CBCT with the injection of contrast medium into unilocular cyst of soft tissue for better detection - A case report

Objectives: Nasolabial Cysts are benign non-odontogenic soft tissue lesions of unclear etiology. Increasing application of CBCT Imaging in maxillofacial field is a result of its performance and lower cost together with low radiation dose and its accessibility in dental clinics, however, CBCT scan is less useful in soft tissue lesions because of its low contrast resolution. The present article describes a technique for rectifying this shortcoming.
Methods: . A 61-year-old woman presented with chief complaint of painless swelling in left upper lip. Intra-oral examination revealed fullness of labial vestibule. panoramic radiograph showed a well-defined radiolucent area in anterior left maxillary region. Extensive erosion was detected in CBCT Scans of the interested region. Diagnosis of a chronic peripheral lesion was made. The lesion was aspirated and contrast medium was injected into the lesion. Another CBCT scan was captured
Results: Post-injection CBCT showed a homogenous high attenuating Cyst like lesion in anterior left maxillary region extending from midline to canine which has displaced nasal floor posteriorly. Extensive erosion in anterior maxilla was detected. The lesion size was 3*2*1.5 cm. The radiopaque area was surrounded by a thin uniform radiolucent rim which indicated cyst lining. Based on clinical and radiographic findings a differential diagnosis of extensive nasolabial cyst was made.
Conclusions: CBCT with the injection of a contrast medium into the lesion is a new technique in detecting size, border and extension of soft tissue cysts.