Xanthogranulomatous Inflammation of the Maxilla Mimicking a Dentigerous Cyst: A Rare Case Report

Abstract

Title

Xanthogranulomatous Inflammation of the Maxilla Masquerading as a Dentigerous Cyst: A Rare Clinicopathological Entity

Presenting Author

Dr. Nongthombam Bidyananda Singh, Dr. Manu CB, Dr. Anuradha Deka, Dr. Nayana Sarma, Dr. S. Chakraborty

Aim

To describe an uncommon presentation of xanthogranulomatous inflammation involving the maxilla, radiologically simulating an odontogenic cyst, and to highlight the diagnostic challenges.

Methodology

A 33-year-old male presented with a 6-month history of insidious, progressive, painless left cheek swelling without history of trauma, infection, or difficulty in chewing food. FNAC revealed cystic macrophages and lipoproteinaceous debris, suggestive of a nonspecific cystic lesion. NCCT demonstrated a 3.7 × 3.6 × 3.7 cm well-defined hypodense lesion arising from the upper alveolar ridge of the left hemimaxilla with expansion and remodelling of maxillary walls, provisionally favouring a dentigerous cyst. The lesion was excised via a sublabial approach and submitted for histopathology and immunohistochemistry.

Results

Histopathological examination showed fibrocollagenous stroma with dense xanthomatous infiltrates, multinucleated giant cells, and sheets of CD68-positive histiocytes. Calretinin negativity excluded granular cell tumour. Findings were diagnostic of xanthogranulomatous inflammation, a rare non-neoplastic inflammatory process seldom reported in the maxillofacial skeleton.

Conclusions

Xanthogranulomatous inflammation of the maxilla is an exceptional entity that can closely mimic odontogenic cysts on imaging. Definitive diagnosis requires histopathology with immunohistochemical correlation. Complete surgical excision offers excellent prognosis and prevents recurrence.