J Am Dent Assoc. 2018 Dec;149(12):1073-1080. doi: 10.1016/j.adaj.2018.09.003.
Cone-beam computerized tomographic (CBCT) imaging is increasingly used in the maxillofacial region for various purposes. The volumetric dataset created by means of CBCT increases the possibility of detecting incidental findings.
In this case report, the authors describe an otherwise healthy 45-year-old man who was referred from the Sjogren's Syndrome Center in Jerusalem, Israel, for bilateral parotid CBCT sialographic imaging owing to xerostomia lasting for 4 months. CBCT sialographic imaging using iodine contrast material showed normal glandular structure and activity according to the postcannulation panoramic imaging. CBCT sialographic imaging routine volume interpretation revealed a lesion in the mandibular area causing destruction and perforation of the cortical plates, partial disappearance of adjacent lamina dura, and resorption of adjacent teeth, suggesting an aggressive benign tumor. Histopathologic examination confirmed mural cystic ameloblastoma, which was resected with preservation of the mental nerve and the lower mandibular border. The patient received bone graft and implants, with regular follow-ups and no recurrence after 4 years.
This case strengthens the need for thorough examination of the whole CBCT imaging volume within and outside the region of interest to detect incidental findings with clinical importance.
锥形束计算机断层扫描（CBCT）成像在颌面区域越来越多地用于各种目的。通过 CBCT 创建的体积数据集增加了偶然发现的可能性。
在本病例报告中，作者描述了一位 45 岁健康男性，因口干持续 4 个月，从以色列耶路撒冷的干燥综合征中心转诊来进行双侧腮腺 CBCT 涎管造影成像。使用碘造影剂的 CBCT 涎管造影成像根据后插管全景成像显示正常的腺体结构和功能。CBCT 涎管造影成像常规体积解读显示下颌区域有一个病变，导致皮质板破坏和穿孔、相邻硬脑膜部分消失以及相邻牙齿吸收，提示为侵袭性良性肿瘤。组织病理学检查证实为壁内囊性成釉细胞瘤，采用保留颏神经和下颌下缘的方式进行了切除。患者接受了骨移植和种植体，经过 4 年的定期随访，没有复发。
本病例强调需要彻底检查感兴趣区域内外的整个 CBCT 成像体积，以发现具有临床意义的偶然发现。
