Dual Lesions: A Diagnostic Dilemma

Glandular odontogenic cyst (GOC) is a rare aggressive developmental cyst of the jaw. It most commonly occurs in middle-aged people with mandible anterior region being the most affected site. This lesion can present as a unilocular or multilocular radiolucency and has high recurrence rate. The histopathologic features of the GOC are complex and often coincide with the features of dentigerous cyst, radicular cyst, and low-grade central mucoepidermoid carcinoma (CMEC). At times, the microscopic features are so similar to central low-grade mucoepidermoid carcinoma that it becomes highly impossible to distinguish the two entities even with various advanced investigations. The reported case represents one such diagnostic dilemma occurring in the maxilla which is a rare site, and the lesion/s appeared as two distinct entities, that is, GOC and CMEC on either aspects of the same side of maxilla clinically, yet showing continuity on advanced imaging and demonstrating histopathological perplexity.