of the mandibular nerve canal. Initial incisional biopsy suggested CGCG due to multinucleated giant cells and fibrous stroma, but excisional biopsy confirmed an ABC with sinusoidal spaces alongside a dentigerous cyst lined by nonkeratinized stratified squamous epithelium. This case highlights the critical role of CBCT and excisional biopsy in diagnosing ABCs associated with dentigerous cysts, distinguishing them from CGCG and other lesions through integrated clinical, radiographic, and histopathological evaluation.
© 2025 The Authors. Published by Elsevier Inc. on behalf of University of Washington.
This is an open access article under the CC BY license
([http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/)) | | Article history:
Received 1 August 2025 Revised 3 November 2025 Accepted 9 November 2025 | | | Keywords:
Aneurysmal bone cysts Dentigerous cyst Mandibular diseases Giant cell granuloma
Cone-beam computed tomography
Panoramic radiography Histopathology Differential diagnosis Jaw cysts | | tic spaces lined by fibrous tissue and multinucleated giant cells, which may occur as primary lesions or secondary to other pathologies, such as odontogenic cysts or tumors [1]. Although rare in the jaws, ABCs account for approximately 1% - 2% of bone lesions in the head and neck region and are of- ✩ Competing Interests: The authors have declared that no competing interests exist. ∗ Corresponding author. E-mail address: [saba.khorram@yahoo.com](saba.khorram@yahoo.com) (S. Khorram). [https://doi.org/10.1016/j.radcr.2025.11.021](https://doi.org/10.1016/j.radcr.2025.11.021) 1930-0433/© 2025 The Authors. Published by Elsevier Inc. on behalf of University of Washington. This is an open access article under the CC BY license ([http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/)) ten associated with rapid growth, cortical expansion, and occasional perforation, posing diagnostic and therapeutic challenges [2,3] . In this case report, an ABC associated with adentigerous cyst was identified in the ascending ramus of the mandible, initially misdiagnosed as central giant cell granuloma (CGCG) based on incisional biopsy but confirmed as an ABC with a dentigerous cyst component following excisional biopsy. This case highlight

FAQs

Why was the lesion initially misdiagnosed as central giant cell granuloma (CGCG)?

The initial incisional biopsy suggested CGCG due to multinucleated giant cells and fibrous stroma, which overlap histopathologically with ABC in some presentations.

What imaging modalities were emphasized for diagnosis?

Panoramic radiography and cone-beam computed tomography (CBCT) were central, helping characterize the multilocular radiolucent lesion and its relationship to nearby anatomical structures.

What confirmed the final diagnosis of an ABC associated with a dentigerous cyst?

Excisional biopsy identified ABC features with sinusoidal spaces and confirmed a dentigerous cyst component lined by nonkeratinized stratified squamous epithelium.

Sep 29, 2026

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