Ectopic Dentigerous Cyst Manifests as Facial Cellulitis

Abstract

A healthy 29-year-old female presented with a 2-week history of left-sided facial swelling. She had no history of nasal congestion, rhinorrhea, or post-nasal drip. No dental procedures nor recent infection, such as rhinosinusitis or dental infection, were reported. Physical examination revealed swelling and tenderness in her left cheek, with warmth and discoloration of the overlying skin. Intra-orally, she had a complete set of adult teeth with the exception of the left and right upper third molar. Paranasal sinus computed tomography revealed a hyperdense cystic mass extending from the left maxillary sinus floor (Figure). The cystic lesion expanded and eroded anterior, inferior and posterolateral portions of the maxillary sinus wall. A left buccal abscess was also noted. The patient was treated with a combination of medical and surgical management. A 10-day course of an intravenous antibiotic with augmentin was given. The cystic mass was enucleated from the left maxillary sinus via the Caldwell-Luc procedure. Incision and drainage of the buccal abscess was also performed submucosally. The pathogens cultured from both cysts and the abscess was Staphylococcus aureus. Histopathological examination revealed a dentigerous cyst associated with an ectopic tooth. Dentigerous cyst, also known as follicular cyst, is the most common type of developmental odontogenic cyst.1 It is an expansile cyst formed by the