For citation purposes: Araujo RZ, Gomez RS, de Castro WH, Lehman LFC. Differential diagnosis of antral pseudocyst, surgical ciliated cyst, and mucocele of the maxillary sinus. Annals of Oral & Maxillofacial Surgery 2014 May 04;2(1):10.

Case report

 
Pathology

Differential diagnosis of antral pseudocyst, surgical ciliated cyst, and mucocele of the maxillary sinus.

R Araujo, R Gomez, W Castro, L Lehman
 

Authors affiliations

(1) Federal University of Minas Gerais, Minas Gerais, Brazil

* Corresponding author Email: rafaelzaraujo@hotmail.com
rafaaraujo77@hotmail.com

Abstract

Introduction

Pathologic alterations of the maxillary sinus, including antral pseudocysts, surgical ciliated cysts, and mucoceles of the maxillary sinus, may pose a diagnostic challenge. These conditions are often misdiagnosed, compromising the subsequent clinical and surgical approach. Although these lesions may present with similar clinical and imaginological features, their differential diagnosis is important for correct treatment planning owing to their distinct biological behaviour. The purpose of this paper is to report one case of each of these conditions, together with a discussion of their differential diagnosis and treatment plan.

Case report

In case 1, patient was a candidate for orthognathic surgery. A pre-operative cone beam computed tomographic showed a hyperdense domed-shaped image above the first and second molars, and with the provisional diagnosis of antral pseudocyst, no specific treatment carried out. Case 2, patient complained of light intermittent discomfort on the left side of her maxilla for over a year and had a history of orthognathic surgery involving both jaws performed 19 years ago. Radiographic image showed a well-circumscribed hypodense area in the maxilla above the left first molar and an excisional biopsy was performed, which ultimately confirmed the diagnosis of surgical ciliated cyst. In Case 03, patient presented with a history of a painful swelling on the left side of his face, which started 6 months earlier. Magnetic Resonance Image showed a hyperdense lesion, occupying the left maxillary sinus and an the surgical excision of the lesion, confirmed the mucocele of the maxillary sinus diagnosis.

Conclusion

Owing to their similar radiographic features and asymptomatic presentations, AP, SCC, and MMS can be misdiagnosed. Clinical signs and symptoms, patient history, and adequate radiographic evaluation are necessary to make accurate decisions regarding their initial diagnosis and subsequent treatment plans.

Licensee OA Publishing London 2014. Creative Commons Attribution License (CC-BY)
Keywords