Nasopalatine Duct Cyst

The nasopalatine cyst is the most common epithelial and nonodontogenic cyst of the maxilla. The cyst originates from epithelial remnants from the nasopalatine duct. The cells may be activated spontaneously during life or are eventually stimulated by the irritating action of various agents (infection, etc.). It is different from a radicular cyst. The definite diagnosis should be based on clinical, radiological, and histopathological findings. The treatment is enucleation of the cystic tissue, and only in rare cases a marsupialisation needs to be performed. A case of a nasopalatine duct cyst in a 35-year-old male is reviewed. The typical radiologic and histological findings are presented. 1. Introduction The nasopalatine duct cyst (NPDC) was first ever described by Meyer in 1914 [1, 2]. Nasopalatine duct cyst, also termed as incisive canal cyst, arises from embryogenic remnants of nasopalatine duct, the communication between the nasal cavity and anterior maxilla in the developing fetus. Most of these cysts develop in the midline of anterior maxilla near the incisive foramen [3]. It is one of the most common nonodontogenic cysts of the oral cavity occurring in about 1% of the population [4]. NPDCs affect a wide age range; however, most present in the fourth through sixth decades of life, and most studies show a significantly higher frequency in men than woman, with the ratio being 2.5？:？1 [5–11]. Patients may be asymptomatic, with the lesion being detected on routine radiographs; however, many will present with one or more symptoms. Complaints are often found to be associated with an infection of a previously asymptomatic nasopalatine duct cysts and consist primarily of swelling, drainage, and pain [10, 12]. The vitality of nearby teeth should not be affected; however, it is not uncommon to see evidence of endodontic therapy because the nasopalatine duct cyst was previously clinically misdiagnosed as a periapical cyst or granuloma. The present case of NPDC is one such typical pathology with the classical presentation which could have been easily misdiagnosed as a periapical lesion. 2. Case Report 2.1. History A 35-year-old male reported to the dental clinic with the chief complaint of painless swelling over the palate and anterior maxilla. The swelling was gradually increasing in size for the past 3 months with associated displacement of maxillary central incisors. There was no associated history of trauma. On examination, a well defined firm nontender swelling was seen on the left side of anterior hard palate and crossing over the midline to the right