Ameloblastoma, a type of odontogenic tumor involving ameloblasts. In this paper, we shall present one case report of a keratocyst, which derived from an impacted canine. Recent advances in genetic and molecular understanding have led to eventually eliminate the need for aggressive treatment modalities. This article aims to discuss the clinical features, radiological assessment, histopathology and management of a variety of odontogenic cysts. A, panorex and b, computed tomographic images are used as necessary in the preoperative workup and evaluation, which includes incisional biopsy examination. Kcots differ from other odontogenic cysts because of its aggressive behavior, specific histopathological features and tendency to recurrence. Trends in recurrence of keratocystic odontogenic tumor clinmed. Introduction the keratocystic odontogenic tumor kcot is defined, according to the world health organization who as a benign tumor uni or multicystic, intraosseous tumor of odontogenicorigin, with a characteristic lining of pa. In the whoiarc classification of head and neck pathology, this clinical entity had been known for years as the odontogenic keratocyst. Pdf on may 1, 2014, madhumati amritraj singh and others. Review of the literature and report of a rare case. The patient with a biopsyconfirmed keratocystic odontogenic tumor is brought to the operating room.
Keratocystic odontogenic tumor in the maxillary sinus. This case report discusses odontogenic keratocyst of mandible. It is one of the most controversial pathological entities. This neoplasia is predominantly found in males and people of white origin. First described by philipsen in 1956, 1 the odontogenic keratocyst okc constitutes approximately 11% of all cysts of the jaws. Correlation between imaging features and epithelial cell. These are relatively common lesions most are inflammatory cysts about 55% of all jaw cysts, dentigerous cysts 22% or odontogenic keratocysts keratocystic odontogenic tumours. Management of keratocystic odontogenic tumour with mafiadoc. The keratocystic odontogenic tumor kcot is characterized by its high tendency to recur after surgical treatment. Keratocystic odontogenic tumor definition of keratocystic. The most likely diagnosis of this cystic mandibular lesion is either a kcot or a unilocular ameloblastoma. Okc is now referred to by the world health organization who as a keratocystic odontogenic tumour kcot, and who defined it as a benign uni or multicystic, intraosseous tumour of odontogenic origin, with a characteristic lining of parakeratinized stratified squamous epithelium. Jan 29, 2020 mandibular adenomatoid odontogenic tumor. A keratocystic odontogenic tumor kot formerly known as an odontogenic keratocyst is a benign cystic tumor of dental origin that probably arises from primitive dental lamina, most commonly occurs in the posterior mandible, and almost certainly represents the lesion that used to be known as a primordial cyst.
Management of this case required the multidisciplinary collaboration of different specializations and careful planning to devise a correct therapeutic. Keratocystic odontogenic tumor synonyms, keratocystic. There were 18 lesions in the posterior mandible, 3 in the anterior mandible and 6 in the posterior maxilla fig. Because of its features, the keratocystic odontogenic tumor must have more aggressive treatment, compared with odontogenic cysts, and longterm followup is mandatory. It is a benign developmental odontogenic tumor with many distinguishing clinical and histologic features. Before i get started, let me say that in 2005, the world health organization actually changed the name of odontogenic keratocyst to keratocystic odontogenic tumor. Original article the growth and osteoclastogenic effects of.
Odontogenic keratocyst is a distinctive form of developmental odontogenic cyst because of its specific histopathologic features, an aggressive biologic behavior and a high recurrence rate. Management of the keratocystic odontogenic tumor has been one of the most. Odontogenic keratocyst mandible an interesting case report. The diagnosis may be confirmed by the anatomical pathology report.
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. Teeth examination revealed that teeth 22 and 23 are missing, and teeth 21 and 24 are positive at cold sensitivity test without mobility. Keratocystic odontogenic tumor article about keratocystic. Histopathologic examination shows a parakeratinized epithelium with a clear basal layer and a wavy appeared luminal surface. Odontogenic cysts were not considered in the new 2005 classification, which means that the previous 1992 classification is still relevant for cysts of the jaws and maxillofacial region, with one notable exception.
Various treatment modalities and differing recurrence rates have been reported for kcot. Okcs have been reclassified under odontogenic tumours in 2005 by the who and have since been termed as keratocystic odontogenic tumours kcots. The aim of the present study was the morphometric evaluation of the epithelial lining and fibrous capsule in histological specimens of keratocystic odontogenic tumors kots before and after marsupialization. Expression of epidermal growth factor receptors by odontogenic jaw cysts.
The newly acknowledged neoplastic potential and its implications for treatment strategies are also discussed. The odontogenic keratocyst can be defined as a cystic benign tumor, being localized at the level of the mandible or the maxilla. Inflammatory odontogenic cysts 1 radicular cyst see od1 notes cyst at apex or around root of a nonvital tooth. This article is in a hope to suggest that the naming of okc as a benign tumor allows the surgeon to tailor their treatment. The keratocystic odontogenic tumor kcot, formerly known as the odontogenic keratocyst okc, received its new designation in order to better convey its neoplastic nature 1. Keratocystic odontogenic tumors kcots are certainly among the most studied lesions in oral pathology, which is not a surprise considering their perplexing clinical behavior and complicated mechanism of pathogenesis. The 2005 who classification now uses the term keratocystic odontogenic tumor. A large extragnathic keratocystic odontogenic tumour. Morphometric evaluation of keratocystic odontogenic tumor before and after marsupialization abstract. Importance keratocystic odontogenic tumors kcots of the jaw affect more than 65% of patients with basal cell nevus syndrome bcns.
The treatment of ooc is by enucleation and the prognosis, following enucleation is excellent with a. Surgery frequently causes facial disfigurement and is not always curative. Another frequent lesion is the keratocystic odontogenic tumor kcot, which is the second most common type of odontogenic tumor. Keratocystic odontogenic tumors, keratocyst, odontogenic keratocyst, iodine tincture 1. Classification of keratinizing odontogenic cysts and tumors is not entirely satisfactory to the clinician and pathologist. Kcots comprise approximately 11% of all cysts in the maxillofacial region and due to unspecific clinical and radiographic features, it can be misdiagnosed. Case report open access presentation of a keratocystic. A keratocystic odontogenic tumor is a benign but locally aggressive developmental odontogenic tumor that derives from dental lamina or form their remains and is most commonly located in the mandibular ramus and body. Also known as the keratocystic odontic tumor, it is believed to be stemming from the dental lamina. Retrospective analysis of 104 cases of keratocystic odontogenic tumor e539 introduction the odontogenic keratocyst, currently known as kerato cystic odontogenic tumor kcot is a benign cystic lesion of odontogenic origin with a potentially aggressive and infiltrative behavior. More likely, they are caused by related environmental factors.
This case report discusses odontogenic keratocyst of. What are synonyms for keratocystic odontogenic tumor. Reclassification and treatment of odontogenic keratocysts scielo. Ive gotten a few questions about odontogenic keratocysts lately, so i figured it would be good to write an article detailing what we know about them. The keratocystic odontogenic tumor oral and maxillofacial surgery. Morgan odontogenic tumors comprise a range of disorders of growth, from malignant and benign. Adenomatoid odontogenic tumor keratocystic odontogenic tumour. Orthokeratinized odontogenic cyst ooc is a rare, developmental odontogenic cyst which was considered in the past to be a variant of odontogenic keratocyst okc later renamed as keratocystic odontogenic tumor kcot. Istanbul university, dentistry faculty, department of oral and maxillofacial surgery, istanbul, turkey. Keratocystic odontogenic tumor, benign tumor, surgery, maxilla 1. The keratocystic odontogenic tumor is a benign odontogenic cystic neoplasia characterized by its thin, squamous epithelium with superficial parakeratosis. Synonyms for keratocystic odontogenic tumor in free thesaurus. The recurrence rates are variable depending on the type of treatment.
Odontogenic keratocyst of mandible a case report with. An odontogenic tumor is a neoplasm of the cells or tissues that initiate odontogenic processes examples include. Predictive factors of recurrence by ki67 and agnor labelling. Keratocystic odontogenic tumor according to lopes et al. Keratocystic odontogenic tumour of lesions treated in our clinic. Topical 5fluorouracil is a novel targeted therapy for the. Maxillary peripheral keratocystic odontogenic tumor. Introduction the frequency of odontogenic cysts in children is relatively low. Dentistry 204 oral pathology 54 cysts of the oral region a. The world health organization recent classification of head and neck tumours reclassified the keratocyst as a benign neoplasm recommending the term keratocystic odontogenic tumour kcot. It is aggressive, grows rapidly and invades the surrounding tissues. Case report radiological and clinical features of peripheral. Expression of p73 and trail in odontogenic cysts and tumors. Keratocystic odontogenic tumor mimicking lateral periodontal.
The odontogenic keratocyst is a very well known odontogenic cyst. We analyzed the etiopathogenetic, clinical, radiographic, and histopathologic aspects of keratocystic odontogenic tumors, particularly in association with dental anomalies of number, with the aim of providing useful information for their correct diagnosis, treatment, and prognosis within a multidisciplinary approach. Finally, treatment consists of surgical excision and follow up is characterized by a high rate of recurrence. Firat selvi 1, merva soluk tekkesin 2, sirmahan cakarer 1, s. For oral reconstruction following excision of cancer or invasive tumors of the oral structures.
There is an overall male predominance and the mandible is affected three times as commonly as the maxilla. There is a unilocular lytic lesion in the right mandibular angle with imaging appearances of either keratocystic odontogenic tumor or a unilocular ameloblastoma. Chapter 21 odontogenic and non odontogenic tumors of the jaws introduction. Features of peripheral keratocystic odontogenic tumor 302 int j clin exp med 2014. They present more commonly in the posterior mandible of young adults than the maxilla. Keratocystic odontogenic tumor kcot of the mandible. For example, reconstruction of the alveolar ridge if distorted as a result of the. Nov 10, 2009 the keratocystic odontogenic tumor is a benign developmental tumor with many distinguishing clinical and histologic features. Kcots are regarded as benign aggressive tumors and resection is usually considered as a last option. Aug 11, 2009 many treatment modalities have been advocated for its treatment, but none in particular has been regarded as the best treatment option. Keratocystic odontogenic tumor kot represents form 515% of all maxillar cystic lesions.
In 2005, the who working group considered odontogenic keratocyst okc to be a tumor and recommended the term keratocystic odontogenic. It also highlights the reclassification of odontogenic keratocysts to keratocystic odontogenic tumours. Treatment consisted of enucleation and curettage for 22 of the lesions, resection. Oralsurgery 548 dentalupdate julyaugust 2015 odontogenic cysts an overview abstract. Odontogenic and non odontogenic tumors of the jaws are a relatively rare and heterogeneous group of benign and malignant neoplasms, hamartomas, and other bonerelated lesions that demonstrate great variability in etiology, biologic behavior, and clinical significance. In 2005 the who introduced the former odontogenic keratocyst to the category of benign odontogenic tumours. Odontogenic keratocyst symptoms, treatment, pictures. Keratocystic odontogenic tumor, benign tumor, surgery. Keratocystic odontogenic tumor journal of oral science. The mouth opening was unlimited, and there was no deviation of the mandible in habitual occlu. Among the pathological entities that affect the maxillofacial region, keratocystic odontogenic tumour has been subject to a lot of debates.
Odontogenic keratocyst has been rechristened as keratocystic odontogenic tumor by who working group in 2005. Surgical treatment of keratocystic odontogenic tumour. The odontogenic keratocyst, now officially known as the keratocystic odontogenic tumour kcot is an intraosseous tumor characterized by distinctive histopathologic findings. Introduction odontogenic keratocyst okc was a neoplasm described by philipsen in 1956 and was confirmed by 1 browne in 1970 and 1971 2 3. Keratocystic odontogenic tumour kcot, formerly referred to as odontogenic keratocyst, is an aggressive benign neoplasm of the jaws with a high recurrence. Keratocystic odontogenic tumor calcifying cystic odontogenic tumor lumen cavity connective tissue wall epithelium. This was necessitated to differentiate this lesion from its orthokeratinizing variant which is currently considered as odontogenic cyst. Surgical management of dentigerous cyst and keratocystic. Keratocystic odontogenic tumors clinical and molecular. Formerly called keratocystic odontogenic tumor the orthokeratinizing odontogenic cyst is considered an unrelated entity without risk of recurrence or aggressive growth or association with nevoid basal cell carcinoma syndrome epidemiology. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. The parakeratinized subtype became the keratocystic odontogenic tumor kcot, which integrated the group of odontogenic epithelial tumors into its. Case report keratocystic odontogenic tumor simulating.
Keratocystic odontogenic tumor kcot presents most frequently in the second, third and fourth decades of life 54. Decompression as a treatment for odontogenic cystic lesions. Apr, 2016 odontogenic keratocyst or keratocystic odontogengic tumor. Keratocystic odontogenic tumor kcot, formerly referred to as odontogenic keratocyst, is a benign neoplasm of odontogenic origin which may present an aggressive and infiltrative behavior leading. Keratocystic odontogenic tumour an overview sciencedirect. Morphometric evaluation of keratocystic odontogenic tumor. Odontogenic keratocysts okcs are developmental cysts which occur typically in the jawbones. The mouth opening was unlimited, and there was no deviation of the mandible in habitual occlusion. Presentation of a keratocystic odontogenic tumor with.
At that time, it was believed to be a benign, but potentially aggressive and re. Biological pathways involved in the aggressive behavior of the keratocystic odontogenic tumor and possible implications for molecular oriented treatment an overview. Keratocystic odontogenic tumour masquerading as a mucosal. Mar 31, 2012 benign odontogenic tumors odontogenic epithelium 1. These cystic lesions of the jaws, along with odontogenic tumors such as ameloblastomas abs, have the potential to grow and significantly expand the jaws through the process of bone resorption and expansion into contigu. Find out information about keratocystic odontogenic tumor. Management of the keratocystic odontogenic tumor has been one of the most controversial entities of the maxillofacial surgery. Therefore, in 2005 these lesions were reclassified as keratocystic odontogenic tumors kcots and defined as benign, odontogenic, uni or multicystic intraosseous tumors, with characteristic parakeratinized squamous epithelium lining, having a potential for aggressive and infiltrative growth.
Also distinguished by parakeratinized epithelial lining. New tumour entities in the 4th edition of the world health. The use of vismodegib to shrink keratocystic odontogenic. Okc was renamed as keratocystic odontogenic tumor kcot in the who classifications of head and neck tumors in 2005 due to its aggressive, high recurrence rates and specific histological characterstics and was reclassified into the cystic category in who classification of head and neck pathology 2017. Okc is now referred to by the world health organization who as a keratocystic odontogenic tumour kcot, and who defined it as a benign uni or multicystic, intraosseous tumour of odontogenic origin, with a characteristic lining of parakeratinized stratified. Odontogenic keratocysts make up around 19% of jaw cysts. Here we report a case of a recurrent buccal lesion in a 62yearold. Sometimes associated with nevoid basal cell carcinoma syndrome gorlin syndrome. Treatment consisted of enucleation and curettage for 22 of the lesions, resection for 2 and marsupialization for 3. Keratocystic odontogenic tumour kcot, traditionally known as odontogenic keratocyst, received its new title as kcot by the world health organisation who in order to emphasise its neoplastic biological nature.
Odontogenic keratocyst okc is a developmental cyst that was first described by philipsen 1956. It has the potential for infiltration and local aggressiveness and has a high rate of recurrence. Abstract the keratocystic odontogenic tumour kcot is a relatively common oral and maxillofacial lesion that derives from remnants of the dental lamina. Its main features are slow growth and benign but locally aggressive behavior, with a high risk of recurrence 3. Most bcnsrelated and some sporadic kcots have malignant activation of the hedgehog signaling pathway.
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