Infected orthokeratinized odontogenic cyst: a rare cause of facial cellulitis

Abstract

Orthokeratinized odontogenic cysts (OOCs) are relatively uncommon developmental cysts lined with orthokeratinized epithelium consisting of a prominent granular layer and a basal layer of low cuboidal flattened cells that show no tendency for nuclear palisading. These cysts have been considered a distinct entity from odontogenic keratocysts since they exhibit a less aggressive behavior and a very low rate of recurrence. Developmental odontogenic cysts can become infected but serious complications, such as potentially life-threatening cellulitis, are rare. This report describes a rare case of facial cellulitis secondary to an infected OOC located in the mandible of a 27-year-old man. The relevant literature about the clinical-pathological features of OOC is reviewed.

Orthokeratinized odontogenic cyst associated with multinucleated giant cell reaction: report of unusual findings

“…In spite of being rare, developmental cysts may present infections, as in the case reported by Carvalho et al 7 , in which the secondary infection was associated with an OOC, where rupture of the cortical bone served as the port of entry for the infection. In the case here reported, the radiographic images could suggest that rupture of the cortical bone could also have served as port of entry of the infection that generated an inflammatory response as a reaction to a foreign body.…”

“…Nevertheless, some reports have shown painful symptomatology associated with secondary infection [7][8] , and extension between 1 and 3 centimeters. However, cases of large dimensions have been reported 5,7 , as in the case here reported, the size of which at the largest diameters was 10.3 centimeters, covering the region from the premolars up to the body of the mandible.…”

“…The histopathological characteristics it presents are an epithelium with an orthokeratinized lining, made up of a prominent granulous layer, and basal layer of flattened cuboidal cells that show no trend towards the palisaded nuclear arrangement [1][2][6][7] . Their treatment consists of marsupialization or surgical enucleation 2,7 .…”

“…Their treatment consists of marsupialization or surgical enucleation 2,7 . These lesions show a low level of aggressiveness and tendency towards recurrence at a rate lower than 4% 2,8 .…”

Orthokeratinised odontogenic cyst mimicking periapical cyst

“…Onuki et al 19 reported a case of OOC which was suspected to be a radicular cyst. Cyntia et al 20 highlighted the importance of including OOC in the differential diagnosis of developmental odontogenic cysts with secondary infection. Vuhahula et al 13 found that reduced enamel epithelium that had completed its tooth-forming function had the capability to keratinise under appropriate stimuli.…”