Radiologic diagnosis of an atypical multilocular Stafne bone lesion

Background: The typical patient diagnosed with a Stafne cyst is male and 40 to 60 years old. The ovoid cavities are usually located lingual in the molar region of the lower jaw underneath the inferior alveolar nerve and appear unilateral. The bone lesion is most probably caused by the pressure of the submandibular gland against the lower jaw bone. Case presentation: A 48-year old patient was referred to the department of oral surgery of the dental university clinic in Vienna by a local dentist, following a diagnosis of two apparent cavities identified by a panoramic x-ray. The findings in the panoramic x-ray and CT scan were inconclusive. The surface of the two lingual open, ovoid cavities in the left mandibula exposed plain cortical bone. In the MRI-scan, adipose, lymphatic and gland tissues were found which are characteristic features of Stafne cyst bone cavities. Conclusion: Diagnosing a Stafne cyst on a panoramic x-ray is almost impossible. Further radiologic investigation is essential in order to exclude differential diagnoses. A CT scan can verify the typical lingual opening of the cavity. The diagnosis of a Stafne cyst can only be made by assessing the soft tissue contained in the cavity, therefore a MRI scan is highly recommended.