Oral & Maxillofacial Surgery Keratocystic Odontogenic Tumour : An Incidental Finding (original) (raw)
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Diagnostic and treatment features of keratocystic odontogenic tumors
Stomatos, 2013
Keratocystic odontogenic tumors (KCOT) comprise a unique pathological entity characterized by aggressive/destructive behavior and propensity to recurrence. This study describes the diagnostic and treatment features of a KCOT lesion. A 22-year old man was referred for surgical treatment of pericoronitis on tooth no. 37. Panoramic radiography revealed a unilocular, large radiolucent area extending from tooth no. 36 to the left mandibular ramus. Aspiration and incisional biopsy were performed, and the tissue sample was sent for microscopic evaluation. Microscopically, a cystic lesion was observed, lined by keratinized squamous epithelium and fi lled with keratin lamellae, confi rming the diagnosis of KCOT. Surgery was performed in an outpatient setting and involved osteotomy, detachment of the cystic lesion, and removal of teeth no. 36, 37, and 38. The patient was clinically and radiographically followed for 12 months, and no evidence of recurrence was observed. KCOTs should be considered in the differential diagnosis of lesions affecting the posterior region of the mandible. Accurate clinical, radiographic, and microscopic examinations are essential to establish the defi nitive diagnosis and choose the most effective therapy.
Conservative Treatment Protocol for Keratocystic Odontogenic Tumour: a Follow-up Study of 3 Cases
Journal of Oral and Maxillofacial Research, 2010
The keratocystic odontogenic tumour is classified as a developmental cyst derived from the enamel organ or from the dental lamina. The treatment of keratocystic odontogenic tumour of the jaw remains controversial. The aim of this study was to report the outcome of our conservative treatment protocol for keratocystic odontogenic tumour. Methods: Three patients with different complaints referred to Oral and Maxillofacial Surgery Clinic, Faculty of Dentistry, Selçuk University. Initial biopsy was carried out in all patients and keratocystic odontogenic tumours were diagnosed subsequent to histopathological examination. The patients with keratocystic odontogenic tumours were treated by enucleation followed by open packing. This conservative treatment protocol was selected because of existing young aged patients. The average follow-up duration of the cases was 2 years. Results: Out of 3 cases, 2 lesions were present in mandible and 1 lesion in maxilla. There was no evidence of recurrence during follow-up. All the cases were monitored continuously with panoramic radiographs, computed tomography and clinical evaluations. Conclusions: This conservative treatment protocol for keratocystic odontogenic tumours, based on enucleation followed by open packing would be a possible choice with a view of offering low recurrence rate and low morbidity rate particularly in young patients.
Keratocystic odontogenic tumor: a retrospective study of 183 cases
Journal of Oral Science, 2008
In 2005, the WHO Working Group considered odontogenic keratocyst (OKC) to be a tumor and recommended the term keratocystic odontogenic tumor (KCOT), separating the lesion from the orthokeratinizing variant, which is now considered an odontogenic cyst. We analyzed the clinicopathological features of KCOTs encountered over a period of 28 years at Meikai University Hospital. The diagnosis was confirmed by reevaluation of hematoxylin and eosin-stained slides on the basis of the 2005 WHO Classification. Clinical history was also taken into consideration. A total of 183 KCOTs were found, and the two genders were affected almost evenly (51.3% male; 48.7% female; male to female ratio 1.05 to 1). Patient age at the time of diagnosis ranged from 6 to 78 years, with a peak in the third decade of life (mean age: 32.8 years). The mandible was the site of occurrence of 70.5% of tumors; 16.4% occurred in the maxilla and 13.1% in both. Association with the nevoid basal cell carcinoma syndrome (NBCCS) was found in 6.0% of all tumors, and recurrence was found in 13.1% of patients. We found that tumors that initially appeared in the maxilla alone had a higher recurrence rate than those that first appeared in the mandible alone. Pathological examination of KCOT is important to avoid misdiagnosis and provide appropriate treatment and follow-up.
Keratocystic odontogenic tumour of maxilla and mandible – A case report
International Journal of Applied Dental Sciences, 2020
Keratocystic odontogenic tumor (KOT) is a benign odontogenic tumor with a potentially aggressive and infiltrative behavior. KOT most commonly occurs in mandible and demonstrates a unilocular, round, oval, scalloped radiolucent area, while large lesions may appear multilocular. An important characteristic feature of KOT is its propensity to grow in an antero-posterior direction within medullary cavity of bone causing minimal expansion. Definitive diagnosis relies on histological examination. The lesion described later, was removed surgically via an intraoral approach under general anesthesia and histologically reported as a Keratocystic Odontogenic Tumour.
Keratocystic Odontogenic Tumour: Current concepts, theory and presentation of 2 contrasting cases
Odontogenic keratocyst (OKC) is a cyst of tooth origin with an aggressive clinical behavior including a high recurrence rate. It has been rechristened to Keratocystic odontogenic tumour (KCOT), as it better reflects its neoplastic nature. We report 2 contrasting cases of KCOT in association with impacted teeth and revisit the various treatment modalities used to tackle the aggressive nature and keep its recurrence at bay. Most promising being use of molecular biology to treat such tumours which could eventually reduce or eliminate the need for aggressive methods to manage the lesions.
Introduction: Keratocystic Odontogenic tumor (KCOT) is a odontogenic neoplasm of jaw which has high recurrence potential. Case Report: This paper reports a case of KCOT in left hem-imandible with buccal and lingual cortical perforations. The case was treated by segmental resection with disarticulation and reconstructed with avascular fibula graft. Postoperative prosthetic rehabilitation was done with cast partial denture. Conclusion: For complete management of KCOT involving hemimandible, a treatment plan of resection and reconstruction with long term follow up should be carried out. Also the patient's deformity should be prosthetically rehabilitated to give him a functionally and esthetically acceptable dentition.
Odontogenic Keratocyst Tumor: A Case Report and Literature Review
Open Journal of Stomatology, 2016
First described by Philipsen in 1956, the odontogenic keratocyst is characterized by a large squamous keratinization of its border, an aggressive growth and a high recurrent rate. It is now designated by the World Health Organization as a keratocystic odontogenic tumour (KOT). Clinically, the KOT is manifested by an asymptomatic growth. Radiographically, it appears as a well-defined unilocular or multilocular osteolytic lesion. The diagnostic approach is based on a combined analysis of the medical history, the clinical appearance and the radiographic appearance. The diagnosis may be confirmed by the anatomical pathology report. Finally, treatment consists of surgical excision and follow up is characterized by a high rate of recurrence. The authors report a case of keratocystic odontogenic tumor of the upper jaw and review the various diagnoses, therapeutics and follow up aspects of this type of tumors.
A recurrence case of keratocystic odontogenic tumor
International Journal of Medical and Dental Case Reports
Keratocystic odontogenic tumor is a rare, benign, intraosseous tumor of odontogenic origin with a potential of aggressive and infiltrative behavior. It shows specific histopathological features, and follow-up is characterized by a high rate of recurrence. Moreover, therefore, to reduce the chances of recurrences, along with the surgical modalities like enucleation, chemical and thermal cauterization may be used to deal with the problem of satellite microcysts. We present a case of odontogenic keratocyst with recurrence in a 60-year-old male who reported with the chief complaint of pain in left mandible.
Keratocystic Odontogenic Tumor: A Case Report And Review Of The Literature
The Internet Journal of Dental Science, 2009
Because of its agressvity, its high recurrence and possible malignant transformation, odontogenic keratocyst is added to the benign odontogenic tumours category, the new term is keratocystic odontogenic tumor (KCOT). its pathogenesis and its treatment were largely studied in the latest years in order to improve its prognosis. we present a case of 80 year old patient who presents KCOT occurring in chin area, the selected treatment was the enucleation of the lesion. We present also a literature review, while insisting especially on the pathogenesis and the treatment of the KCOT.