Marsupialization followed by enucleation of a large maxillary dentigerous cyst in a young child: A case report and literature review

This report presents a rare case of a dentigerous cyst (DC) associated with the maxillary right canine in a young child, successfully treated with marsupialization followed by enucleation. A 9-year-old girl was referred to a maxillofacial hospital after routine dental exam revealed a large lesion in maxilla. Radiograph showed a 5 × 6 cm unilocular radiolucent lesion in the right maxillary sinus, with destruction of the sinus and nasal cavity walls and displacement of the upper right canine into the floor of the right eye. Marsupialization was performed, and the patient was monitored every 6 months. Histology confirmed a dentigerous cyst lined with non-keratinized stratified cuboidal squamous epithelium. One-year post-surgery, the cyst had significantly reduced in size, and the canine had descended. A second surgery was performed to completely remove the cyst and the associated canine. This case demonstrates the successful management of a large dentigerous cyst in a 9-year-old patient through staged treatment, initially with marsupialization, followed by complete cyst removal. The conservative approach allowed for the reduction of the cyst size and facilitated the natural descent of the displaced canine. Regular follow-up and timely surgical intervention were crucial in achieving a positive outcome and preventing recurrence. This case highlights the effectiveness of marsupialization in managing maxillary dentigerous cysts in young children. •A large dentigerous cyst was found in a 9-year-old's maxilla, an unusual site and age for this condition.•Marsupialization reduced the cyst's size and allowed the displaced canine to descend, demonstrating the benefits of conservative management.•After one year, the cyst shrank, bone regenerated, and the canine was repositioned, leading to effective secondary cyst removal.•Marsupialization followed by enucleation is a viable approach for large dentigerous cysts in children, preserving structures and avoiding more invasive procedures.