Presentation of a keratocystic odontogenic tumor with. A recurrence case of keratocystic odontogenic tumor. Patient details 35 year old female reported to bvp opd with cco swelling in lower right back tooth region since 6 months. Ay earold femalewas referredpresentinga slight asymptomatic swelling on the right mandibular angle and ascending ramus of years of evolution figure a. Pdf odontogenic keratocyst mandible an interesting case. Odontogenic keratocyst is a locally aggressive and highly recurrent lesion, which occurs mostly on the posterior mandible with a slightly higher rate in males. Senior registrar, professorial unit, royal national throat, nose and ear hospital, grays inn road, london wci x 8da summary. Odontogenic keratocyst shows involvement of mandible over maxilla, with peak incidence in second and third decade and it is exceedingly rare before 10 years of age. A comparative study of decompression and enucleation versus resectionperipheral ostectomy. Due to highly recurrent nature of the odontogenic keratocysts, patients followup continues.
Case report keratocystic odontogenic tumor simulating lateral periodontal cyst and nasopalatine duct cyst. In 2005, the world health organisation who classified the parakeratinized variant of okc as a cystic neoplasm and introduced the term keratocystic. The odontogenic keratocyst okc is a developmental, non inflammatory chronic cystic lesion. Keratocystic odontogenic tumor in the maxillary sinus. Thus, the aim of this study was to discuss the aspects regarding the diagnosis, prognosis and treatment of kcot, through the report of two cases. Two cases of primary soft tissue okc in an adult female are described. If youre in the mood to see a picture of an odontogenic keratocyst after it has been cut out of someones jaw as well as the tooth, take a look at this case report and scroll down to the images. There are many types of cysts of the jaws, but what makes the odontogenic keratocyst unusual are its characteristic histopathological and clinical features, including potentially aggressive behaviour, high recurrence rate, and an association with the nevoid basal cell carcinoma syndrome.
Case report multiple recurrent odontogenic keratocysts. This cyst actually arises from the cell rests of dental lamina. We report a case of an otherwise healthy individual who developed 17 cysts over 15 years. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. We present a case report of a 19yearold female with infected odontogenic keratocyst associated with the impacted mandibular second molar with the odontome and a submandibular space infection. The distinction between keratocystic odontogenic tumor and other. Treatment and 3d image followup of a recurrent keratocyst case report therezabussolaro,c1. Clinically, the kot is manifested by an asymptomatic growth. It can become quite large because of its ability for significant expansion, extension into adjacent tissues and rapid growth and also has high reccurence rate as it shows a thin, friable wall, which is often difficult to enucleate from the bone in toto, and have. Pdf the keratocystic odontogenic tumour is classified as a developmental cyst derived from. Case presentation odontogenic kertocyst presented by dr.
Keratocystic odontogenic tumor associated with an ectopic. It is now designated by the world health organization as a keratocystic odontogenic tumour kot. Okc received its new title as keratocystic odontogenic tumour kcot by the who 2005 in order to suggest its aggressive and recurrent nature. Nasib chand khabra 1, ish pandhi 1, kiran dn 2, sunil alipuria 1, bhawna gulati 1, and aastha narula 1. T he odontogenic keratocyst is a common odontogenic cyst which accounts for 10% of all oral cysts. A case report on surgical management of odontogenic. Radiographically, most okcs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst. The aim of this report is to present a clinical case of a nonhealing radiolucent lesion that created a diagnostic dilemma.
This report will bring forward data on the demographics of odontogenic keratocyst in the northwest which has not previously been published and compares it to data from other regions of the usa and other countries. Case report keratocystic odontogenic tumor simulating lateral. Maxillary keratocystic odontogenic tumor with calcifications. It was formerly known as odontogenic keratocyst okc. Unusual ct appearance in an odontogenic keratocyst of the. Giant keratocystic odontogenic tumor of the maxillary sinus. Decompression of mandibular odontogenic keratocyst using a custom drain a. It is because of this characteristic that a variety of treatment modalities has been suggested for this cyst. A unique case of keratocystic odontogenic tumor mimicking.
An 11 yearold boy with a complaint of swelling in left side of the upper jaw was referred to our clinic. Treatment and 3d image followup of a recurrent keratocyst. Odontogenic keratocysts make up around 19% of jaw cysts. A rare case report of orthokeratinized odontogenic. Case report in march 1999, a 39yearold female was referred to the department of endodontics at the school of dentistry, university of florence, italy. The orthokeratinizing odontogenic cyst is considered an unrelated entity without risk of recurrence or aggressive growth or association with nevoid basal cell carcinoma syndrome. Odontogenic keratocyst in the mandible, surgical treatment. He denied any neurosensory deficit associated with right inferior alveolar nerve.
Pdf conservative treatment protocol for keratocystic. Odontogenic keratocyst treated by the partsch operation. Here is a case report which documents multiple jaw cysts. It most often affects the posterior mandible and most commonly presents in the third decade of life. A keratocystic odontogenic tumour kcot occurring in the maxillary sinus is very often misdiagnosed to be a dentigerous cyst. In this article we report a rare case of scc which originated from a keratocystic odontogenic tumor in a 20. Odontogenic keratocyst appearing as a soapbubble or. Sivakumar 1department of oral and maxillofacial surgery, sree balaji dental college and hospital, bharath university, chennai, india 2sree balaji dental college and hospital, bharath university, chennai, india. Marsupialization as a treatment option of a large odontogenic.
Floresmir, c1 methodsintervention case presentation. Identification of an odontogenic keratocyst and treatment. Odontogenic keratocyst a case presentation purshotam nainani 1, anish gupta, pratibha kavle2, amit mathur3 abstract. The diagnostic approach is based on a combined analysis of the medical history, the clinical appearance and the radiographic appearance. Large odontogenic keratocyst of mandible a case report article pdf available in journal of the indian dental association 57. Case report open access odontogenic keratocyst in the mandible, surgical treatment and reconstruction. Cakur b, miloglu o, yolcu u, goregen m and gursan n.
Occurrence of a gingival cyst in adults that exhibits the histopathologic hallmarks of an odontogenic keratocyst okc is rare. A case report of odontogenic keratocyst in anterior mandibule position. Panoramic image showing multiple cystlike radiolucencies in upper and lower jaws. Examined by decade of age, 23 of these cases were in the first decade. Systemic signs and symptoms, past medical history and hematologic tests were within normal limits. It can occur anywhere in the jaw but is commonly seen in the posterior part of the mandible. Case report a yearold male patient came to the department with a chief complain of pus discharge from the right upper back teeth region months ago with pain and swelling days ago. Management of multiple odontogenic keratocyst in a case of. Long term follow up on keratocysts treated according to a defined protocol. A 32yearold male presented with complaint of a persistent. When the cyst is multilocular and located at the molar ramus area, it may be. Histologic examination revealed an odontogenic keratocyst with no evidence of mineralization or calcification within the lesion.
The swelling was progressive and was associated with pain since 15 days. Caucasian patient, male, 18 years old, sought care in outpatient oral and maxillofacial surgery. Case report keratocystic odontogenic tumor simulating. The odontogenic keratocyst can occur anywhere within the jaws, and examples within the gingival soft tissues have even been reported. Acid phosphatase activity was weak in all epithelia except that in keratocysts, which displayed a marked activity. The prevalence of kcot in the maxillary sinus is only 1%. Odontogenic keratocyst okc is the cyst arising from the cell rests of dental lamina. However multiple odontogenic keratocysts found in children are often re. The maxillary lesion was not associated with any impacted tooth. The okc is distinctive among jaw cysts given its tendency toward recurrence and aggressive clinical. Pai, mds abstract although odontogenic keratocysts are common in clinical practice, the simultaneous occurrence of multiple cysts in both the maxilla and mandible of a patient is rare. According to high recurrence rate of kot, there are many controversies in treatment of the lesion, especially in syndromic cases with younger ages. Since the recognition of the odontogenic keratocyst, 5 and later having its histological criteria defined, 6 this lesion has been theme of investigation and study motivated by its tendency of recurrence and potential aggressive nature.
First described by philipsen in 1956, the odontogenic keratocyst is characterized by a large squamous keratinization of its border, an aggressive growth and a high recurrent rate. Panoramic radiograph showing an extensive radicular lesion at the region of teeth 22, 23, 24 clinical photograph of case 26. A case of peripheral odontogenic keratocyst arising in a 57yearold white female patient involving the posterior mandibular gingiva that recurred after 12 months of followup is presented. Keratocyst odonogenic tumor in the anterior of the maxilla. This reported case reinforces that patients presenting peripheral odontogenic keratocyst should be carefully followed up after conservative surgical treatment. Management of the keratocystic odontogenic tumor has been one of the most controversial entities of the maxillofacial surgery. The orthokeratinized odontogenic cyst ooc is a rare developmental odontogenic cyst that has been considered as a variant of the keratocystic odontogenic tumour kcot until wright 1981 defined it as a different entity. The term odontogenic keratocyst was first described by philipsen in 1956. In this paper, we shall present one case report of a keratocyst, which derived from an impacted canine. We report a rare case of gorlingoltz syndrome in a 20yearold male patient who presented with a slow growing swelling on lower right and left back teeth. The oxidative enzymes showed strong activity in the keratocyst epithelium which contrasted with weak activity in the reference cysts. An expansile lesion in the body of the left mandible had high attenuation 225 hu on nonenhanced ct scans. Odontogenic keratocyst or keratocystic odontogenic tumour.
There is a 29 x x 27 mm unilocular cystic slightly expansile lesion involving the body and angle of the left mandible, adjacent to the roots of the tooth 36 and 37 and to a lesser extent the unerupted mesially angulated 38. Keratocystic odontogenic tumor are considered to be benign, even though they are locally aggressive and show high recurrence rates after conservative management. Case report a 55 years old female patient presented with a painful swelling in the left cheek region present since 3 months. Odontogenic keratocyst okc is a common developmental odontogenic cyst affecting the maxillofacial region. However, there are very few case reports in the literature of the simultaneous occurrence of these two lesions, and hence this case is very rare. Albodbai mh 21 keratocystic odontogenic tumor in the maxillary sinus. A case report on surgical management of odontogenic keratocyst. Odontogenic keratocyst is a distinctive form of developmental odontogenic cyst because of its specific histopathologic features, an aggressive biologic behavior and a high. Odontogenic keratocysts are believed to arise from remnants of the dental lamina and are found in locations which may be encountered by periodontists. The odontogenic keratocyst is a very well known odontogenic cyst.
Resident of oral and maxillofacial radiology, faculty of dentistry, shahid sadoughi university of medical science, yazd, iran. Keratocystic odontogenic tumor kot is one of the major components of nevoid basal cell carcinoma syndrome nbccs, which usually occurs in young ages and includes significant structures of jaws. Here, we report the case of a 14yearold caucasian girl, who presented with bilateral agenesis of the upper incisors, diagnosed via orthopantomography opg figure 1 and skull xray in the laterolateral projection. Mylanahalli doddarangiah prakash, borlingegowda viswanatha, glen edwin dsouza. Features of peripheral keratocystic odontogenic tumor 301 int j clin exp med 2014. An odontogenic keratocyst is a rare and benign but locally aggressive developmental cyst. Odontogenic keratocysts in nevoid basal cell carcinoma. The okc was designated by the world health organization who in 2005 as a keratocystic odontogenic tumor kcot and is defined as a benign uni or multicystic, intraosseous tumor of odontogenic origin, with a characteristic lining of parakeratinized stratified squamous epithelium and. A case report on surgical management of odontogenic keratocyst 11 2vijay ebenezer, r. Enucleation and liquid nitrogen cryotherapy in the treatment of keratocystic odontogenic tumors. Odontogenic keratocyst okc characterized by a single lesion, with greater frequency in the mandibular jaw. Odontogenic keratocyst okc is a developmental odontogenic cyst, which was first identified and classified by phillipsen in 1956 and the histological criteria for diagnosis was put forth by pindborg and hansen in 1962.
Multiple okcs are usually seen in association with nevoid basal cell carcinoma syndrome nbccs but approximately 5% of patients with okc have multiple cysts without concomitant syndromic presentation. The past medical history was not contributory and no alteration was detected on extraoral and intraoral examination. Odontogenic keratocyst okc originates from the dental lamina and is more commonly seen in the. In recent studies a somatic mutation of ptch gene in some.
Orthokeratinized odontogenic keratocyst is a lessaggressive nonsyndromic variant of odontogenic keratocyst okc. For your viewing pleasure, heres a photo of what an odontogenic keratocyst looks like at the cellular level thanks to nephron for the photo. Introduction odontogenic keratocyst okc tumors were first described as a cholesteatoma by hauer et al. This report represents a case of multiple okcs in a nonsyndromic patient. The diagnosis may be confirmed by the anatomical pathology report. The high attenuation was considered to be due to highly concentrated protein of thick, viscous keratin in the lumen of the keratocyst. Pain was gradual in onset, throbbing type, continuous, nonradiating, aggravates on mastication, and relieved on taking medication.
The radiographies from chest and skull were unremarkable and no cutaneous abnormality was revealed. A unique case of keratocystic odontogenic tumor mimicking malignancy. Multiple odontogenic keratocyst, gorlingoltz syndrome, nonsyndromic. He had multiple okcs, calcification of falx cerebri, bifid ribs, frontal bossing. Journal of oral and maxillofacial surgery, 64, 308316. Surgery is the usual treatment, and recurrence or association with gorlingoltz syndrome has rarely been described. When the cyst is multilocular and located at the molar ramus area, it. Pdf a case report of odontogenic keratocyst in anterior mandible ijar indexing academia.
Here, we report the first case of okc in a 27yearold male showing granular cell changes. Nevoid basal cell carcinoma syndrome, a rare autosomal dominant disorder, comprises a number of abnormalities such as multiple nevoid basal cell carcinomas, skeletal abnormalities and multiple odontogenic keratocysts. Odontogenic keratocyst looks can be deceptive, causing. British journal of oral and maxillofacial surgery 1985 23, 210215 1985 the british association of oral and maxillofacial surgeons odontogenic keratocyst of the maxilla. The use of the partsch operation, with subsequent cyst enucleation after several years, prevented paresthesia, allowed bone healing, and facilitated surgical access. Approximately one year after starting orthodontic treatment, our patient came to the emergency department because of a phlegmonous. Case report unusual ct appearance in an odontogenic keratocyst of the mandible. Massive keratocystic odontogenic tumor of mandible. Thus, it has been the subject of much research over the last 40 years. Pdf large odontogenic keratocyst of mandible a case report. Odontogenic keratocyst an unusual clinical case presentation. Considering the rarity of this syndrome, we present a 12yearold boy affected by this syndrome.
Philipsen in 1956 1was the first person to describe odontogenic keratocyst okc. Histologic examination revealed an odontogenic ker. Jaw cysts constitute approximately 17% of oral pathology specimens. It was suggested that okc originates from dental lamina remains. The odontogenic keratocyst okc is classified as a developmental epithelial cyst and comprises approximately 11% of all cysts of the jaws.
In this case report, we are highlighting an unusual presentation of okc with. A 14yearold caucasian girl presented for observation of bilateral agenesis. The most characteristic clinical feature of okc is the high recurrence rate. In this case report, surgical treatment of the odontogenic keratocyst in the right posterior mandible and reconstruction of the defected site is presented. Keratocystic odontogenic tumor invading the right maxillary sinus. Both presented as an asymptomatic small nodule on the buccal gingiva of the anterior mandible. The presence of multiple odontogenic keratocysts can be associated with the gorlingoltz syndrome. Usually, multiple odontogenic kerato cysts okcs occur as a component of nevoid basal cell carcinoma syndrome. Removal of bone at the labial aspect respective to the lesion. Okc has been of special interest because of aggressive behavior, specific histopathological features, and high recurrence rate. We hereby report a case of kcotassociated with an ectopic tooth in the maxillary sinus. Typical pathology proven case of odontogenic keratocyst which is a benign cystic lesion involving the mandible or maxilla they typically appear as an expansile solitary unilocular lesion extending longitudinally in the mandible. Case report keratocystic odontogenic tumor with an ectopic. In the fibrous capsule of the keratocyst a high activity of leucine aminopeptidase was recorded.