Keratocystic odontogenic tumor

Introduction and importance: Odontogenic keratocyst is a distinctive form of developmental odontogenic cysts that deserves a special consideration because of its specific clinical behavior and histopathologic features. The clinical and radiographic features of OKC are indefinite; while some may be associated with pain, swelling or drainage, most of them are asymptomatic. This case reports a rare radiographic and histpathological features of recurrence OKC. Case Presentation: A 47-years-old male patient presented with a main complaint of painful mass in the oral cavity with a history of previous lesion occurred in the posterior portion of mandible related to extraction of impacted third molar. The oral examination revealed a swelling in molar region of right mandible with lingual plate expansion. The radiographic and histopathologic were consistent with the diagnosis of OKC. Consequently, the lesion was surgically removed with no clinical or radiological recurrence observed during the 8-months post-operative follow-up. Clinical Discussion This case explained the clinical differences between OKC and other lesions, and highlights the distinctive radiologic and microscopic features which make a confliction with previous studies, concerning the symptoms that may related to Nevoid Basal Cell Carcinoma Syndrome, and revealed the proper treatment depending on the recurrence appearance and the treatment methods that used previously. Conclusions This case highlights a rare multilocular appearance of recurrent OKC in mandible with no Nevoid Basal Cell Carcinoma Syndrome related, supports the marginal resection as an effective procedure in management of recurrent OKCs cases.

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The presentation of recurrent odontogenic keratocysts of the mandible with an emphasis on the tooth‐bearing area: a systematic review and meta‐analysis

Silva

Stoelinga

Naclério‐Homem

2020

Oral Surgery

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Aim: To gain insight in the actual ratio of recurrent odontogenic keratocysts (OKCs) occurring in the tooth-bearing area as compared to the posterior region of the mandible in order to come up with reliable data to base upon a rational treatment policy. Material and Methods: We searched MEDLINE, Web of Science, Scopus, Cochrane Library and Google Scholar databases for studies reporting on the location of recurrent mandibular OKCs. Risk Difference with a confidence interval of 95% of having the lesion in the tooth-bearing area versus the posterior region was the effect measure. P value for the summary effect of <0.05 was considered statistically significant. Results: The 1411 records retrieved were reduced to 13 studies to be qualitative/quantitative assessed. The pooled values showed that the difference in the clinical risk of having recurrent OKCs in the posterior region of the mandible and in the tooth-bearing area of the maxilla is of 7% (CI: À0.08, 0.22; P = 0.36), the posterior region being more susceptible to develop a recurrent OKC. Conclusions: The recurrence rate of OKCs in the posterior mandible is not significantly higher than of those located in the tooth-bearing part of the mandible; however, there is no reason to follow a more aggressive treatment policy for OKCs in the tooth-bearing area. Clinical RelevanceScientific rationale for study Once patients have an estimated difference of 21% to have primary keratocysts in the posterior mandible, it is important to gain insight into the actual ratio of recurrent keratocysts of the mandible. Principal findingsThe difference in the clinical risk of having recurrent keratocysts between the posterior region and toothbearing area of the mandible is 7%. Practical implicationsThe ratio of recurrent keratocysts in the posterior mandible is not significantly higher as compared to the tooth-bearing area. Therefore, there is no reason to follow a more aggressive treatment policy for keratocysts in the tooth-bearing area.

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Keratocystic odontogenic tumor

Cited by 5 publications

References 15 publications

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Relationship between mast cells and E-cadherin in odontogenic keratocysts and radicular cysts

A recurrence odontogenic keratocyst formation of mandible with distinctive features: a case report

The presentation of recurrent odontogenic keratocysts of the mandible with an emphasis on the tooth‐bearing area: a systematic review and meta‐analysis

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