Table 2.
Entities included in the differential diagnosis (DD)/compatibility of features with the clinical data or radiological findings of the case
| DD | Age | Gender | Jaw location | Clinical presentation | Radiographic appearance | General consideration | Probability for correct diagnosis |
|---|---|---|---|---|---|---|---|
| Adenomatoid odontogenic tumor | 3–82 years; +65% in 2nd decade/+− | M:F = 1:2/− | Maxilla > mandible/− | Slow growing, asymptomatic, associated with unerupted teeth/− | Well defined unilocular radiolucency/− | Excision usually curative; rare recurrence/− | Unlikely |
| Odontogenic fibroma | Mean 40 years; range 11–66 years/− | M:F = 1:2.8/− | Mandible:maxilla = 6.5 :1/+ | Asymptomatic, jaw expansion; loosening of teeth/+ | Well defined unilocular radiolucency/− | Excision—the treatment of choice; rare recurrence/− | Unlikely |
| Keratocystic odontogenic tumor | Peak 20–30 years; range 1st–9th decade/+ | M > F/+ | Mandible (60%–80%), posterior region/+− | Slow growing, minimal cortical expansion/− | Unilocular or multilocular radiolucency/+− | Curettage increases chances of recurrence/+ | Less likely |
| Langerhans cell disease | 50% of cases <10 years/+ | Definite male predilection/+ | More common in posterior mandible/− | “floating teeth” & mucosal involvement, as a proliferative gingival mass; common tenderness and pain/+− | Punched out or ill-defined unilocular radiolucency/−+ | Recurrence common/+ | Likely |
| Central giant cell granuloma | Peak 10–20 years, range 2–80 years/+ | Males (1st decade), females (after 1st decade)/+ | Occasionally crosses midline/+ | Usually asymptomatic; cortical perforation and extension into soft tissue when aggressive/+ | Unilocular or multilocular radiolucency; non-corticated margins/+ | Clinical details mostly in conformity with this lesion, except for the fistula | Most likely |
| Osteogenic sarcoma | Mean 33 years/− | Male predilection/+ | No definite jaw predilection | Swelling; loosening of teeth, pain, paresthesia/+− | Varies: radiolucency, mixed sclerotic and radiolucent or completely sclerotic/−+ | Rapid clinical course; curettage possibly lead to exacerbation/+− | Unlikely |
| Burkitt’s lymphoma | Peak 7 years/− | M:F = 2–4:1/+ | Maxilla:mandible = 2:1/− | Extensive alveolar bone destruction; rapidly growing; pain and paresthesia with/without systemic symptoms/− | Radiolucency with poorly defined margins/+− | Very rapid clinical course; curettage unlikely to achieve control | Unlikely |
+: compatible; +−: partly compatible; −: incompatible