• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권2호
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• pp.150-160
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• 2005

Background: For normalization of displaced anatomical structure by large cyst, two-step procedure (decompression and enucleation afterward) has been recommended. However, the histological transformation after cystotomy for decompression was shown frequently in secondary enucleation. Therefore, analyses about effects and histological changes after decompression have been necessary. Methods: 48 cases diagnosed as large odontogenic cyst in the jaw and treated by decompression and secondary enucleation were retrospectively analyzed in clinical, rediographical, and histological aspects. Results: In dentigerous cyst, decompression was much useful. Impacted permanent teeth were erupted and reduction rate was higher than that of odontogenic keratocyst (OKC) and apical periodontal cyst. In OKC, among the 29 cases, 11 cases showed no-keratosis, proliferation and rete-ridge elongation after decompression. 4 cases showed no-keratosis, only. 7 cases showed orthokeratosis and rete-ridge elongation and 6 cases showed reteridge elongation, only. 1 case had no change. And the recurrence rate for OKCs was 10.3%. For all odontogenic cysts in this study, dysplasia was not found in cystic lining after decompression. Conclusions: This study implied that decompression for large odontogenic cyst was useful treatment modality because it was conservative treatment and recurrence rate was low although long treatment period was required.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권1호
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• pp.55-63
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• 2012

The odontogenic keratocyst (OKC) was originally classified as a developmental cyst, and OKCs were histologically divided into orthokeratotic (O-OKCs) and parakeratotic (P-OKCs) types. Clinical features differ between O-OKCs and P-OKCs with P-OKCs having a tendency to recur after surgical treatment. According to the revised histopathological classification of odontogenic tumors by the World Health Organization (2005), the term keratocystic odontogenic tumor (KCOT) has been adopted to describe P-OKCs. In this retrospective study, we examined 186 KCOTs treated at the Maxillofacial Surgery Department of the Tokyo Medical and Dental University Hospital from 1981 through 2005. The patients ranged in age from 7 to 85 years (mean, 32.7) and consisted of 93 males and 93 females. The most frequently treated areas were the mandibular molar region and ramus. The majority of KCOTs in the maxillary region were treated by enucleation and primary closure. The majority of KCOTs in the mandibular region were enucleated, and the wound was left open. Marginal resection was performed in the 4 patients with large lesions arising in the mandible. In patients who were followed for more than a year, recurrences were observed in 19 of 120 lesions (15.8%). The recurrences were found at the margins of the primary lesion in contact with the roots of the teeth or at the upper margins of the mandibular ramus. Clinicians should consider aggressive treatment for KCOTs because the recurrence rate of P-OKCs is higher than that of other cyst types such as O-OKCs, dentigerous cysts, primordial cysts that were non-keratinized, and slightly keratinized stratified squamous epithelium. Although more aggressive treatment is needed for KCOTs as compared to other cystic lesions, it is difficult to make a precise diagnosis preoperatively on the basis of clinical features and X-ray imaging. Therefore, preoperative biopsy is necessary for selecting the appropriate treatment for patients with cystic lesions.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권2호
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• pp.162-164
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• 2004

Odontogenic keratocysts are developmental odontogenic cysts which derived from rests of dental laminas and often found in posterior area of mandible. Because this lesion has tendency of frequent recurrence, treatment of choice is often radical removal of the lesion. Sometimes in case of large cysts, however, conservative therapy like marsupialization is often selected in treatment plan. A 39-years old woman referred to our department for evaluation of large radiolucent lesion that occupies the areas from mandible angle to upper part of ramus and condyle. In cytology, the lesion was identified as odontogenic keratocyst. Marsupialization was our treatment of choice, and the result was so favorable. 2 years later, there was small radiolucent lesion on upper part of mandibular ramus on panoramic view. It was suspected as recurred lesion, and excisional biopsy was done. On biopsy result, it was not a cystic lesion but fibrosis.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권5호
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• pp.429-434
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• 2009

Basal cell nevus syndrome is a rare inherited disorder characterized by mulitple cutaneous basal cell carcinoma, pits of the palms and soles, cysts of the jaws, skeletal abnormalities and ectopic calcifications. Currently there are new lines of investigation based on biomolecular studies, which aim at identifying the molecules responsible for these cysts and thus early allowing an early diagnosis of these patients. We report a case of a 9-year-old boy with the various manifestation of basal cell nevus syndrome, which are multiple odontogenic keratocysts, pits of the soles, bifid ribs, ectopic calcification, macrocephaly, and hypertelorism, etc. Total five odontogenic keratocysts were found. For the reduction of the size of the odon-togenic keratocysts, following preoperative marsupialization, there were surgically enucleated. And the impacted upper right lateral incisor and canine are tracted orthodontically.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권2호
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• pp.73-77
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• 2014

Keratocystic odontogenic tumor (KCOT) is a benign cystic intraosseous tumor of odontogenic origin. An infection of a KCOT is not common because KCOT is a benign developmental neoplasm. Moreover, a severe deep neck space infection with compromised airway caused by infected KCOT is rare. This report presents a 60-year-old male patient with a severe deep neck space infection related to an infected KCOT due to cortical bone perforation and rupture of the exudate. Treatment of the deep neck space infection and KCOT are reported.

• Imaging Science in Dentistry
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• 제47권2호
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• pp.135-140
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• 2017

Squamous cell carcinoma (SCC) arising within the lining of an odontogenic keratocyst (OKC) is a rare occurrence. Although potentially locally destructive, OKC is a benign odontogenic process that typically presents with clinical and radiographic features characteristic of a benign intraosseous neoplasm. We present the clinical and radiographic features of a maxillary mass that demonstrated SCC arising from the lining of an OKC. Although the initial clinical and radiographic presentation suggested an infection or malignant neoplasm, biopsies revealed an infiltrative well-differentiated SCC contiguous with and arising from the focus of a pre-existing OKC. The patient subsequently underwent a type II hemi-maxillectomy with neoadjuvant chemoradiation. This report discusses the clinical and radiographic features associated with intraosseous malignancies, especially those arising from an otherwise benign odontogenic lesion. While the majority of OKCs are benign, the current report illustrates the potential for carcinomatous transformation within the lining of an OKC.

• Imaging Science in Dentistry
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• 제51권2호
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• pp.203-208
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• 2021

Ghost cell odontogenic carcinoma (GCOC) is a rare malignant neoplasm characterized by the presence of ghost cells. It is considered to originate from either a calcifying odontogenic cyst(COC) or a dentinogenic ghost cell tumor(DGCT). Its clinical and radiographic characteristics are non-specific, including slow growth, locally aggressive behavior, and eventual metastasis. This case report describes a 43-year-old Thai man with plain radiographs and cone-beam computed tomographic images revealing a unilocular radiolucency with non-corticated borders surrounding an impacted left canine associated with radiopaque foci around the cusp tip. Based on the microscopic findings, the lesion was diagnosed as GCOC. Partial maxillectomy of the right maxilla was performed, and radiotherapy was administered. An obturator was made to support masticatory functions Three years later, the lesion showed complete bone remodeling and no signs of recurrence, and long-term follow-up was done regularly.

• Imaging Science in Dentistry
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• 제33권4호
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• pp.235-238
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• 2003

Squamous cell carcinoma arising in an odontogenic cyst is uncommon. The diagnosis of carcinoma arising in a cyst requires that there must be an area of microscopic transition from the benign epithelial cyst lining to the invasive squamous cell carcinoma. We report a histopathologically proven case of squamous cell carcinoma arising in a residual mandibular cyst in a 54-year-old woman.

• Imaging Science in Dentistry
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• 제42권1호
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• pp.55-60
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• 2012

Gorlin-Goltz syndrome is an autosomal dominant disorder principally characterized by cutaneous basal cell carcinomas, multiple keratocystic odontogenic tumors, and skeletal anomalies. This syndrome may be diagnosed early by dentist because keratocystic odontogenic tumors are usually one of the first manifestations of the syndrome. Early diagnosis and treatment are of utmost importance in reducing the severity of long term sequelae of this syndrome. This report presents a rare event of Gorlin-Goltz syndrome occurring in a 39-year-old male and his 8-year-old daughter. The clinical and investigative features of this familial disorder has been described in detail.

• Restorative Dentistry and Endodontics
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• 제25권4호
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• pp.491-493
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• 2000

A case of a botryoid odontogenic cyst of the globulomaxillary area between the right upper lateral incisor and the canine presenting as an apical periodontal cyst was reported. The cyst showed an unilocular radiolucency with a well delineated hyperostotic border. Histologic examination revealed multiple cysts lined by one or two-cell layers, some areas demonstrated a bud-like thickening of the epithelium. Clear cells were also conspicuous, but devoid of inflammatory reaction in the cystic wall. Some considerations regarding differential diagnosis, histogenetic and biologic behaviour of the lesion were discussed.