A radiolucency in bone without periosteal bone reaction is seen in
High-Yield Explanation
Any lesion of bone destruction that has ill-defined borders and a lack of peripheral bone response (sclerosis) should be viewed with suspicion.
Squamous cell carcinoma originating in bone
The internal structure is wholly radiolucent with no evidence of bone production and very little residual bone left within the center of the lesion.
Periapical image reveals bone destruction similar to periodontal disease around the lateral incisor from a squamous cell carcinoma originating in the soft tissues of the alveolar process. In image A note the lack of a sclerotic bone reaction at the periphery.