Asymptomatic calcifying cystic odontogenic tumor presenting as a random radiographic finding

Calcifying cystic odontogenic tumor (CCOT), a rare odontogenic lesion, usually appears as radiolucency with radiopacities. This characteristic finding may not always be evident depending on the lesion stage, growth, and histopathological features. An asymptomatic case of CCOT alongside an unerupted third molar that was discovered randomly after a routine panoramic radiograph is presented in a 28-year-old male patient. The imaging examination by cone beam computed tomography revealed a unilocular corticated radiolucency in close association with the buccal aspect of a fully impacted mandibular third molar that extended to the apical third of the tooth. The roots appeared outside the lesion and there was no evidence of resorption or jaw bone erosion. Based on the imaging findings, the provisional clinical diagnosis was dentigerous cyst. After the surgical removal of the cystic lesion, which had adhered in the cemento-enamel junction of the third molar, the histopathological examination showed a CCOT. Unerupted third molars should be investigated radiographically even in the absence of clinical signs for the early diagnosis and management of the various odontogenic cysts and tumors.