Correlation between imaging features and epithelial cell proliferation in keratocystic odontogenic tumour

Abstract

Objectives: This study was undertaken to investigate the relationship between radiographic appearance and epithelial cell proliferations in keratocystic odontogenic tumours (KCOTs). Methods: A retrospective radiographic analysis was performed on 284 cases of KCOT to gain insight into the radiographic characteristics. Expression of Ki-67 in 30 of the 284 cases was detected by the labelled streptavidin-biotin (LSAB) method and evaluated by an image analysis system. Results: The radiographic presentation of KCOT was divided into four types: unilocular, multilocular, multiple and naevoid basal cell carcinoma syndrome (NBCCS). The expression of Ki-67 in NBCCS was significantly different from the solitary and multiple KCOTs (P 5 0.018, 0.002). In multilocular KCOTs it was also significantly different from the unilocular and syndrome-associated lesions (P 5 0.000). In contrast, no significant differences were observed between the solitary and multiple lesions (P 5 0.220). Conclusions: A high correlation exists in KCOT between its biological behaviour and imaging features. The solitary KCOT seems less biologically aggressive and it should be classified as a cyst rather than a tumour. This means that more than half of KCOTs manifest themselves as ordinary cysts.

Evaluation of Keratocystic Odontogenic Tumors Using Cone Beam Computed Tomography

“…Unilocular, multilocular, or multiple well-circumscribed radiolucent lesions surrounded by a thin radiopaque border with a smooth or loculated periphery are the typical radiographic features of KCOTs ( 11 ). In previous studies, these lesions were reported most commonly as unilocular and, less commonly, as multilocular lesions ( 12 , 13 ). However, one lesion that appeared as unilocular in panoramic view was later reported to be multilocular in CBCT images ( 9 ).…”

“…The present study determined that approximately 93% of the lesions caused buccolingual or buccopalatinal expansion. An important characteristic of KCOT is its trend to grow along the major axis of the jaws ( 12 ). Occasionally, KCOTs may erode the buccal plate or mandibular lingual cortex; therefore, on radiographs, a radiolucent shadow is frequently seen in the mandible ( 20 ).…”

“…The main symptom is swelling, although more than three-fourth of the lesions are detected incidentally ( 19 ). KCOTs can cause displacement and resorption of teeth, and the inferior alveolar nerve canal may also be displaced ( 12 ). These lesions were reported to rarely cause tooth root resorption ( 24 ).…”

“…To our knowledge, previous studies did not address the impact of KCOTs on the cortex of mandibular canal. KCOTs can invaginate and occupy the entire maxillary antrum ( 12 ). In the present study, lesions localized in the molar region of the maxilla almost completely occupied the maxillary sinus.…”

Are All Odontogenic Keratocysts Keratocystic Odontogenic Tumors? Correlation between Imaging Features and Epithelial Cell Proliferation

“…However, the radiographic appearances of KCOTs are varied and it is difficult to distinguish KCOTs from other cysts or neoplastic lesions on the basis of their radiographic features alone. [4]…”