Clinical Cases

Globulomaxillary Cyst – A Case Report

Written by Amit Arora

Drs. Udesh Kumar and Amit Arora present a brief case of Globulomaxillary Cyst in a man of 27. Feeling of insecurity, need of family support, conscious of his image and sweaty palms and soles were among the symptoms leading to the simillimum.

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

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.

Follow up Medicine prescribed Remarks
1st prescription CALCAREA silicata 30/tds/15 days
2nd prescription CALCAREA silicata 30/tds/15 days No specific change
3rd prescription CALCAREA silicata 30/tds/15 days Slight change in size of swelling
4th prescription CALCAREA silicata 30/tds/15 days Noticable change in swelling
5th prescription Sac Lac 30/tds/15 days Swelling much reduced.
6th prescription No medicine prescribed as swelling is completely resolved. 2.5 months after remedy, no problem.

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. 5th and 6th New Delhi. B Jain Publishers (P) Ltd, 2015.

About the author

Amit Arora

Amit Arora (B.H.M.S) has been working as Medical officer for the past 16 years in the Directorate of AYUSH, Department of Health and Family Welfare, Govt of NCT of Delhi. He is presently posted as Chief Medical officer (NFSG) at Indara Gandhi Hospital, Dwarka. He was awarded with Homoeo Icon award by Delhi homoeopathic Federation in 2019. He has experience of teaching for 3 years in Dr. B R Sur Homoeopathic Medical College and Hospital. He has also authored a book “Textbook of Immunology, Microbiology and Parasitology” published by B Jain publishers.

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