A case report and literature analysis of maxillary sinus odontogenic keratocyst invading the middle turbinate

Abstract Background: Odontogenic keratocyst (OKC) is a typical cystic lesion found in the maxilla and mandible. Although it has distinctive imaging features, the diagnosis and treatment of OKC can be challenging, particularly when it occurs in unusual locations. This case report presents a rare case of OKC invading the middle turbinate of the maxillary sinus, which was confirmed through operation and pathology.Case presentation: A 23-year-old female patient was admitted to Jinan Stomatological Hospital with swelling and pain in the right posterior maxillary area. The patient had undergone panoramic oral radiographs at other hospitals that revealed a suspected dentigerous cyst in the maxillary sinus. The physical examination showed no abnormal skin or mucosal manifestations, swollen lymph nodes, or abnormalities in the eyes, ears, or nose. The intraoral examination revealed a bony swelling in the distal part of the second molar, which was painful when pressed and felt like a table tennis ball. The CBCT findings confirmed the presence of a cystic liquid density shadow inside the maxillary sinus, with the cyst wall connected to the third molar's surface. The cyst surrounded most of the third molar's tooth body, with only a part of the tooth linked to the maxillary sinus's medial wall. The boundary between the right middle turbinate and the lesions in the maxillary sinus was unclear.Conclusions: This case report highlights a rare occurrence of OKC invading the middle turbinate of the maxillary sinus. The patient was successfully treated through surgical intervention, and the pathology confirmed the diagnosis. While OKC is a typical cystic lesion, this case underscores the importance of considering it as a differential diagnosis when encountering unusual imaging features or clinical presentations.