Globulomaxillary Cyst – A Case Report

INTRODUCTION

Globulomaxillary cyst is defined as a fissural cyst that appears between the maxillary lateral incisor teeth and adjacent canine teeth. It is thought to arise as a fissural cyst from entrapped epithelium during fusion of the globular portion of the medial nasal process with maxillary process. It is generally asymptomatic and presents as a pear shaped swelling in the oral region.

CASE REPORT

Name: XYZ, Sex: Male,   Age: 27 years,  Marital Status: Married

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PRESENTING COMPLAINT:

A 27 year old male patient reported with chief complaint of painless globular swelling inside the upper portion of mouth in front part of hard palate region. It started 3 months ago.

HISTORY OF PRESENTING ILLNESS:

The swelling was insidious in onset and started as a minute swelling which has progressed to the present size of 1.5 cm. No other associated symptoms were there. There was no history of any kind of trauma or any oral infection.

TREATMENT HISTORY:

A few courses of antibiotics were prescribed and then he was advised to get  surgical enucleation.

PAST HISTORY: NO history of any significant illness.

FAMILY HISTORY: No significant family history present.

PHYSICAL GENERALS:

Thermal reaction: Chilly

Appetite: Adequate

Thirst: Adequate

Desire: Sweets

Aversion: Nothing significant

Stool: Once per day in morning, regular bowel movements

Urine: Regular, no associated complaint. D4-5N0

Perspiration: Normal, more in palms and soles.

Sleep: Sound sleep

MENTAL GENERALS:

Though working as a Govt. servant with a sufficient salary, he has financial insecurity. He worries about what will happen if he loses his job. He is careful about spending money. He feels insecure when alone. In the office he is conscious of his image.

EXAMINATION OF SWELLING:

The swelling is globular in shape, approx 1.5 cm, which is firm in consistency. There is no tenderness.

GENERAL PHYSICAL EXAMNATION:

Build: Mesomorphic

Pulse: 70 beats/minute

B.P. 130/80 mm Hg

Temperature: Afebrile

Nails: No clubbing noticed

SYSTEMIC EXAMINATION:

G.I.T/C.V.S/C.N.S/ Musculoskeletal system: No abnormality detected.

DIAGNOSIS: Globulomaxillary cyst

BASIS OF DIAGNOSIS:

CECT face: A well defined hypodense non enhancing cystic lesion on lingual aspect of hard palate with extension between root of lateral incisor and canine teeth suggestive of non-odontogenic benign cystic lesion of upper jaw, likely Globulomaxillary cyst.

TREATMENT:

Medicine selected: CALCAREA silicata 30

Basis of medicine selection: The mental generals indicated the Calcarea personality and Silica personality. Like Calcarea, the feeling of insecurity, need of family for his support. Like silica he is conscious of his image. Along with that the sweaty palms and soles. So combining these two salts, Calcarea silicata was selected as the constitutional remedy.

Basis of selection of potency: Low potency was selected for the pathological condition and medicine is repeated to cover pathogenicity of case.

Conclusion: The medicine was selected on basis of totality of the symptoms and potency selection was done as per the teachings of Organon of Medicine. In order to cover pathology of case, low potency was selected and repeated. This constitutional selection of remedy saved the case from surgery. (Photos below)

CECT report

Before treatment

After treatment

REFERENCES:

1. Globulomaxillary cyst. Updated on 2016 June 29 [Cited on 2020 January 30]. Available from: https://en.wikipedia.org/wiki/Globulomaxillary_cyst
2. Lakshmi S Reddy. Full moon shaped unusual appearance of globulomaxillary cyst- A case report. Published on 2017 August 4 [Cited on 2020 January 30]. Available from: http://www.jiaomr.in/article.asp?issn=0972-1363;year=2017;volume=29;issue=1;spage=50;epage=52;aulast=Reddy
3. Hahnemann S. Organon of Medicine. 5^th and 6^th New Delhi. B Jain Publishers (P) Ltd, 2015.