PMC10071921_01
(a) Extraoral photograph of patient showing mild swelling in middle third of face. (b) Intraoral photograph showing abscess wrt teeth 12 and 13
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On examination, there was an extraoral swelling over the right lip area, extending mediolaterally from lateral aspect of nose to the corner of the mouth with mild obliteration of nasolabial fold [Figure 1a]. On intraoral examination class 3 mobility wrt teeth 12 and 13, mild vestibular tenderness with soft fluctuant swelling was found [Figure 1b].
Orthopantomograph (OPG) showing radiolucency wrt teeth 12 and 13
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Keen observation of the same revealed ill-defined radiolucency in the right maxillary anterior alveolar bone extending up to the floor of the right maxillary sinus suggesting its involvement [Figure 2].
Magnetic resonance imaging (MRI) scan (a) coronal view, (b) axial view showing soft tissue opacification in the right maxillary sinus with mucosal thickening
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MRI scan revealed mucosal thickening with T2 hypointense components and non-enhancement of involved mucosa/soft tissue suggestive of fungal aetiology in the right maxillary sinus and hyper density of the maxillary antrum [Figure 3].
Histopathological report showing non-septate hyphae
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Condensed acute and chronic inflammatory cells and few epithelioid cell granulomas along with multinucleated giant cells were also found [Figure 4]. The periodic acid-Schiff staining confirmed the presence of right-angled hyphae which confirmed the presence of mucormycosis [Figure 4].