PMC3335564_01
A golf-ball-sized swelling on the right maxilla causing facial asymmetry.
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fig1
The overlying skin was smooth, intact, and appeared little stretched (Figures 1 and 2).
Anteroposterior extension of the swelling.
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fig2
The overlying skin was smooth, intact, and appeared little stretched (Figures 1 and 2).
Aspirated material was a red colored, viscous fluid.
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fig3
Vitality test gave a positive normal response of the involved teeth (Figure 3).
IOPA radiograph of maxillary right posterior region showing a partial radiolucency superimposed on the edentulous region.
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fig4
There was no evidence of root stump, cystic radiolucency, or any abnormality in relation to the floor of the maxillary sinus (Figure 4).
Occlusal view shows a circular radiolucency with a thin discontinuous cortication present on the buccal aspect of the maxilla.
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fig5
Occlusal radiograph showed a well-defined, unilocular, circular radiolucency present on the buccal aspect of the right maxilla extending from distal aspect of first premolar to distal aspect of third molar surrounded by a thin, discontinuous cortical margin (Figure 5).
Panoramic view showing a radiolucency with haziness present on the right maxilla, zygomatic arch, anterior wall, and floor of the maxillary sinus were not clearly demarcated.
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fig6
Interestingly, all remaining first permanent molars were grossly decayed and associated with well-defined periapical radiolucencies; probably radicular cysts (Figure 6).
PA Water's view shows haziness with decrease in size of the right maxillary sinus.
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fig7
No any abnormality detected in relation to medial, lateral, and superior wall of the sinus (Figure 7). 
(a, b) CT scan view (coronal section soft tissue window), (c, d) CT scan view (coronal section bone window). Both views show a well defined soft tissue lesion causing displacement of inferolateral wall of the right sinus without involving it.
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fig8
It is causing pressure and superior displacement of inferiolateral walls of the maxillary sinus, decreasing the size of the sinus without actual perforation or involvement (Figures 8(a)-8(d)).
(a, b, c) CT scan view (Axial section soft tissue window), (d, e) CT scan view (Axial section bone window). Both views show a well-defined soft tissue lesion causing displacement of anterolateral wall of the right sinus with involving it.
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fig9
There was no any sign of perforation or erosion of respective maxillary bone (Figures 9(a)-9(e)). 
Surgical enucleation of the lesion through an intraoral approach, photograph after removal of the lesion in toto showing bony concavity on anterolateral wall of the sinus.
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fig10
The surgical enucleation of the cyst was carried out under local anesthesia and strict asepsis through an intraoral approach (Figure 10).
Sectioned gross specimen shows solidified cheese like material surrounded by a soft capsule.
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fig11
The sectioned gross specimen revealed yellowish, solidified pus like material surrounded by a thin-layered soft capsule (Figure 11).
Histopathological section shows features of residual cyst.
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fig12
The histopathological features of atrophic, metaplastic, nonkeratinized, stratified squamous epithelium associated with minimal inflammation confirmed the diagnosis of an established residual cyst (Figure 12).