Answer to Case of the Month #153

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Answer to Case of the Month #153 Christina M. Theoret, MD, Garnet V. Packota, DMD, MSc, FRCD(C), David A. Leswick, MD, FRCP(C) Canadian Association of Radiologists Journal Volume 60, Issue 4, Pages 213-216 (October 2009) DOI: 10.1016/j.carj.2009.02.020 Copyright © 2009 Canadian Association of Radiologists Terms and Conditions

Figure 1 (A) Waters/occipitomental view. Enlargement of the left greater wing of the sphenoid, zygomatic arch, and facial asymmetry (white arrows). Diminutive maxillary sinus (arrowheads). Mandibular findings are seen faintly (black arrows). (B) Pantomograph. Expansile lytic lesion centered in the left mandibular angle without associated periosteal reaction or cortical breakthrough (black arrows). Left sphenoid expansion (arrowheads) is also seen. There is superior displacement of the inferior alveolar canal in the left mandible (grey arrows). Canadian Association of Radiologists Journal 2009 60, 213-216DOI: (10.1016/j.carj.2009.02.020) Copyright © 2009 Canadian Association of Radiologists Terms and Conditions

Figure 2 Axial and coronal reformatted nonenhanced CT images (1.25-mm bone algorithm and bone window). (A) Axial image showing bony expansion and ground-glass matrix involving the left zygomatic and sphenoid bones with narrowing of the vidian canal (black arrows). (B) Axial image showing bony expansion and ground-glass matrix involving the left zygomatic and sphenoid bones with narrowing of the foramen rotundum (white arrows). (C) Coronal reformatted image showing bony expansion and ground-glass matrix involving the left zygomatic and sphenoid bones with narrowing and displacement of the vidian canal (black arrow) and the foramen rotundum (white arrow). Canadian Association of Radiologists Journal 2009 60, 213-216DOI: (10.1016/j.carj.2009.02.020) Copyright © 2009 Canadian Association of Radiologists Terms and Conditions

Figure 3 Three-dimensional reformatted volume-rendering image with surface shade display built from 1.25-mm standard algorithm images. Note the facial asymmetry with enlargement of the left lateral orbital wall and zygomatic bone. Streak artifact is secondary to the patient's dental fillings. Canadian Association of Radiologists Journal 2009 60, 213-216DOI: (10.1016/j.carj.2009.02.020) Copyright © 2009 Canadian Association of Radiologists Terms and Conditions