Squamous cell carcinoma arising from the lining of an odontogenic cyst is one important rare subcategory of such lesions with an incidence of 0. Odontogenic tumours are rare lesions and many nonspecialist histopathologists will not have seen many during their working lifetime. A revised histopathological classification of odontogenic tumors by the world health organization who has been published in 20055 by the international agency for research on cancer iarc, in which odontogenic keratocyst kcot and calcifying odontogenic cyst ccot were reclassified as tumors. Primary intraosseous squamous cell carcinoma arising in an. 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. These cysts show variable features and some lie on a cysttumour interface, making classification and diagnosis difficult. Keratocystic odontogenic tumor is not the most common of odontogenic cysts but it is an extremely important one for the pathologist to recognize. At that time, it was believed to be a benign, but potentially aggressive and re. Nov 10, 2009 the keratocystic odontogenic tumor is a benign developmental tumor with many distinguishing clinical and histologic features.
Cysts that derive their epithelium from tissues involved in tooth formation are classed odontogenic and can be inflammatory or developmental in origin. Treatment consisted of enucleation and curettage for 22 of the lesions, resection. Among the jaw lesions, keratocystic odontogenic tumor, ameloblastoma, dentigerous cyst forms the common ones. 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. Here, we discuss a rare case of keratocystic odontogenic tumor occurring in the maxilla with an ectopic tooth position.
Specialist in pathology and oral medicine, fulltime research professor. A 14yearold caucasian girl presented for observation of bilateral. An odontogenic keratocyst is a rare and benign but locally aggressive developmental cyst. Ameloblastoma this is by far the most common unequivocal. Pdf histopathological and immunohistochemical study in. Dec 11, 2018 the tumor can be large and aggressively invade the jaw and surrounding tissue and displace teeth. During a 28year period, a total of 183 tumors recorded at the division of pathology, department of diagnostic and.
Keratocystic odontogenic tumor journal of oral science. Even though there are classical clinical features for each of the odontogenic lesions, at times, it may be difficult to arrive at a clinical. 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. 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. There is no clinical consensus for the treatment of keratocystic odontogenic tumor kcot. The keratocystic odontogenic tumor is believed to arise from dental lamina and represents between 412% of all odontogenic cysts. Keratocystic odontogenic tumor odontogenic keratocyst. The lesion occurs over a wide age range with a peak in the second and third decades and demonstrates a predilection for white males 2.
The odontogenic keratocyst is a very well known odontogenic cyst. Orthokeratinized odontogenic cyst ooc is a relatively uncommon developmental cyst comprising about 10% of cases that had been previously coded as odontogenic keratocysts okcs. Squamous odontogenic tumor sot is a rare benign odontogenic epithelial neoplasm. Odontogenic keratocyst symptoms, treatment, pictures. Albodbai mh 21 keratocystic odontogenic tumor in the maxillary sinus. Odontogenic myxomas are known to recur after surgical treatment. The newly acknowledged neoplastic potential and its implications for treatment strategies are also discussed.
There were 18 lesions in the posterior mandible, 3 in the anterior mandible and 6 in the posterior maxilla fig. Ameloblastoma is a rare, benign or cancerous tumor of odontogenic epithelium much more commonly appearing in the lower. Odontogenic keratocystokc, is so named because 1 the cyst is odontogenic in origin and 2 the epithelium produces so much keratin, that it accumulates in. Characterization and management of the keratocystic. Keratocystic odontogenic tumor according to lopes et al. Only cases of pioscc arising from the lining of an odontogenic cyst, including the keratocystic odontogenic tumor, were selected. Diagnosing the most common odontogenic cystic and osseous. Aug 23, 2015 a variety of cysts frequently present in the jaws.
The keratocystic odontogenic tumor vu research portal vrije. A 14yearold caucasian girl presented for observation of bilateral agenesis. Malignant odontogenic tumours histopathology reporting guide. Because of its features, the keratocystic odontogenic tumor must have more aggressive treatment, compared with odontogenic cysts, and longterm followup is mandatory. Histopathological and immunohistochemical study in. The orthokeratinizing odontogenic cyst is considered an unrelated entity without risk of recurrence or aggressive growth or association with nevoid basal cell carcinoma syndrome. Keratocystic odontogenic tumor kcot, formerly known as okc, is a benign unicystic or multicystic intraosseous neoplasm of odontogenic origin which arises from the remnants of the dental lamina both in mandible and maxilla. Keratocystic odontogenic tumour of lesions treated in our clinic.
These are relatively common lesions most are inflammatory cysts about 55% of all jaw cysts, dentigerous cysts 22% or odontogenic keratocysts keratocystic odontogenic tumours. Furthermore, the appearance of such malignancy in an odontogenic tumor such as keratocystic odontogenic tumor is considered extremely rare. Squamous cell carcinoma arising from an odontogenic. A slowgrowing painless expansive swelling is the common presenting symptom.
Consists of variably cellular fibrocollagenous tissue with scattered, small, inactive odontogenic epithelium in strands, cords or nests calcification can be seen in association with odontogenic epithelium and when extensive could consider classification as ossifying variant of odontogenic fibroma. Odontogenic keratocyst, abbreviated okc, is an uncommon odontogenic cyst. Aug 11, 2009 the odontogenic keratocyst is a very well known odontogenic cyst. Frozen sections of 26 of the keratocysts were incubated to show the following enzyme activities. Feb 11, 2017 odontogenic keratocystokc, is so named because 1 the cyst is odontogenic in origin and 2 the epithelium produces so much keratin, that it accumulates in the cystic lumen. 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. Histopathologically, sot can be easily misdiagnosed as an acanthomatous ameloblastoma. The odontogenic keratocyst has been one of the most controversial pathological entities of the maxillofacial region since philipsen first described it in 1956. Odontogenic keratocysts make up around 19% of jaw cysts. Keratocystic odontogenic tumor in the maxillary sinus. Odontogenic keratocyst keratocystic odontogenic tumor developmental cyst derived from remnants of dental lamina with a biological behaviour similar to a benign neoplasm with a distinctive lining of 6 to 10 cells in thickness, and that exhibits a basal cell layer of palisaded cells and a surface of corrugated parakeratin. Histopathological and immunohistochemical study in keratocystic odontogenic tumors. Histopathological features of keratocystic odontogenic tumor.
Although notch receptors and ligands have been shown to play a role in cell fate decisions in ameloblastomas, the role of these cell signaling. The enculated lesion was sent to the laboratory for histological examination which gave the result of parakeratotic keratocystic. Case report keratocystic odontogenic tumor with an ectopic. Keratocystic odontogenic tumor with an ectopic tooth in. Cytokeratins 14 and 19 in odontogenic cysts and tumors. Keratocystic odontogenic tumour masquerading as a mucosal.
Kcots are regarded as benign aggressive tumors and resection is usually considered as a last option. Treatment consisted of enucleation and curettage for 22 of the lesions, resection for 2 and marsupialization for 3. Jaw tumors and cysts symptoms and causes mayo clinic. Histopathological and immunohistochemical study in keratocystic. The term odontogenic keratocyst was first used by philipsen in the year 1956. Keratocystic odontogenic tumor with an ectopic tooth in maxilla. A descriptive study of 177 cases from a brazilian population. This condition is often encountered in young patients, who are in their 2nd or 3rd decade of life.
This is a retrospective study of patients with kcot treated in a single unit over 17 years. Journal of medical case reports squamous cell carcinoma arising from a keratocystic odontogenic tumor. The mandible is more commonly involved than the maxilla 6583% of. Pdf histopathological features of keratocystic odontogenic. The odontogenic keratocyst can be defined as a cystic benign tumor, being localized at the level of the mandible or the maxilla. Nov 21, 2011 histopathological features of keratocystic odontogenic tumor. Table 1 description of keratocystic odontogenic tumours and treatment in a series of 21 patients.
Recurrence rate of keratocystic odontogenic tumor after conservative. The odontogenic keratocyst okc, currently designated by the world health organization as a keratocystic odontogenic tumor is a locally aggressive, cystic jaw lesion with a putative high growth potential and a propensity for recurrence. In the whoiarc classification of head and neck pathology, this clinical entity had been known for years as the odontogenic keratocyst. Histopathological features of keratocystic odontogenic. Keratocystic odontogenic tumor, benign tumor, surgery, maxilla 1. The keratocystic odontogenic tumor is a benign developmental tumor with many distinguishing clinical and histologic features. 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. Pogrel, in current therapy in oral and maxillofacial surgery, 2012. Age, sex, signs and symptoms, affected jaw, cyst type, treatment, histopathology, and outcome were recorded. Squamous cell carcinoma arising from a keratocystic. The discovery of increased mitotic activity in the cyst epithelium, the potential for epithelial budding from basal layer or daughter cysts in the cyst. This benign tumor is the most common odontogenic tumor.
In the who iarc classification of head and neck pathology, this clinical entity had been known. Clinical and histological findings in these 52 cysts are reported. Keratocystic odontogenic tumour canadian dental association. It most often affects the posterior mandible and most commonly presents in the third decade of life. It was known as keratocystic odontogenic tumour, abbreviated kot, from 2005 to 2017. Subsequently several studies have discussed the clinical and. In this paper, we shall present one case report of a keratocyst, which derived from an impacted canine. There is an overall male predominance and the mandible is affected three times as commonly as the maxilla. Keratocystic odontogenic tumors kcots are classified as benign odontogenic tumors by the world health organization who 1. The keratocystic odontogenic tumor was the most prevalent histological type 30%, followed by the ameloblastoma 23,7%.
Presentation of a keratocystic odontogenic tumor with. Ghost cell odontogenic carcinoma arising in the background of a benign calcifying cystic odontogenic tumor of the mandible. Introduction odontogenic keratocyst okc was a neoplasm described by philipsen in 1956 and was confirmed by 1 browne in 1970 and 1971 2 3. Predictive factors of recurrence article pdf available in oncology letters 5 march 2017 with 47 reads.
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