Nasopalatine duct cyst: A jigsaw puzzle

For the success of endodontic treatment outcome, diagnosis plays a very important role. Endodontic diagnosis is similar to a jigsaw puzzle which cannot be made from a single isolated piece of information. Radiography plays a vital role in diagnosing dental diseases. Overcoming the major disadvantage of two dimensional imaging of superimposing the dento-alveolar structures, 3 dimensional images by Cone Beam Computed Tomography is of great help. It is very common that when radiographs show a superimposition of the incisive foramen over the apex of maxillary central incisors, mimicking apical periodontitis, unnecessary endodontic treatment or retreatment may be prescribed. Diseases of non endodontic origin that affect the tooth apex, such as Nasopalatine duct cyst, should be included in the differential diagnosis. In the present case report the role of CBCT in diagnosis is being discussed.

Nasopalatine duct cyst with sebaceous differentiation: a rare case report with literature review

Background The aim of this study was to report a rare case of nasopalatine duct cyst with sebaceous differentiation. Further, a systematic search of the literature was performed to identify studies reporting patients with intraosseous jaw cysts with sebaceous differentiation. Case presentation A 55-year-old Korean man was referred to our hospital because of a cystic lesion of the anterior maxilla. Radiologic examination revealed a well-circumscribed radiolucent lesion in the anterior maxilla. Histology showed a respiratory columnar and cuboidal epithelium-lined cyst. Transition from the ciliated columnar epithelium to stratified squamous epithelium with sebaceous differentiation was observed. Based on these findings, the final diagnosis was nasopalatine duct cyst with sebaceous differentiation. A systematic search of the literature was performed to identify studies reporting patients with intraosseous jaw cysts with sebaceous differentiation. There were 24 cases of sebaceous differentiation in the epithelium of the cysts including 2 odontogenic keratocysts, 8 orthokeratinized odontogenic cysts, 8 dentigerous cysts, 1 radicular cyst, and 2 glandular odontogenic cysts. However, no case reports describing the occurrence of nasopalatine duct cysts with sebaceous differentiation have been reported. Conclusion This first case report of nasopalatine duct cysts with sebaceous differentiation could provide insight into the diagnostic process of cystic lesions with sebaceous differentiation.