Calcifying Cystic Odontogenic Tumor in Radiologically Normal Dental Follicular Space of Mandibular Third Molars: Report of Two Cases

Abstract

Two cases of calcifying cystic odontogenic tumor (CCOT) of the dental follicle in an impacted third molar without clinical and radiological evidence are reported during routine histopathological examination. In both the cases left mandibular third molar was mesioangularly impacted with pericoronal radiolucency of less than 2.5 mm, which was not indicative of any pathology. As a routine protocol (which is not practiced widely) of our institution, dental follicles associated with extracted molars were sent for histopathological examination. Histopathological features were consistent with CCOT with pathognomonic ghost cell transformation of odontogenic epithelium. The patients were followed for one year with no recurrence. This paper emphasizes the importance of routine histopathological examination of dental follicles associated with asymptomatic impacted teeth without any clinical or radiographic evidence of follicular lesion.

Calcifying odontogenic cyst, dentinogenic ghost cell tumor, and ghost cell odontogenic carcinoma: A systematic review

“…Most GCOC (59.9%) appeared as mixed lesions with ill‐defined border. Sarode et al reported two cases of COC arising in the dental follicle of impacted third molars, showing a radiolucency of less than 2.5 mm in both cases. These authors highlighted the importance of routine histopathological examination of dental follicles in impacted teeth, even without any radiological evidence of follicular lesion.…”

“…In the present review of the literature on COC, DGCT, and GCOC, many publications did not describe full radiographic findings. It is true that radiological features, although suggestive, do not define the diagnosis of COC and DGCT . However, for future case reports, a better description of the radiographic findings is encouraged.…”

“…It is true that radiological features, although suggestive, do not define the diagnosis of COC and DGCT. [31][32][33][34] However, for future case reports, a better description of the radiographic findings is encouraged.…”

Calcifying odontogenic cyst: A case report

“…Association with an impacted tooth appears in approximately one‐third of cases . COCs can occur within the dental follicle of impacted third molars and can present as a radiolucency of <2.5 mm. This highlights the importance of routine histopathological analysis of all tissues associated with the crowns of impacted teeth, even where follicular lesions are not suspected radiographically.…”

Calcifying odontogenic cyst: a report of two clinical cases

“…There are no clinical signs or pathognomonic radiological signs of this lesion; only histological examination allows for its differentiation from other cystic diseases of the maxillae. There are cases of COC discovered during the avulsion of mandibular wisdom teeth after histological analysis of the pseudofollicular sac [2]. COC can be found in patients of all ages, equally in young children, adolescents, and adults [2,3].…”