A patient presents with bilateral expansion of the mandible, a history of early primary tooth loss, impacted permanent teeth, and bilateral multilocular radiolucencies on panoramic radiograph. The MOST likely diagnosis is:

Correct answer: C. Cherubism

• A. Ameloblastoma is typically unilateral, most common in the posterior mandible — not characteristically bilateral and symmetric.
• B. Multiple myeloma causes 'punched-out' lytic lesions throughout bone — not symmetric jaw expansion in childhood.
• C. Correct. Cherubism is an autosomal dominant condition (SH3BP2 gene mutation) presenting in childhood with bilateral symmetric expansion of the mandible (and sometimes maxilla), multilocular radiolucencies, early tooth loss, and impacted or displaced teeth. Patients have a characteristic 'cherubic' facial appearance. The bilateral symmetric nature is the key distinguishing feature.
• D. OKC is usually unilateral in the posterior mandible — bilateral symmetric involvement is not typical.