PMC10321781_01
Gross view of: A - facial asymmetry and extraoral swelling evident along the left side of the face; B - draining sinus with pus discharge evident at the left mandibular third molar region.
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A draining sinus with pus discharge was evident at the left mandibular third molar region (Figure 1A, and 1B).
A - Orthopantamogram shows well-defined radiolucency along the left ramus region; B - Computed tomography axial view shows a well-defined, expansile, destructive lesion with perforation of the buccal and lingual cortical plate; C - Magnetic Resonance Imaging T2-weighted axial images show hyperintense signal with well-defined capsule surrounding the lesion in the posterior ramus of the left mandible.
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OPG revealed well-defined radiolucency along the left mandibular ramus (Figure 2A). MRI T2-weighted axial images revealed a hyperintense signal with a well-defined capsule surrounding the lesion in the posterior ramus of the left mandible (Figure 2B and 2C).
Gross view of the biopsy. Scale bar = 2 cm.
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Photomicrograph of the biopsy. A and B - acellular, avascular, eosinophilic lamellated tissue suggestive of chitin (H&E, 4x and 10x, respectively); C - protoscolices (arrowheads) in the germinal membrane (H&E, 40x).
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Detached germinal membrane with protoscolices of parasite form the "hydatid sand" was evident, which is pathognomonic of hydatid cyst (Figure 4A, 4B, and 4C).
1-year follow-up with postoperative Orthopantamogram reveals a healing lesion with well-defined bony trabeculae formation.
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After a 1-year follow-up, OPG revealed a healing lesion with well-defined bony trabeculae formation and no evidence of recurrence (Figure 5).