Morphometric evaluation of keratocystic odontogenic tumor before and after marsupialization

Abstract

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. Histological sections from six KOTs that had undergone marsupialization followed by enucleation were photographed. The thickness and features of the capsule and of the epithelial lining of the tumor were evaluated upon marsupialization and upon subsequent enucleation using Axion Vision software. The histological specimens taken upon marsupialization presented an epithelial lining that is typical of KOTs. After marsupialization, the enucleated specimens had a modified epithelial lining and a fibrous capsule that both presented a greater median thickness (p = 0.0277 and p = 0.0212, respectively), morphological changes, and significant enlargement. These modifications can facilitate full surgical treatment and may well be related to a low KOT recurrence rate.

Recurrence challenge in odontogenic keratocyst variants, two clinical cases

“…Cao [16], in his clinical study of large mandibular odontogenic keratocystic tumours in adolescents treated by decompression, found no recurrence over a period of 1 to 5 years after operation. Some authors [17] conducted a morphometric analysis of the epithelial lining and fibrous capsule in histological sections of odontogenic keratocystic tumours before and after decompression. They reported a considerable thickening of the tumour's fibrous capsule.…”

Correlation Between the Presence of Stromal Myofibroblasts and the Proliferative Potential of Odontogenic Keratocyst and Ameloblastoma

“…(3) Locally aggressive lesions that have high recurrance rate after conventional surgical enucleation, it is well known this is due to the absence of capsule in AB & highly friable cyst wall with satellite cysts within okc capsule, the highly aggressive potential of both lesions was attributed to many biological, molecular & genetic factors in many studies however few studies were done on the correlation between presence of the stromal myofibrblast in both lesions with their invasive potential . (4) Myofibroblasts found in the connective tissue stroma and characterized by the presence of a contractile apparatus. They are found in normal tissues such as blood vessels, lymph nodes and bone marrow as well as in various invasive and metastatic malignant tumors.…”

Giant Keratocystic Odontogenic Tumor of the Mandible – A Case Report

“…In 2005, the World Health Organization (WHO) re-classified OKC and labelled it keratocystic odontogenic tumor (KCOT). The following features of the tumor contributed to that decision: i) clinically: local malignancy with high recurrence rate (up to 60% [ 1 – 4 ]), ii) histopathologically: pullulation of the stratum basale of the epithelium into the connective tissue and absence of mitotic figures in the stratum suprabasale, iii) genetically: occurrence of mutations of the suppressor gene PATCHED 1 [ 1 – 13 ]. The tumor develops more often in the mandible than maxilla, mainly in the posterior part of its body and ramus area.…”

“…The tumor develops more often in the mandible than maxilla, mainly in the posterior part of its body and ramus area. It occurs less frequently as an extraosseous manifestation in the gingival area, and rare cases in the malar area have also been documented [ 1 , 3 – 6 ]. KCOT may be related to the unerupted third molar [ 6 , 13 ].…”

“…Keratocystic odontogenic tumors constitute between 2% and 11% of all mandibular neoplasms [ 2 , 4 ]. They are more frequent in males and have their peak incidence in the third decade of life [ 1 , 2 , 13 ]. They may develop sporadically or accompany Gorlin syndrome (nevoid basal cell carcinoma syndrome, NBCCS) [ 7 ].…”