Findings:
There is an expansile, unilocular, lobulated lesion measuring approximately 3 x 2 x 4.2 cm in the left mandibular angle, which expands the mandible with associated thinning of the cortex, which is preserved. The lesion extends anteriorly from the lateral root of the second molar to the ascending ramus of the mandible posteriorly, surrounding the impacted left lower third molar.
Internally the mass is of soft tissue density. There is no pathological fracture, periosteal reaction or extraosseous tissue extension.
The inferior alveolar nerve canal courses along the posterior and medial aspect of the lesion with focal area of dehiscence of the canal.
Unremarkable appearance of the reminder of the mandible with enlocated temporomandibular joints. Impacted, unerupted upper and lower third molars bilaterally.
The paranasal sinuses and mastoid air cells are clear.
Impression:
There is a unilocular lytic lesion in the left mandibular angle with imaging appearances of either unilocular ameloblastoma or a keratocystic odontogenic tumour.