Botryoid odontogenic cyst

Pediatric Odontogenic Cysts and Tumors

Pediatric odontogenic cysts and tumors are rare and often associated with developing or impacted teeth. Odontogenic cysts are broadly categorized as inflammatory or developmental while odontogenic tumors are classified histologically as epithelial, mesenchymal, or mixed tumors. This article will discuss the presentation, diagnosis, and treatment of odontogenic cysts and tumors in the pediatric population.

Multifocal lateral periodontal cysts: a report of 4 cases and review of the literature

Lateral periodontal cyst (LPC) is a developmental jaw cyst of odontogenic origin. It has characteristic histopathologic features that are identical to those seen in the peripherally occurring gingival cyst of adults (GCA). The polycystic variant of LPC is termed the botryoid odontogenic cyst (BOC). The histogenetic origin of LPC is probably the rests of dental lamina in the alveolar bone. In the case of BOC, it might be that several adjacent epithelial rests simultaneously undergo cystic change and eventually form a polycystic lesion. Few previous examples of multifocal occurrence of LPC can be found in the literature. We report an additional 4 patients with this rare presentation of multiple, separate LPCs, and review the literature on this topic.

[Botryoid odontogenic cyst]

INTRODUCTION

The botryoid odontogenic cyst (BOC) is a developmental cyst of odontogenic epithelial origin considered as a rare multilocular variety of lateral periodontal cyst (WHO 1992). This cystic lesion site is in the periodontal space of vital teeth.

OBSERVATION

A 21-year-old woman consulted for a swelling of the anterior maxillary region. The clinical examination revealed bucal swelling extending from the left central incisor to the first left premolar. The mucosa was normal. The adjacent teeth were vital. X-ray revealed a bilocular radiolucency extending between the roots of teeth 21 and 24. The lesion was enucleated, under local anaesthesia via a vestibular approach. Histology was typical of a BOC with cystic spaces lined by squamous epithelium with thickening and clear cells. Forty-eight months after surgery, there was sign of recurrence.

DISCUSSION

BOC is known to be a recurrent odontogenic cyst. Several cases of multiple recurrences have been reported up to nine years after the initial surgery. Long-term follow-up is thus mandatory.

Botryoid odontogenic cyst: report of a case with extensive epithelial proliferation

Botyroid odontogenic cyst (BOC) is considered a rare multilocular variant of the lateral periodontal cyst. In this report; clinical and histopathological features of a case of BOC found in mandibular mental region of a 32-year-old woman is presented. There was a multilocular radiolucency extending from the roots of the right premolar to the left premolar, involving almost the whole height of the mandible. Histologically, there was extensive intraluminal epithelial proliferation in the lining and MIB-1 positive cells were noted in the basal layer.

Glandular Odontogenic Cyst

This case report describes the clinical, radiologic, and histopathologic features of the glandular odontogenic cyst (GOC). Although a relatively rare lesion not previously reported in the endodontic literature, the GOC is recommended for inclusion in a differential diagnosis of a dentoalveolar radiolucency. The GOC is a destructive lesion that can be easily misdiagnosed microscopically as a central mucoepidermoid carcinoma.

Osseous repair of a lateral periodontal cyst

THE LATERAL PERIODONTAL CYSTS is a slow-growing radiolucent, developmental lesion occurring most frequently in males during the sixth decade. As part of the differential diagnosis, it must be distinguished from the collateral keratocyst and the gingival cyst of adults as well as other entities. Speculation remains as to the lateral periodontal cyst's developmental origin. Whether it is from reduced enamel epithelium, remnants of dental lamina, or cell rests of Malassez remains to be determined. The following longitudinal case report describes the review of literature and clinical and histologic findings as well as unusual treatment of a through-and-through perforating lateral periodontal cyst. Due to the large bony defect left after the cyst's removal, a decalcified freeze-dried bone graft was placed to close the defect. The repair of the lesion was followed for 30 months.

The glandular odontogenic jaw cyst: report of a case

A case of a rare odontogenic cyst arising in the lateral periodontal membrane in the mandible in a 14 year old girl is reported. This lesion appeared to be a new entity and has been named glandular odontogenic cyst (GOC) or sialo-odontogenic cyst. Histologically the lesion was lined by mucous producing cuboidal epithelium containing several areas of thickening and numerous duct-like structures. The cyst recurred with the same histology two years postoperatively.

Lateral periodontal cyst. Multifactorial analysis of a previously unreported series

The objective of the present study was to review a series of 23 lateral periodontal cysts and 2 botryoid odontogenic cysts retrieved from the files of the State University of New York at Buffalo (SUNY) Oral Pathology Biopsy Service for epidemiologic characteristics as well as radiographic findings, clinical presentation, histopathologic features, and management. This study corroborated some previously established characteristics of the lesion but also revealed some surprising aberrations. A significant difference in the age range and mean age by gender was detected with the Student's t test within this population at the 0.05 level. The classic presentation of a lateral periodontal cyst seems to be that of an asymptomatic, small, ovoid, well-corticated radiolucency that occurs in an interradicular locus in the mandibular premolar segment of a middle-aged man. However, lateral periodontal cysts may manifest with pain and cause cortical perforation, may present as large expansile radiolucencies, may arise in the maxillary molar segment, and may develop in young females. Because of the tendency for aggressiveness of other lesions that may present with a similar picture, it is important to establish the final diagnosis of lateral periodontal cyst on a histologic basis in conjunction with the clinical and radiographic findings.

The polymorphous odontogenic cyst

Over the years there have been sporadic reports of unusual cystic lesions of the jaws, not readily classified under conventional headings but which have been variously diagnosed as median-mandibular, glandular, sialo-odontogenic or botryoid odontogenic cyst. We present five cases which do not fit into other categories of odontogenic cyst, two of which have recurred within a few years of conservative treatment. This paper aims to alert clinicians to the propensity for regrowth of these cysts, proposes the term polymorphous odontogenic cyst for these lesions, to encompass their varied histological appearances and discusses their distinction from other cyst types with mucous and papillary formations in epithelium.

Botryoid odontogenic cyst: analysis of 33 cases

The botryoid odontogenic cyst is considered to be a multiloculated variant of the lateral periodontal cyst. Fewer than 40 of these lesions have been described, many of which have recurred. This paper describes the demographic, clinical, microscopic, and radiographic features of 33 unreported cases from the files of the Oral Pathology Biopsy Service at the University of North Carolina School of Dentistry. Our findings are in agreement with previously published cases for an average age of 57 years and the most common site for occurrence in the lower premolar area. Follow-up information on 12 patients determined that 2 had recurrences.

Glandular odontogenic cyst: analysis of cytokeratin expression and clinicopathological features

The glandular odontogenic cyst (GOC) is a rare odontogenic cyst which is still controversial in regard to classification, terminology, and origin. The first Japanese case of GOC is reported. Immunohistochemical examination for expression of cytokeratins and epithelial membrane antigen by monoclonal antibodies suggested that the lining epithelium was of odontogenic origin with metaplastic mucus-laden cells. We have reviewed the literature and compared the clinicopathological findings of the reported case of GOC with those of botryoid odontogenic cysts (BOC). The anatomical location, age range, and sex of GOC cases were very similar to those of BOC. GOC appears to be a multiocular and mucoepidermoid variant of non-keratinizing odontogenic cysts, which also includes BOC. GOC should be separated from the other types of odontogenic cyst and central mucoepidermoid tumours of salivary gland origin.

Developmental odontogenic cysts. An update

This review paper reports recent advances in the subject of developmental odontogenic cysts, essentially those of the past decade, starting with reference to the new WHO classification (1). On keratocysts, the latest reported recurrence rates are assessed as are their mode of growth, immunocytochemistry, immunology, genetic studies, and work on specific keratocyst antigens. There is a critical account of the group of lesions which includes the gingival cyst of adults, lateral periodontal cyst, botryoid odontogenic cyst and glandular odontogenic cyst, and their possible relationship to one another. On dentigerous cysts, reference is made to the relationship between them and deciduous teeth, as well as to their immunocytochemistry and immunology. Recent work on the unicystic ameloblastomas, their classification and prognosis, is assessed, as is the calcifying odontogenic cyst and its relationship with solid odontogenic tumours.

The lateral periodontal cyst: an update

Lateral periodontal cysts account for 0.8% of all jaw cysts seen in our department. Published reports have indicated that they occur most frequently in the 5th to 7th decades, that there is a male preponderance and that they are located mainly in the mandibular canine-premolar region. In our own series of 20 cases, 10 were found in the anterior maxilla. We have distinguished unicystic and multicystic (including botryoid) varieties. They were lined predominantly or exclusively by thin reduced enamel epithelium-like tissue which contained many clear cells and epithelial thickenings referred to as plaques. Glycogen was present in the epithelium of two-thirds of our cases although not exclusively in the clear cells, many of which showed no positivity. Two of our examples of the botryoid variety were different histologically, being lined predominantly by non-keratinizing stratified squamous epithelium with crowded and pyknotic nuclei and no clear cells. One case contained melanin while another showed epithelial crypt formation and superficial palisaded low columnar cells as seen in the glandular odontogenic cyst. This raised the question of whether the latter may form part of the clinicopathologic spectrum of lateral periodontal cyst. The histogenesis of lateral periodontal cysts is uncertain but we favour origin from reduced enamel epithelium.

The lateral periodontal cyst. A histopathological and radiographic study of 32 cases

The lateral periodontal cyst is a developmental odontogenic cyst usually found in the premolar area of the lower jaw. The clinical, radiographic and histopathological features of 32 previously unreported lateral periodontal cysts were reviewed. In four cases the follow-up, which extended over several years, was also studied. Different theories of pathogenesis are discussed.

Botryoid odontogenic cyst: report of a case with clinical and histogenetic considerations

A case of a botryoid odontogenic cyst is reported. Some considerations regarding histogenetic and biologic behaviour of the lesion are discussed.

Botryoid odontogenic cyst. Report of a case with histologic evidence of multicentric origin

Histologic examination of an excisionally biopsied botryoid odontogenic cyst (BOC) documented that it was composed of at least 2 separate cysts, the location of which suggested that both originated within the alveolar bone rather than from within the periodontal ligament. These observations provide evidence for a multicentric origin of this example of BOC, and are consistent with a previous suggestion that lateral periodontal cysts of non-inflammatory origin arise from remnants of the dental lamina.

Lateral periodontal cyst. Review of the literature and report of a case

The lateral periodontal cyst is a rare odontogenic cyst of developmental origin. It occurs on the lateral periodontal region of a vital tooth and has specific histologic features. In this paper a case of a lateral periodontal cyst is presented and cases previously reported in the literature are reviewed. The present case concerns a 50-year old woman who presented for an asymptomatic gingival swelling of the left canine mandibular region of 2 month's duration. X-ray examination showed a well circumscribed radiolucency with a radiopaque margin lying between the roots of the lateral incisor and canine. The associated teeth were vital. Enucleation of the lesion was performed. The histologic examination of the specimen showed a cyst lined by thin non-keratinized epithelium with focal thickenings containing clear cells.

A botryoid odontogenic cyst with multiple recurrences

A botryoid odontogenic cyst (BOC) which recurred 4 times over a period of 9 years is presented. Immunocytochemical comparison of cytokeratin composition of the cyst epithelium with that of the overlying oral epithelium showed distinct differences. The cyst epithelium expressed keratins typical of both simple and nonkeratinizing squamous epithelia. The keratin profile of BOC is in line with previous findings on odontogenic epithelia, thus confirming its odontogenic origin.

The glandular odontogenic cyst: an apparent entity

This article reports 8 examples of a rare cyst of the jaws that appears to be a distinct entity and which we have named glandular odontogenic cyst because of its unusual histopathological features. This lesion occurs over a wide age range in both sexes, tends to recur, and may become very large. However, one example in this series remained small over a period of 9 years; another, somewhat atypical example, was associated with an ameloblastoma.

Recurrent botryoid odontogenic cyst (lateral periodontal cyst)

The terms botryoid odontogenic cyst and lateral periodontal cyst have both been used to describe a histologically distinct type of cyst characterized by a thin epithelial lining exhibiting focal thickenings or plaques. The cyst reported herein is a well-documented example of this type of cyst, which exhibited persistent and recurrent behavior.

Botryoid odontogenic cyst: clinicopathologic analysis of ten cases with three recurrences

The botryoid odontogenic cyst (BOC) is a rare cyst of odontogenic origin originally described in 1973 by Weathers and Waldron as a variant of the lateral periodontal cyst. Ten examples of this rare lesion were studied by light and electron microscopy and the clinical and radiographic findings were analyzed. Eight of ten lesions were located in the mandible; the anterior mandible being the dominant site. Five of the ten lesions were unilocular, the largest measuring 4.5 X 1.2 cm. Only two of the ten botryoid odontogenic cysts were radiographically multilocular. Three lesions represented recurrences 8, 10, and 10 years after previous surgical intervention. All patients were white with an average age of 46 years. Perhaps the most significant information gained from this investigation of botryoid odontogenic cysts is the fact three of ten lesions recurred after initial surgical removal. It is important that practitioners take note of the fact that: 1) a recurrence potential may exist for the botryoid odontogenic cyst that has gone unrecognized, 2) recurrence may not occur until a decade after initial surgery, and 3) lesions may occasionally become destructive.

Two cystic lesions with features of both the botryoid odontogenic cyst and the central mucoepidermoid tumour: sialo-odontogenic cyst?

Two cases are reported with identical clinical, radiographical and histological features. These features share a combination of the botryoid odontogenic cyst and a central mucoepidermoid tumour, and it is suggested that the term sialo-odontogenic cyst be adopted for such lesions to avoid confusion and mismanagement.