PMC8163553_01
Photoradiograph of the impaction of the left mandibular wisdom tooth and surrounding cystic radiolucent image: (a) orthopantomogram; (b) computed tomography of axial image; (c) computed tomography of sagittal image.
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Radiographic examination showed impaction of the left mandibular wisdom tooth and a cystic radiolucent area spreading around the crown of the tooth (Figure 1).
Photomicrograph of the dentigerous cyst. The cystic wall, which is covered by flat squamous cell epithelium, is composed of fibrous connective tissue with scarce inflammatory infiltrate (H-E staining, original magnification x20).
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The histopathological diagnosis of the specimen was a dentigerous cyst (Figure 2).
Reddish granular tissue that easily bleeds is observed protruding from the mesial wall of the extraction socket of the second mandible (arrow).
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Around the time of his third follow-up, which was 42 days after his surgery, rapid proliferation of granulomatous tissue was found in the extraction socket of the second molar (Figure 3).
The excised site after one week. A stump of the mass can be seen on the mesial wall of the extraction socket (arrow).
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Due to a concern regarding the possibility of a malignant tumor, an excisional biopsy was performed.  Figure 4 shows the excision site one week after the biopsy.
Photomicrograph of the mass in the tooth extraction socket. The specimen is partially covered with acanthotic squamous cell epithelium that is composed of granulation tissue with prominent small capillaries and large amounts of inflammatory infiltrate such as lymphocytes, plasma cells, and leukocytes. The endothelial cells often have plump cytoplasm (H-E staining, original magnification x40).
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The endothelial cells often had plump cytoplasm with a thick wall (Figure 5).
Immunohistochemical staining. The endothelial cells are positive for CD34 (a), ERG (b), and WT-1 (c) (each original magnification x100). Approximately 5% of the endothelial cells are positive for Ki-67 (d) (original magnification x100).
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Immunohistochemically, CD34, erythroblast transformation-specific-related gene (ERG), and WT-1 were positive for endothelial cells, with Ki-67 positivity found in approximately 5% of the epithelial cells (Figure 6).