|LETTER TO THE EDITOR
|Year : 2012 | Volume
| Issue : 3 | Page : 201-202
A case of dentigerous cyst in maxillary sinus presenting as proptosis
Kompalli Jwala Naga Siva Charan, Chamarthi Madhavi, Gopisetti Hanumantha Rao
Department of Radio Diagnosis and Ophthalmology, Maharajah's Institute of Medical Sciences, Nellimarla, Vizianagaram, Andhra Pradesh, India
|Date of Web Publication||15-Oct-2012|
Kompalli Jwala Naga Siva Charan
Maharajah's Institute of Medical Sciences, Nellimarla, Vizianagaram District, Andhra Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Charan KN, Madhavi C, Rao GH. A case of dentigerous cyst in maxillary sinus presenting as proptosis. J NTR Univ Health Sci 2012;1:201-2
A 18 year old female patient presented with a history of painless proptosis for the past 1 month. On examination she was found to have a dentigerous cyst in the maxillary sinus which was eroding the bony orbital walls and causing proptosis.
A dentigerous cyst or follicular cyst is an odontogenic cyst thought to be of developmental origin associated with crown of an unerupted tooth. The occurrence of proptosis with a case of dentigerous cyst in maxillary sinus is quite rare. Here we report a case of dentigerous cyst in maxillary sinus in a young female presented initially with a complaint of proptosis. To our knowledge only one case of dentigerous cyst presenting as a proptosis was reported in literature. 
A 18 year old female patient came with chief complaint of gradually increasing size of right eye ball which was painless for past 1 month [Figure 1]. She had no other complaints pertaining to the eye. She gave a history of recurrent attacks of upper respiratory tract infection for the past 4 yrs. On examination her uncorrected visual acuity was 6/6 in both eyes. Her intraocular pressure, color vision and visual fields were normal in both the eyes. Her extraocular moments were full in both eyes. Her exophthalmometric readings with Hertel's exophthalmometer were 24 mm in RE and 22 mm in LE with a base diameter 100 mm. On palpation finger could not be insinuated between lower lid and lower orbital margin. On auscultation no bruit was heard. On CT scan examination, there is an expansile lytic lesion in the region of right maxillary sinus which shows homogenous low attenuation and contains an unerupted tooth. The lesion is seen protruding into the inferomedial portion of the right orbit with superior displacement of inferior rectus muscle resulting in proptosis. [Figure 2] She underwent a Caldwell luc surgery for enucleation of the dentigerous cyst and maxillary sinusitis and cyst was sent for histopathological examination. The histopathology report showed a thick fluid filled cyst with thin nonkeratinized cuboidal epithelial lining with areas of odontogenic islands. She had a 1 mm reduction in proptosis 6 months postoperatively.
Most common location of dentigerous cyst is mandibular 3 rd molars and maxillary canines.  Highest incidence of dentigerous cyst occurs in second and third decades.  These cysts have high potential for bony destruction. The usual radiographic appearance is that of a well demarcated radiolucent lesion with radio opaque borders containing unerupted tooth within.  These cysts have high potential for transforming themselves into malignancy.  This case has been reported because of its rarity to present as proptosis.
| References|| |
|1.||Avitia S, Hamilton JS, Osborn RF. Dentigerous cyst presenting as orbital proptosis. ENTJ 2007, 86:23-4. |
|2.||Rohilla M, Namdev R, Dutta S, Indian Soc. Pedod. Prev. Dent., 2011: 29, 244-47. |
|3.||Kirtaniya BC, Sachdev V, Single A, Sharma AK, Indian Soc. Pedod. Prev. Dent. 2010:28, 203-8. |
|4.||Mendenhall WM, Werning JW, Fernandes R, Malyapa RS, Mendenhall NP. Ameloblastoma. Am J Clin Oncol 2007;30:645-8. |
|5.||Güven O, Keskin A, Akal UK. The incidence of cysts and tumors around impacted third molars. Int J Oral Maxillofac Surg 2000;29:131-5. |
[Figure 1], [Figure 2]