Calcifying cystic odontogenic tumor

Odontogenic Cysts

Odontogenic cysts are epithelial-lined pathologic cavities and surrounded by fibrous connective tissue that originate from odontogenic tissues that occur in tooth-bearing regions of maxilla and mandible. Cystic conditions of the jaw cause bony destruction and may cause resorption or displacement of adjacent teeth. Odontogenic cysts have developmental or inflammatory origins. More cases have been published in the adult age group than the pediatric population. Periapical cyst and dentigerous cysts are frequently reported conditions in dental practice. Histopathologic examination remains the gold standard investigation. Odontogenic cysts are managed with enucleation or marsupialization procedures. Early recognition and referral to oral surgery minimize the extent of jaw bone destruction.

Calcifying odontogenic cyst associated with the impacted third molar: a case report

Calcifying odontogenic cyst (COC) is a benign, locally aggressive, slow-growing lesion. Its occurrence constitutes about 2% of all odontogenic cysts. The most frequent sign is painless, slow growing swelling. Radiographically it appears as a well-defined unilocular radiolucency. The microscopical features of lesion showed well-delineated cystic proliferation of odontogenic epithelium with ghost cells and fibrous connective tissue wall. In the present study, 42 years old man who has COC associated with the impacted third molar treated with enucleation is reported after 6 months follow-up.

Perfil clínico e histopatológico do cisto odontogênico calcificante: relato de caso

O cisto odontogênico calcificante (COC) foi primeiramente descrito em 1962, considerado como condição patológica benigna de ocorrência rara em maxila e mandíbula, caracterizado por revestimento cístico de células epiteliais odontogênicas contendo células fantasmas com propensão a regiões de calcificação.  Neste artigo, descreveu-se a configuração clínica e histopatológica do COC por meio de relato de caso submetido a tratamento cirúrgico e acompanhamento pós-operatório. Uma paciente de 11 anos apresentou um aumento de volume em região maxilar a esquerda próxima ao sulco nasolabial sem sintomatologia dolorosa. Os exames radiográficos indicaram lesão radiolúcida, bem circunscrita e expansiva em maxila, que foi submetida a enucleação associada a ostectomia marginal das paredes corticais ósseas. O quadro histopatológico foi caracterizado por revestimento cístico com epitélio odontogênico ameloblástico, ninhos espalhados de células fantasmas e regiões eosinofílicas de material compatível com dentinóide. O relato de caso apresentou perfil clínico de COC, que pode ser confundido com outras lesões císticas ou tumorais, sendo essencial diagnóstico por meio de análise histopatológica. A abordagem cirúrgica proporcionou diagnóstico e tratamento. Após acompanhamento clínico e radiográfico, não houve recorrência do COC.

Calcifying Odontogenic Cyst with Extensive Areas of Dentinoid: Uncommon Case Report and Update of Main Findings

The calcifying odontogenic cyst (COC) is a benign odontogenic cyst that occurs in the gnathic bones. This cyst is part of a spectrum of lesions characterized by odontogenic epithelium containing “ghost cells,” which may undergo calcification. Areas of an eosinophilic matrix material compatible dentinoid also may present adjacent to the epithelial component. However, these areas of dentinoid commonly do not appear so abundant in COCs. In this study, we report a case of intraosseous COC with extensive areas of dentinoid and perform an update regarding the clinical, radiographical, histopathological, and differential diagnosis, treatment, and prognosis of this cystic lesion.

Calcifying cystic odontogenic tumor associated with an odontome - a diverse lesion encountered

The human jaw is an exclusive habitat for odontogenic lesions. Ghost cells associated odontogenic lesions are a diverse group with a variety of presentations in the jaws. Calcifying cystic odontogenic tumor is a benign cystic neoplasm of odontogenic origin which demonstrates ghost cells in the epithelial component. This tumor sometimes mimics the features of a cyst clinically and radiographically, but histopathologically as well as behavior-wise shows the features of a tumor. Many classification systems have been proposed and revised from time to time. Presently a dualistic concept is highlighted to classify this group of lesions. The present case highlights a case of calcifying cystic odontogenic tumor associated with a complex composite odontome, which appeared like a cyst clinically and radiographically.

Cone beam CT as an aid to diagnosing mixed radiopaque radiolucent lesions in the mandibular incisor region

We present two cases where the identities of mixed radiopaque radiolucent lesions in the lower incisor region were unclear, although the position of the lesions and positive pulp sensitivity tests were suggestive of periapical osseous dysplasia. In the first case, the lesion presented as a solitary round mixed radiopaque radiolucent periapical lesion, suggestive in some images as periapical osseous dysplasia. Cone beam CT (CBCT) provided clear images, which confirmed the diagnosis and, additionally, the images showed evidence of initial lesions associated with other anterior teeth and some destruction of the labial plate, not evident on the conventional radiographs. In the second case, radiopacities were identified within the lesion on conventional radiographs, but CBCT imaging also showed extensive and unexpected perforation of the lingual plate. Such destruction of cortical plates may be a feature of periapical osseous dysplasia, which is not visible in conventional radiography.