Giant maxillary cyst with intrasinusal evolution

Giant maxillary cysts deserve one's attention, mainly because of all the complication they can originate, such as facial aesthetic changes, jaw fractures, infections and occasional but the most severe one the neoplasia of its epithelium. Here we present the case of a 51-year-old man who was sent to the Clinic of Oral and Maxillofacial Surgery of Timisoara, Romania, because of a facial asymmetry due to the hyper-dimension of the right superior genian and labial region, consecutive to the volume growth of the subjacent alveolar process. The clinical and paraclinical investigations, especially the fine-needle aspiration and the 3D imagistic investigation, most likely lead to the diagnosis of maxillary cyst with intrasinusal evolution, the lesion being caused by the untreated teeth of the superior right hemiarcade. The surgery was performed in general anesthesia and consisted of a cystectomy and the curettage of the right maxillary sinus, followed by the restoration of alveolar process with the help of bone graft materials. The histopathological examination of the lesion confirmed the diagnosis of maxillary radicular cyst. This case shows the frequently asimptomatic and long-term evolution of maxillary cysts, their growing volume causing massive bone destructions and affections of the neighboring anatomic structures.