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Nasolabial Cyst — MFDS Part 1 MCQ

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HardOral PathologyNasolabial CystMFDS Part 1

A 52-year-old woman presents with a slowly enlarging, painless swelling of the left nasolabial fold, elevation of the nasal ala and obliteration of the maxillary labial sulcus. The adjacent teeth are vital. CT shows a well-defined cystic lesion lateral to the midline in the soft tissue between the nasolabial fold and anterior maxilla. There is a shallow, smooth indentation of the adjacent cortex but no intraosseous epicentre. Histology shows cuboidal-to-columnar epithelium with mucous goblet cells. Which statement best characterises this lesion?

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Correct answer: C — It is a non-odontogenic extraosseous cyst probably related to distal nasolacrimal duct epithelium

This is a nasolabial cyst: a developmental, non-odontogenic cyst arising in the soft tissues beneath the nasal ala, probably from distal nasolacrimal duct epithelium. Its extraosseous location is decisive; a large lesion may produce smooth pressure indentation of the anterior maxilla without acquiring an intraosseous epicentre. The lining is commonly cuboidal or columnar with goblet cells, although squamous metaplasia can occur. Option A describes a nasopalatine duct cyst, which is centred intraosseously in the incisive canal. Option D describes the developmental basis of a gingival cyst. Option B is most consistent with an odontogenic keratocyst, while option E describes a radicular cyst associated with a non-vital tooth.

Reference: Toribio Y, Roehrl MHA. The nasolabial cyst: a nonodontogenic oral cyst related to nasolacrimal duct epithelium. Archives of Pathology & Laboratory Medicine. 2011;135(11):1499–1503. https://pubmed.ncbi.nlm.nih.gov/22032581/