Case of the Week: Florid Cemento-osseous Dysplasia with Simple Bone Cyst

Happy New Year! Starting off with a fun and rare case that I don’t see too often.

This week I have an interesting case of two different lesions (florid cemento-osseous dysplasia and simple bone cyst) that have been reported together. The combination of the two were first reported in 1976. This is case combination is a rarity. I’m sharing this case to emphasis that importance of thorough investigation of florid cemento-osseous dysplasia along with continual monitoring. I’ll go over the two radiographic appearances of each lesion using my LESION acryonym.

Florid Cemento-osseous dypslasia

  • Location = involves two quadrants or four quadrants (mandible / maxilla or both).
  • Edge = well-defined.
  • Shape = no identifiable shape.
  • Internal aspect = Stage 1 – purely radiolucent, Stage 2 – mixed radiolucent/radiopaque, Stage 3 – purely radiopaque (+/- radiolucent rim visible).
  • Other = +/- thinning of cortical plates.
  • Number = one in one jaw, two in both jaws.

Simple Bone Cyst

  • Location = more common in the mandibular premolar/molar region.
  • Edge = well-defined, thin corticated border.
  • Shape = scallops between roots, ‘hydraulic’ appearance, +/- round/ovoid.
  • Internal aspect = radiolucent.
  • Other = +/- displace adjacent teeth over time, +/- thinning of cortical plates.
  • Number = single.

This case is from a cone beam CT with videos. The simple bone cyst on this case is in the posterior right mandible.

florid cemento-osseous dysplasia, simple bone cyst
Reconstructed pantomograph