Diagnostic and treatment features of keratocystic odontogenic tumors (original) (raw)

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: 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.

Keratocystic odontogenic tumour -An unusual presentation

IP Innovative Publication Pvt. Ltd., 2017

Keratocystic Odontogenic Tumour (KCOT) is one of the most controversial odontogenic tumor which remains an enigma to the world of dentistry, because of its varied biological behaviour. Initially, it was considered as a cyst but in 2005, WHO reclassified it as keratocystic odontogenic tumor because of its aggressive & recurrent behaviour & placed it in the categories of odontogenic tumors. Histopathologically it has pathognomonic appearance, but in some cases, it may show unusual histopathological presentation & can be confused with other cystic odontogenic tumors. Hard tissue formation in KCOT capsule & presence of Rushton bodies are an uncommon findings. Herewith, we report a case of 26 year old male patient with an unusual histopathologic presentation of KCOT mimicking unicystic ameloblastoma (UAB) at places & also showing Rushton bodies, areas of calcification & darkly stained cells within the capsule.

Oral & Maxillofacial Surgery Keratocystic Odontogenic Tumour : An Incidental Finding

2018

Odontogenic Keratocyst is the second most common cyst after radicular cyst. In the year 2005, keratocysticodontogenic tumor was coined by WHO owing to its inclination more towards tumor than cyst. It was necessitated due to the aggressive behaviour of the lesion also associated with genetic and chromosomal variations consistent with progression towards neoplastic changes. In this case report, we present a young patient with KCOT involving a large section of mandible (extending from 33 to 46). Any aggressive approach would have ensured extensive morbidity. Hence, we went for a conservative approach of enucleation with peripheral ostectomy and apicectomy of involved teeth followed by placement of Carnoys solution. This ensured no remnants of satellite cells. The patient has been on regular follow-ups with normal healing and no signs of recurrence.

Keratocystic odontogenic tumor. Case report and review of the literature

The New York state dental journal, 2013

Keratocystic odontogenic tumor is an intraosseous benign tumor of epithelial origin that can appear as a unicystic or multicystic lesion. It is characterized most significantly by its high recurrence rate. This is why surgical removal is the chosen therapeutic approach in most cases. However, while surgery may be the safest technique to prevent recidivism, it may also result in numerous complications with large tumors. A number of authors have suggested a more conservative treatment for large keratocystic odontogenic tumors. The case examined in this article is that of a 48-year-old male patient who presented with a five-month swelling on the left side of his face, located in the mandibular area.

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.

Keratocystic Odontogenic Tumor ( KCOT ) in Maxillary Sinus arising from an Infected Dentigerous Cyst

2017

Keratocystic odontogenic tumor (KCOT) is one of the most aggressive odontogenic pathology, which is now being considered more as a benign tumor rather than it's previously known name Odontogenic Keratocyst (OKC). It's aggressive nature is attributed to its high recurrence rate. Its typical feature shows a thin, friable wall, which is often difficult to enucleate from the bone in one piece as many times it has multiple adhesions known as small satellite cysts within the fibrous wall. At times, it is also associated with bifid-rib basal cell nevus syndrome (Gorlin syndrome). Multiple surgical approaches were introduced including decompression, marsupilization, enucleation with or without adjunct (Carnoy's solution, enucleation), wide local resection followed by reconstruction. Many treatment modalities have been advocated for its management, but still its specific management is debatable. Considering its unpredictable and higher recurrence rate, WHO in 2005 categorized it ...

Odontogenic keratocyst: imaging features of a benign lesion with an aggressive behaviour

Insights into imaging, 2018

The latest (4th) edition of the World Health Organization (WHO) Classification of Head and Neck Tumours, published in January 2017, has reclassified keratocystic odontogenic tumour as odontogenic keratocyst. Therefore, odontogenic keratocysts (OKCs) are now considered benign cysts of odontogenic origin that account for about 10% of all odontogenic cysts. OKCs arise from the dental lamina and are characterised by a cystic space containing desquamated keratin with a uniform lining of parakeratinised squamous epithelium. The reported age distribution of OKCs is considerably wide, with a peak of incidence in the third decade of life and a slight male predominance. OKCs originate in tooth-bearing regions and the mandible is more often affected than the maxilla. In the mandible, the most common location is the posterior sextant, the angle or the ramus. Conversely, the anterior sextant and the third molar region are the most common sites of origin in the maxilla. OKCs are characterised by ...

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.