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Int Poster J Dent Oral Med 14 (2012), No. 1     15. Mar. 2012

Int Poster J Dent Oral Med 2012, Vol 14 No 1, Poster 581

Nasopalatal Cyst – A Case Report

Language: English
 

Authors:
Reader Dr. Shilpa Busnur Jayadevappa, B.D.S, M.D.S, Prof. Dr. Kodhandarama Govindappa Srinivas. B.D.S, M.D.S, HOD,
Rajiv Gandhi University of Health Sciences, S.J.M. Dental College and Hospital, Department of Oral medicine and Radiology, Chitradurga, Karnataka, India
Assist. Prof. Dr. Harini Thakkilipati Chowdappa, B.D.S, M.D.S,
Rajiv Gandhi University of Health Sciences, S.J.M. Dental College and Hospital, Department of Oro-maxillofacial Pathology, Chitradurga, Karnataka, India

Date/Event/Venue:
29-10-2010 to 31-10-2010
37th State Level Karnataka Chapter - Indian Academy of Pathology and Microbiology Conference
Basaveshwara Medical College and Hospital, Chitradurga.Karnataka, India
 

Introduction

Nasopalatal cyst (NPC) is rare but most common among the developmental, non- odontogenic cysts of the jaws. NPC also called as incisive canal cyst, Nasopalatal canal/duct cyst. It is unique in that it develops in only a single location, in the midline anterior maxilla. . NPC was first described by Mayer in 1914. It arises from the embryonic ducts of scrapa and stenson. It accounts for about 5-10% of the jaw cysts and 1% of the population. Majority of the cases occur between fourth to sixth decades of life. Males are more commonly affected than the females. Most of NPCs are asymptomatic. Usually patient complains of palatal swelling, upper anterior teeth displacement, sub-labial swelling, and low grade pain. Various combinations of swelling, discharge and pain may occur. NPCs are usually treated by enucleation, in case of large cysts, marsupialization may be considered before definitive enucleation. Recurrence rate ranges from 0% to 11%.
 

Objectives

A thirty-eight year old female patient presented with the swelling in the anterior region of palate since 1year. Patient noticed the swelling 1 year back which has gradually increased to present size. The swelling associated with discomfort during biting and chewing the food. Intra-oral examination revealed a solitary, well defined, oval shaped swelling measuring about 2 x 1.5cms in the anterior palate in the midline (Figure 1). Overlying mucosa was normal. The swelling was hard, tender and non mobile. Considering the case history and examination of lesion we gave provisional diagnosis of Nasopalatal cyst and differential diagnosis of Median palatal cyst and Radicular cyst in respect to 11 or 21.

 
Fig. 1: Showing intra oral midline swelling
 
 

Material and Methods

Maxillary occlusal radiograph (Figure 2) revealed a solitary, well defined, ovoid radiolucency measuring about 2 x 1.5cms located in midline of the anterior maxilla below the roots of maxillary central incisors. Computed tomography (C.T) confirmed the presence of well defined, midline cystic lesion in the anterior portion of the hard palate bulging into the oral cavity (Figure 3 and 4).

Fig. 2: Maxillary occlusal radiograph showing a solitary, well defined, ovoid radiolucency Fig. 3: CT Coronal view showing well defined, midline cystic lesion in the anterior portion of the hard palate bulging into the oral cavity
 
Fig. 4: CT Axial view showing well defined, midline cystic lesion in the anterior portion of the hard palate
 
 

Results

Then the patient underwent excisional biopsy of the cystic lesion. On histopathological examination, the cystic lining showing simple cuboidal epithelium and underlying connective tissue showing chronic inflammatory cell infiltrate (Figure 5). The histological features were suggestive of Nasopalatal cyst.

 
Fig. 5: Showing cuboidal epithelium in the cystic lining
 
 

Conclusions

Nasopalatal cyst is rare but most common among the developmental, non-odontogenic cysts of the jaws. The lesion may be asymptomatic or manifests as swelling, pain and discharge from the anterior hard palate. Histopathologically, the type of cystic lining varies according to the location involved (palatine, nasal or intermediate). The cuboidal cystic epithelial lining is very rarely seen. So one should always correlate both clinical and histopathological features to arrive at final diagnosis.
 

Literature

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  2. Herráez-Vilas JM, Gay-Escoda C, Berini-Aytés L. Quiste del conducto nasopalatino. Revisión de la literatura y aportación de 14 casos. Rev Eur Odonto-Estomatol. 1994 Jul-Ago; 6(4):231-236.
  3. Neville BW, Damm DD, Allen CM, Bouquot JE. Oral and maxillofacial pathology. In: Developmental defects of the oral and maxillofacial region.2nd ed. Saunders; 2002. pp 27-30.
  4. Ely N, Sheehy EC, McDonald F. Nasopalatine duct cyst: a case report. Int J Paediatr Dent. 2001 Mar; 11(2):135-137.
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  7. Regezi JA, Sciubba JJ, Jordan RCK. Oral pathology clinical pathologic correlations. In: Cysts of the jaws and neck. 4th ed. Philadelphia, Saunders; 2003. pp. 256-257.
  8. Nortje CJ, Farman AG. Nasopalatine duct cyst. An aggressive condition in adolescent Negroes from South Africa? Int J Oral Surg. Apr 1978; 7(2):65-72.
  9. White SC, Pharoah MJ. Oral Radiology Principles and Interpretation. In: Cyst of jaws. 5th ed. Mosby; 2000. pp 400-401.
  10. Shear M. Cysts of the oral region. In: Nasopalatine duct (incisive canal) cyst. 3rd ed. Vargheese Publishing; 1992. pp 111-123.
     

Abbreviations

NPC: Nasopalatal Cyst
 

This Poster was submitted by Dr.Shilpa Busnur Jayadevappa.
 

Correspondence address:
Dr. Shilpa Busnur Jayadevappa
Rajiv Gandhi University of Health sciences
S.J.M. Dental College and Hospital, Department of Oral medicine and Radiology
Room No. 1
B.D. Road
Chitradurga-577501
Karnataka
India