Calcifying epithelial odontogenic cyst associated with complex odontome of maxilla

Unusual Association of Calcifying Cystic Odontogenic Tumor with Compound Odontoma and Ameloblastoma: Case Report and Review of the Literature

Calcifying cystic odontogenic tumor (CCOT) is a rare odontogenic cyst accounts for <2% of all odontogenic cysts. Simple unicystic CCOT is commonly encountered accounts for 65%, whereas other forms of CCOT are <3%. CCOT is associated with two or more odontogenic tumors, it is called combined odontogenic lesions or hybrid lesions. The aim of the present article is to report a rare case of CCOT and highlighting the clinical feature and treatment aspects of combined lesions. A 25-year-old female complained of pain and swelling in the left maxilla for 6 months. Examination revealed diffuse swelling in the maxilla, firm in consistency, and tender on palpation. Panoramic radiograph showed impacted canine with multiple radiopaque structures and well-defined lesion in the maxillary sinus. The lesion was surgically removed and histopathologically diagnosed as CCOT with compound odontoma and ameloblastoma. Pub Med database search from 1978 to June 2020 revealed only three case reports of combined odontogenic tumors associated with CCOT.

Calcifying odontogenic cyst associated with compound odontoma – A rare entity

Calcifying odontogenic cyst (COC) or Gorlin's cyst categorized as a distinct entity by Gorlin et al. in 1962. It is a rare benign developmental cystic lesion that accounts for less than 1% of all odontogenic cysts. It can occur in association with various types of odontogenic tumors such as odontomas. COC is a hybrid lesion of the jaw presenting a manifold variety of clinical behaviors and histopathological characteristics including cystic, solid (neoplastic), and aggressive forms. COC exhibits diversity in terms of its clinical presentations, histopathologic features, and biological behavior. Normally, it presents as asymptomatic, slow developing lesion affecting the maxilla and mandible equally with strong predilection for the anterior segment. Radiographically, these lesions usually present as a unilocular, well-defined radiolucency with radiopaque structures within the lesion, either as irregular calcifications or tooth-like densities. The distinct features of COC as solid or cystic lesions presents with an ameloblastomous component admixed with varying proportions of ghost cells and spherical calcifications. Here, we report an article of calcifying odontogenic cyst associated with compound odontoma in a young patient with lesion in the anterior mandible with review of the various terminologies and classification and histopathology.

Calcifying odontogenic cyst: Report of an uncommon entity with a brief literature review

The aim of this clinical report is to document a rare and unusual case of calcifying odontogenic cyst (COC) in the maxillary anterior region in a 13-year-old girl.

A COC is an extremely uncommon developmental, odontogenic entity and accounts for 0.3%–0.8% of odontogenic cysts. The lesion presents as an array of varied radiographic and clinicopathological characteristics and biological attributes and exists in three histomorphologic patterns – benign cystic, solid (neoplastic) and aggressive (malignant) forms. Thus, several nomenclatures and classifications have been put forth to explain the nature of the clinical entity. However, ambiguities regarding the exact nature of the lesion still prevail. Due to nonspecific clinicoradiographic features, histopathological interpretation remains the key for diagnosis. We report an uncommon occurrence of COC in a 13-year-old female who reported to our Outpatient Department with an asymptomatic right midfacial swelling. The clinical and radiographic findings were suggestive of adenomatoid odontogenic tumor and dentigerous cyst. The decision to enucleate the lesion was considered, and histopathological features were compatible with the diagnosis of COC. Re-ossification with no recurrence was noticed after a 1-year follow-up. COC is an unusual developmental odontogenic cyst that clinically and radiologically simulates other more common jaw entities. Thorough knowledge of the bizarre presentation and biological attributes of such lesions are imperative for an early diagnosis and definitive treatment. Long-term follow-up is advocated to prevent recurrences.

Jaw lesions associated with impacted tooth: A radiographic diagnostic guide

This review article aimed to introduce a category of jaw lesions associated with impacted tooth. General search engines and specialized databases such as Google Scholar, PubMed, PubMed Central, MedLine Plus, Science Direct, Scopus, and well-recognized textbooks were used to find relevant studies using keywords such as "jaw lesion", "jaw disease", "impacted tooth", and "unerupted tooth". More than 250 articles were found, of which approximately 80 were broadly relevant to the topic. We ultimately included 47 articles that were closely related to the topic of interest. When the relevant data were compiled, the following 10 lesions were identified as having a relationship with impacted tooth: dentigerous cysts, calcifying odontogenic cysts, unicystic (mural) ameloblastomas, ameloblastomas, ameloblastic fibromas, adenomatoid odontogenic tumors, keratocystic odontogenic tumors, calcifying epithelial odontogenic tumors, ameloblastic fibro-odontomas, and odontomas. When clinicians encounter a lesion associated with an impacted tooth, they should first consider these entities in the differential diagnosis. This will help dental practitioners make more accurate diagnoses and develop better treatment plans based on patients' radiographs.