Bilateral aneurysmal bone cyst of maxilla

Abstract

Aneurysmal bone cyst (ABC) is an uncommon benign lesion
originating in the craniofacial region and has seldomly been
reported in Tanzania and other parts of the world. Between 2-12%
of ABC are located in the head and neck region and 90% are found
in the posterior mandible while less than 1% of the cysts are biopsed
in the maxilla. In this study we report a case of ABC arising from
both maxilla of a 19-years old African man as revealed by both
roentgenographic and microscopic findings. The presenting
symptoms of our patient were mainly painless swelling, difficult in
chewing and closing the mouth. Extra-oral examination revealed
difficult in closing the mouth, a large pinkish swelling protruding
from the mouth and ulcerations on left and right side of the maxilla.
The submandibular and submental lymph nodes were palpable
bilaterally and were mobile. Intra-orally, the swelling involved the
whole of left and right maxillary alveolar process. Only 48, 46, 45
were present on the mandible while the rest of the teeth were
missing. Teeth marks were seen on the swelling. The swelling was
bony hard on palpation and the gingivae had grown to reach the
buccal sulcus and the palatal midline.The aetiology and
pathogenesis of this interesting lesion remained unclear but several
theories were reviewed and the differential diagnosis of the lesion
was also discussed.
The treatment of choice of the case we performed was surgical
excision and curettage of the cavity of the ABC, which is the gold
standard, let alone many other treatment options. The treatment
was directed towards complete removal of the lesion. Before
entering, the lesion was adequately exposed to enable a rapid
curettage to be done. Massive bleeding was encountered as soon as
the lesion was entered and continued until complete curettage was
accomplished and there was no further bleeding. The patient had a
remarkable post-operative period and the outcome of the treatment
was very good.

Key words: Aneurysmal, bone cyst, Maxilla, Craniofacial
region, Curettage.