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http://www.journal-imab-bg.org ABSTRACT the upper jaw. The correct diagnose is very difficult and They present a case with a large cystic lesion of themaxilla hystologically proved as keratocyst. keratocyst, radiolucency, maxilla with radiolucency. They are two big groups-cysts and The odontogenic keratocyst is the third mostcommon cyst of the jaws, after the follicular and radicularcysts. Keratocyst most commonly occurs as single lesionin the jaw of otherwise healthy persons more frequently as frequent in women than in men. According to R.Brannon /2/ and St. Vincent /7/ the lesion has a slight It is twice frequent in the mandible as in the maxillaand the most common sites were maxillary third molarregion and maxillary cuspid area.The odontogenickeratocyst comprises 10.5% of the total cysts./2/ be unilocular, bilocular and multilocular, frequently CASE REPORT A 37 years old woman came to the Oral SurgeryClinic with a facial assymetry caused by a swelling of theleft part of the maxilla. She noticed a painless graduallyenlarged swelling in this area 2 months ago. The last weekthe region of the left maxillary sinus. Extraoral examination: a facial assymetry due to apersistent swelling in the region of the left maxilla. was intact, normal in colour, non connected with the Lab examinations didn’t show deviation fromnormal ranges. X-ray examination: - Water’s projection X-ray shows overshadowed left - CT /CCT, ACT/ reveals a policystic formation The patient underwent a surgical treatment. the floor of the left maxillary sinus cavity. The cyst was dissected from the underlying bone; CYSTIC LESION OF THE MAXILLA - CASE RE- Hristina Mihailova 1 2 1) Department of Maxillo-facial radiology and oral diagnostic, 2) Department of Maxillo-facial surgery, Faculty of Stomatology, Medical University - Sofia, Bulgaria Annual Proceeding (Scientific Papers) ISSN: 1312-773X (Online) http://www.journal-imab-bg.org teeth 23 and 25 were extracted and the apex of 22 wasresected. The bone edges were made smooth, the flap wasclosed. were removed on the 7 th day. The history and the clinical and radiographicfindings suggest a benign odontogenic tumor or cyst. Thehistological result showed: a keratocyst. DISCUSSION: A variety of cysts and tumours have well-circumscribed, multicystic appearance: -ameloblastoma is most frequently unicystic; themulticystic type is rare. Some cases showing a unicysticmulticystic on CT -central giant cell granuloma/CGG/-has a -central mucoepidermoid carcinoma-multilocular -adenomatoid odontogenic tumour-usually -ameloblastic fibroma-unilocular or multilocular Fig. 1. Fig. 2. radiolucency with well defined borders -odontogenic mixoma – multilocular radiolucency -keratocyst The most common feature of these lesions is theirX-ray image: radiolucency. CONCLUSION: history,clinical and radiographic evaluation. The correct This case shows that big bone lesions could beassymptomatic.The case is interesting because of the lackDifferential diagnose includes all cysts of jaws and This case presents the necessity of preoperativeexact X-ray information for the correlation between thelesion, nasal and maxillar cavity and teeth. This is importantfor precising the extent and the kind of the operation. The authors mention the importance of regularpatient follow-up examinations and imaging studies in orderto detect and treat recurrent lesions. http://www.journal-imab-bg.org 1. Bornstein M. M, Filippi A, Alter- tocyst. Oral Surg, July 1976, v. 42, No.1, Shear. Histological typing of odontogenicVerlag REFERENCES: maxillo facial radiology, 1989, Mar, 18/3/, 5. Pippi R., D. Vitolo. A clinical radio- 6. Sugiyama M., M. Miyauchi, Y. Suei.pearance. J. Oral Maxillofac. Surgery, 2004, 7. Vincent St., T. Deahl, D. Johnson.terior maxilla. J.Oral Maxillofac. Surgery, 8. Walstad W., Th. Fields, St. Schow.Oral Maxillofac.Surgery, 1999, 57, 595-599 9. Ziya D. Diagnostic imaging of odon-togenic cysts and tumours in the jaws. Sofi- Fig. 3. Fig. 5. Fig. 4. Fig. 6.