FP, a 22-year-old black woman who consulted in November 2000, complaining of facial pain and crepitation at the left infraorbital level.
He had a progressive growth tumor of left hemimaxillary of 5 months of evolution.
Facial examination revealed an increase in volume in the left infraorbital region, which markedly raised the lower eyelid, disfiguring the gaze down and right.
He had deformation of the nasal pyramid and obstruction of the left nostril by decreased permeability due to elevation of the nasal floor and deformation of the nasal intersinusal septum.
1.
The patient had no ocular changes, reported that she felt growing to the lesion and had anterior nasal discharge that was not observed.
Oral examination revealed stable occlusion, tooth decay 24 and tooth mobility and displacement 22.
A large mass of diffuse limits, covered by healthy and erythematous mucosa, deformed the left upper latero-latero vestibule and the palatal vault.
The apex beat, the lesion presented crepitant zones and other soft tissues, was asymptomatic and presented net limits.
Orthopantomography showed a homogeneous unilocular radiolucent mass of approximately 5.5 cm in diameter, located in a form corresponding to a lesion in the globule position maxillary20 displacing 22 roots of both teeth.
It also displaced the maxillary sinus and reached the infraorbital border, with net, but not corticalized limits.
On CT, in the axial and coronal sections, a radiolucent mass with trabeculations inside was observed, extending from the alveolar ridge to the nasal internasal septum floor.
It expanded and thinned the cortical bones and perforated them in some area.
1.
The previously described protocol for the treatment of GCL was implemented.
Series were created between December 2000 and January 2001.
At the end of pregnancy, the patient reported that she was pregnant, so all treatment was suspended until the end of pregnancy.
In October 2001, almost a month after delivery, the patient returned and reported that she no longer felt crepitation.
On physical examination, a higher location of the lesion was observed and the entire lesion had bone consistency.
At CT, in the axial and coronal sections, an image was observed, which, unlike the lesion in the initial CT scans, was radiopaque with a central radiolucent nucleus.
Its limits did not differ from healthy bone.
1.
Given these findings, 11 months after the beginning of treatment, it was decided to perform surgical enucleation.
Under general anesthesia, the lesion was treated with an oral approach.
As in case 1, an increase in bone volume without clear limits with normal bone structure was found.
Surgical removal of the lesion was performed.
It was necessary to fix the infraorbital rim and the piriform scott.
1.
From the clinical and radiographic point of view, at 22 months of follow-up there is no evidence of residual lesion or recurrence.
No root canal treatment was performed on teeth 22 and 23, which are healthy.
Currently, the patient is in clinical cure 28 months after the beginning of treatment and 17 months after the onset of surgery.
