March, 2018/ Vol 6/Issue 03 Print ISSN: 2321-127X, Online ISSN: 2320-8686 Case Report International Journal of Medical Research and Review Available online at: www.ijmrr.in 197 | Page Aggressive nasopalatine duct cyst with nasal involvement Pandya D. 1 , Dey S. 2 , Bhattacharya M. 3 , Singh P. 4 1 Dr. Divya Pandya, Assistant Professor, Department of Oral Medicine and Maxillofacial Radiology, 2 Dr. Soumadip Dey, Assistant Professor, Department of Oral and Maxillofacial Surgery, 3 Dr. Maumita Bhattacharya, Assistant Professor, Department of Oral Pathology and Microbiology and Forensic Odontology, 4 Dr. Pooja Singh, Assistant Professor, Department of Pedodontic and Preventive Dentistry, all authors are affiliated with Kusum Devi Sundar Lal Dugar Jain Dental College and Hospital, Kolkata, India. Corresponding Author: Dr. Divya Pandya, Assistant Professor, Department of Oral Medicine and Radiology, Kusum Devi Sundar Lal Dugar Jain Dental College and Hospital, Kolkata, India. Dr. Divya Pandya, L 30/1 Bose Para Road, Kamdahari, Garia, Kolkata, West Bengal, India, E-mail: divyapandya854@gmail.com ………………………………………………………………………………………………………………………………... Abstract Nasopalatine duct cyst is a non-odontogenic developmental cyst typically located in the maxillary midline between the tooth roots of central incisors, these cysts are infrequent and can often be misdiagnosed as periapical lesion or cyst. In this article, we present a case of which was clinically and radio graphically provisionally diagnosed as nasopalatine duct cyst in a 62 year old male patient with complaint of swelling in midline of palate. The lesion was surgically removed, and histo pathologically confirmed the provisional diagnosis, thus concluding that it can be a diagnostic dilemma in clinical and radiological examinations. Keywords: Cysts, Developmental, Naso palatine, Non-odontogenic ………………………………………………………………………………………………………………………………... Introduction Nasopalatine duct cyst (NPDC) is the most common non-odontogenic, developmental cyst of non-neoplastic nature. Its location is peculiar and specific in that it affects the midline anterior maxilla. 1 Thenasopalatine duct communicates the nasal cavity with the anterior region of the upper maxilla. During fetal development the duct gradually narrows until one or two central clefts are finally formed on the midline of the upper maxilla. The nasopalatine neurovascular bundle is located within the duct and emerges from its intra-bony trajectory through the nasopalatine foramen [1,2]. NPDC was first described by Meyer in 1914, who wrongly identified it as a paranasal sinus. In the past, NPDC, was termed as anterior palatine cyst or incisive canal cyst arising from embryologic remnants of nasopalatine duct and was regarded as fissural cysts formed between the two maxillae. World Health Organization in 1998 classified these lesions as non- odontogenic developmental cyst along with naso- alveolar and naso-labial cyst. Although they are most common non-odontogenic jaw cysts, they accountfor only 1% of all maxillary cysts[1,3]. NPDC is commonly seen in 4 th and 5 th decade of life with slight male predilection. Clinically it may be asymptomatic and get discovered during routine radiographic examination. Larger lesion presents as a swelling over anterior maxilla, located between the tooth roots of maxillary central incisors. As the presentation of NPDC mimics common periapical lesion like radicular cyst, it is not uncommon to see evidence of endodontic treatment of associated teeth due to previous misdiagnosis of the pathology[1,3-6]. Case Report A 62 year old male patient reported with the chief complaint of a swelling in upper front tooth region of jaw since 2 months. Swelling was insidious in onset and gradually increased to present size with no pain or discharge. Patient revealed a history of trauma few years back in same region. There was no relevant extraoral finding or lymphadenopathy. The patient’s medical history was non-contributory. Manuscript received: 2 nd March 2018 Reviewed: 10 th March 2018 Author Corrected: 17 th March 2018 Accepted for Publication: 21 st March 2018