Glandular odontogenic cysts. Diagnosis and treatment

A vacillating swelling in maxillary anterior region-Diagnostic challenges and management

In most of the cystic lesions appearing in the oral cavity, proper diagnosis and treatment remains a challenge. As glandular odontogenic cyst (GOC) is a rare type of developmental odontogenic cyst, it was not included in our differential diagnosis. The report of GOC was quite surprising as it was rare and never came in this discussion. A 25-year-old male patient was reported to our center with a chief complaint of painless swelling in the right anterior region of the maxilla. The swelling was oval shaped and diffuse extending from the distal aspect of 11 to the mesial aspect of 14 and superiorly extending into the sulcus. Working diagnosis was a periapical cyst, so conventional treatment of root canal treatment, cyst enucleation, and apicoectomy was done. This article presents a rare case which was primarily misdiagnosed and treated and has been subsequently revealed histopathologically as a rare clinicopathological entity.

Glandular odontogenic cyst associated with ameloblastoma: Case report and review of the literature

Glandular odontogenic cyst (GOC) associated with ameloblastoma is an exceedingly rare histologic presentation with no known clinical significance or treatment applications. Four cases have been reported, three in the mandible and one in the maxilla. The age range is 14-65 and with male predilection. All four presented with swellings and two with pain. We add one more case to the literature of a 58-year old male presenting with an expansile multilocular radiolucency between teeth #19-23. The ameloblastomatous changes in this case are consistent with those of a unicystic ameloblastoma-mural subtype. Although the histologic changes are those of a unicystic ameloblastoma, the clinical and radiographic findings are not. This case therefore presents a clinical challenge with regards to treatment planning for recurrence and prognosis. We conclude that treatment for GOC therefore be based on individual clinical presentation.

Key words:Glandular odontogenic cyst, GOC, ameloblastoma, unicystic ameloblastoma, mural unicystic ameloblastoma.

Mucous Cell Prosoplasia in Oral Pathologies: A Brief Review

One of the enigmas in cell differentiation process is prosoplasia, which is contemplated as forward differentiation. A well-known example of prosoplastic switch is mucous cell prosoplasia, which is the transformation of a simple squamous epithelial cell into mucous secreting cell. Numerous theories have been proposed for histogenesis of this phenomenon, which are comprehensively discussed in the present paper. Oral pathologies like odontogenic cysts and salivary gland tumours show mucous prosoplasia quite often; sometimes leading to diagnostic difficulties. In the present paper, efforts have been made to comprehensively discuss diverse aspects of mucous prosoplasia like histogenesis, theories and diagnostic importance in various oral pathologies.

Glandular Odontogenic Cyst: Case Series

Glandular odontogenic cyst (GOC) is an uncommon and aggressive jaw cyst with a high recurrence rate. It may grow into a large size. Diagnosis of the cyst is challenging since it may be confused with some other jaw cysts and malignancies. Treatment methods vary from conservative surgery to radical bone resection. In this case series, we briefly present five cases of GOC diagnosed and treated at our clinic. Thorough histopathological diagnosis and long-term follow-up are necessary in patients with GOC.

An ambiguous asymptomatic swelling in the maxillary anterior region-A case report

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Here we present a case which was initially misdiagnosed and mismanaged but on subsequent histopathologic examination revealed the final diagnosis.

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It is time to rethink whether the previously neglected periapical cyst were also GOC?

Introduction

Glandular odontogenic cyst is a rare and recently recognized type of developmental odontogenic cyst. Being odontogenic in origin, because of the pluripotentiality of the odontogenic epithelium it can show glandular or salivary features.

Presentation of a case

A 46 year old female patient was referred to the Oral and Maxillofacial Surgery department with chief complaint of painless swelling in the right anterior region of maxilla, radiographically associated with teeth 12, 13. Mucosa over the swelling was slightly bluish in colour and no associated palatal swelling was seen. No incidence of trauma was reported and involved teeth were not mobile.

Discussion

Although we have many differential diagnoses, our working diagnosis was a periapical cyst, so conventional treatment of root canal treatment, cyst enucleation, and apicoectomy was planned.

Conclusion

Here we present a case which was initially misdiagnosed and mismanaged but on subsequent histopathologic examination revealed the final diagnosis.

Glandular odontogenic cyst of the anterior mandible

Context:

Glandular odontogenic cyst (GOC) is a rare cyst occurring in the middle-age people with mandibular anterior as the common site of occurrence.

Case Report:

We report a case of massive GOC in a 65-year-old female with an emphasis on its clinical course, histological features, and treatment modalities.

Conclusion:

The aggressiveness and recurrences of GOC warrants clinicians for the careful examination, treatment, and long-term follow-up.

Glandular odontogenic cyst mimicking ameloblastoma in a 78-year-old female: A case report

Glandular odontogenic cyst (GOC) is a rare, potentially aggressive jaw lesion. The common radiographic features include a well-defined radiolucency with distinct borders, presenting a uni- or multilocular appearance. A cystic lesion in the posterior mandible of a 78-year-old female was incidentally found. Radiographs showed a unilocular lesion with a scalloped margin, external root resorption of the adjacent tooth, and cortical perforation. This lesion had changed from a small ovoid shape to a more expanded lesion in a period of four years. The small lesion showed unilocularity with a smooth margin and a well-defined border, but the expanded lesion produced cortical perforation and a lobulated margin. The provisional diagnosis was an ameloblastoma, whereas the histopathological examination revealed a GOC. This was a quite rare case, given that this radiographic change was observed in the posterior mandible of an elderly female. This case showed that a GOC can grow even in people in their seventies, changing from the unilocular form to an expanded, lobulated lesion. Here, we report a case of GOC with characteristic radiographic features.

Dual lesions: a diagnostic dilemma

Glandular odontogenic cyst (GOC) is a rare aggressive developmental cyst of the jaw. It most commonly occurs in middle-aged people with mandible anterior region being the most affected site. This lesion can present as a unilocular or multilocular radiolucency and has high recurrence rate. The histopathologic features of the GOC are complex and often coincide with the features of dentigerous cyst, radicular cyst, and low-grade central mucoepidermoid carcinoma (CMEC). At times, the microscopic features are so similar to central low-grade mucoepidermoid carcinoma that it becomes highly impossible to distinguish the two entities even with various advanced investigations. The reported case represents one such diagnostic dilemma occurring in the maxilla which is a rare site, and the lesion/s appeared as two distinct entities, that is, GOC and CMEC on either aspects of the same side of maxilla clinically, yet showing continuity on advanced imaging and demonstrating histopathological perplexity.

Maxillary reconstruction with bone transport distraction and implants after partial maxillectomy

Maxillary and mandibular bone defects can result from injury, congenital defect, or accident, or as a consequence of surgical procedures when treating pathology or defects affecting jaw bones. The glandular odontogenic cyst is an infrequent type of odontogenic cyst that can leave a bony defect after being treated by aggressive surgical means. First described in 1987 by Padayachee and Van Wyk, it is a potentially aggressive entity, having a predisposition to recur when treated conservatively, with only 111 cases having been reported hitherto. Most reports emphasize its clinical, radiographic, and histologic features, including a few considerations on rehabilitation for these patients. The aim of this article is to present the case of a 24-year-old male patient who, in 2001, was diagnosed with a glandular odontogenic cyst and to focus on the surgical approach and rehabilitation scheme. We performed an anterior partial maxillectomy. The osseous defect was treated using bone transport distraction. Dental and occlusal rehabilitation was achieved with titanium implants over transported bone and an implant-supported overdenture. A 9-year follow-up shows no evidence of recurrence of the pathology, adequate shape and amount of bone, functional occlusal and dental rehabilitation, and patient's satisfaction.

Glandular odontogenic cyst: analysis of 46 cases with special emphasis on microscopic criteria for diagnosis

The glandular odontogenic cyst (GOC) is now a relatively well-known entity with recent reviews indicating over 100 cases reported in the English literature. The GOC's importance relates to the fact that it exhibits a propensity for recurrence similar to the odontogenic keratocyst, and that it may be confused microscopically with central mucoepidermoid carcinoma (CMEC). Numerous histopathologic features for the GOC have been described, but the exact microscopic criteria necessary for diagnosis have not been universally accepted. Furthermore, some of the microscopic features of GOC may also be found in dentigerous, botryoid, radicular, and surgical ciliated cysts. The purpose of this multicenter retrospective study is to further define the clinical, radiographic, and microscopic features of GOC, to determine which microscopic features may be helpful for diagnosis in problematic cases, to determine the most appropriate treatment, and to determine if GOC and CMEC share a histopathologic spectrum. In our series of 46 cases, the mean age at diagnosis was 51 years with 71% of cases in the 5th-7th decades. No gender predilection was noted. 80% of cases occurred in the mandible, and 60% of the lesions involved the anterior regions of the jaws. Swelling/expansion was the most common presenting complaint, although some cases were asymptomatic. Radiographically, most cases presented as a well-defined unilocular or multilocular radiolucency involving the periapical area of multiple teeth. Some lesions displayed a scalloped border. Cases also presented in dentigerous, lateral periodontal, and "globulomaxillary" relationships. The canine area was a common location for maxillary cases. All cases were treated conservatively (enucleation, curettage, cystectomy, excision). Follow-up on 18 cases revealed a recurrence rate of 50% (9/18), with 6 cases recurring more than once (range of follow-up: 2 months to 20 years; average length of follow-up: 8.75 years). The mean interval from initial treatment to first recurrence was 8 years, and from first recurrence to second recurrence was 5.8 years. Two cases recurred three times and the interval from second to third recurrence was 7 years (exact interval only documented in one case). All cases exhibited eosinophilic cuboidal (hobnail) cells, a feature not specific for GOC, but necessary for diagnosis, in our opinion. Univariate analysis indicated several features that are most helpful in distinguishing GOC from GOC mimickers in problematic cases, including: (1) the presence of microcysts (P < 0.0001); (2) epithelial spheres (P < 0.0001); (3) clear cells (P = 0.0002); (4) variable thickness of the epithelial cyst lining (P = 0.0002); and (5) multiple compartments (P = 0.006). Stratified analysis indicated that when microcysts are present, epithelial spheres and multiple compartments are still significant, and clear cells are marginally significant in distinguishing GOCs from GOC mimickers. The presence of microcysts (P = 0.001), clear cells (P = 0.032), and epithelial spheres (P = 0.042) appeared to be most helpful in distinguishing GOC associated with an unerupted tooth from dentigerous cyst with metaplastic changes. There were no statistically significant differences microscopically between GOCs that recurred and those that did not. The presence of 7 or more microscopic parameters was highly predictive of a diagnosis of GOC in our series (P < 0.0001), while the presence of 5 or less microscopic parameters was highly predictive of a non-GOC diagnosis (P < 0.0001). Islands resembling mucoepidermoid carcinoma (MEC-like islands) were identified in the cyst wall of three cases, only one of which had follow-up (no evidence of disease at 74 mo.); therefore, at this time insufficient information is available to determine whether GOC and CMEC share a histopathologic spectrum or whether MEC-like islands in GOCs are associated with more aggressive or malignant behavior.

Glandular odontogenic cyst: systematic review

OBJECTIVES

The aim of this study was to evaluate the principal features of "glandular odontogenic cyst" (GOC), by systematic review (SR), and to compare their frequencies among four global groups.

METHODS

The databases searched were the PubMed interface of MEDLINE and LILACS. Only those reports of GOCs that occurred in a series in the reporting authors' caseload were considered. All cases were confirmed histopathologically.

RESULTS

18 reports on 17 series of consecutive cases were included in the SR. GOC affected males twice as frequently and the mandible almost three times as frequently. The mean age at first presentation was 44 years, coincident with that of the Western global group, in which the largest proportion of reports and cases first presented in the second half of the fifth decade. However, age at presentation of GOCs in the East Asian and sub-Saharan African global groups was nearly a decade younger, this was significant. Six reports included details of at least one clinical presentation. Eight reports included at least one conventional radiological feature. There were some significant differences between global groups. The Western global group had a particular predilection for the anterior sextants of both jaws. The sub-Saharan African group displayed buccolingual expansion (as did the Latin American group) and tooth displacement in every case. 18% of GOCs recurred overall, except in the sub-Saharan African global group.

CONCLUSIONS

GOCs have a marked propensity to recur in most global groups. GOCs presented in older patients and with swellings, affected the anterior sextants of both jaws, and radiologically were more likely to present as a well-defined unilocular radiolucency with buccolingual expansion. Tooth displacement, root resorption and an association with unerupted teeth occurred in 50%, 30% and 11% of cases, respectively.

Glandular odontogenic cyst involving the posterior part of maxillary sinus, a rare entity

The Glandular Odontogenic Cyst (GOC) was first coined by Gardner et al. [2], in 1988 as an odontogenic origin, is a rare developmental lesion considered a distinct entity because of its uncommon clinical and histopathological characteristics. This lesion can involve either jaws, but the anterior region of the mandible is the most affected area. It strikes distinct age groups, with an average patient age of 50 years. Radiographically, GOC does not display specific or pathognomonic features. It may present as a multilocular or unilocular radiolucencies. The cyst has an aggressive nature and high tendency of recurrence, so long-term follow-up should be carried out. The treatment is controversial, varying from conservative methods to block excision. It is believed that the low prevalence of GOC in the literature is because of not only its rarity, but principally to the fact that its main characteristics are also found in other pathological entities, thereby generating controversial diagnoses. The aim of this paper is to present a rare case of Glandular Odontogenic Cyst (GOC), which is uncommon in the posterior maxilla, that mimicks the lateral odontogenic cyst/botroid odontogenic cyst/Central Muco-epidermoid carcinoma. Owing to its tendency to recur, the lesion needs careful and meticulous planning for its surgical removal.

Glandular odontogenic cyst: report of two cases and review of literature

Glandular odontogenic cyst (GOC) is an uncommon jaw bone cyst of odontogenic origin described in 1987 by Gardner et al. It is a cyst having an unpredictable and potentially aggressive behaviour. It also has the propensity to grow to a large size and tendency to recur with only 111 cases having been reported thus far. The first case occurred in a 42-year-old female and presented as a localized swelling extending from 19 to 29 regions. There was a history of traumatic injury at the site. There was evidence of bicortical expansion and radiographs revealed a multilocular radiolucency. The second case occurred in a 21-year-old male, as a large swelling in the mandible and radiograph revealed radiolucency in the region. On histopathological examination, these lesions were diagnosed as GOC. It was concluded that, two cases submitted by us correlate with the existing literature that GOC's affect more commonly in the middle age group, having predilection for mandible and that trauma could be a precipitating factor for its occurrence. The increased recurrence rates can be due to its intrinsic biological behavior, multilocularity of the cyst, and incomplete removal of the lining following conservative treatment.

Glandular odontogenic cyst: a challenge in diagnosis and treatment

The present review analyzes the accumulated data from all cases of glandular odontogenic cyst (GOC) reported in the English language literature. In the 20 years since it was first described, 111 cases have been reported, an incidence of 0.2% of odontogenic cysts. The age range is 14-75, mean 45.7, with a M/F ratio of 1.3:1. GOC has a predilection for the mandible (70%), affecting both anterior and posterior areas. It is typically radiolucent, well defined, either unilocular (53.8%) or multilocular (46.2%). Frequent perforation (61%) and of thinning of cortical plates (24.4%) indicate aggressiveness. Sufficient follow-up indicates that 30% of cases can recur. Treatment by enucleation or curettage carries the highest risk for recurrence, especially in large and multilocular lesions. Peripheral osteoectomy or marginal resection can eliminate the risk. Defined criteria for microscopic diagnosis are described, which in addition to Ki67 and p53 can help in differentiating GOC from lesions with histological similarities (cysts with mucous metaplasia, botryoid and surgical ciliated cysts, low-grade mucoepidermoid carcinoma). Definite diagnosis may not be possible in small incisional biopsies due to the focal presentation of characteristic features required for diagnosis. There is now evidence to support an odontogenic rather than a sialogenic origin.

Glandular odontogenic cyst in China: report of 12 cases and immunohistochemical study

OBJECTIVE

The purpose of this study was to present 12 additional cases of glandular odontogenic cyst (GOC) in the Department of Oral Pathology, School of Stomatology, Wuhan University, People's Republic of China, and to investigate their immunohistochemical cytokeratins (CKs) expression in the epithelial components.

METHODS

A total of 12 GOCs were reviewed clinically and radiographically, and immunohistologic CKs AE1, 7, 8/18, 10/13, 14, 16, 19 and 20 were performed by using a standard biotin-streptavidin immunoperoxidase technique on paraffin sections.

RESULTS

The present series showed that eight occurred in males and four in females. The mean age was 37.6 years with a peak incidence occurring in the third decades (six of 12). Mandibles were more affected than maxillas (7:5), especially anterior mandible (four of seven). Radiographically, ratio multilocular to unilocular radiolucencies was 5:7 usually with well-defined borders. Histologically, cystic spaces were lined by non-keratinized stratified epithelia containing focal plaque-like or whirlpool-like thickenings; surface epithelial layer-containing eosinophilic cuboidal cells; mucous cells; and mucin pools of microcystic areas in the epithelium. Immunohistochemistry showed that epithelium of GOCs stained for CKs AE1, 7, 8/18, 10/13, 14 and 19 with slight changes in their patterns, and no reaction to CKs 16 and 20.

CONCLUSIONS

Most clinical and histologic features in this study were analogous to those reported west population, although with slight difference between them. Histologically, the morphology of the epithelium strongly suggested an odontogenic origin, and CKs expression of GOC was similar to that of odontogenic epithelium, suggesting histochemically that GOC might be derived from odontogenic epithelium.

The use of molecular markers as an aid in the diagnosis of glandular odontogenic cyst

(1) To investigate the use of p53, Ki67, and PCNA as an aid in the diagnosis of glandular odontogenic cyst (GOC); (2) To compare the expression of these markers in GOC, low-grade mucoepidermoid carcinoma (MEPCa), and radicular cyst with mucous metaplasia (RCM) as an aid in the differential diagnosis; (3) To establish guidelines for the diagnosis of GOC.

STUDY GROUP

35 patients: 10 GOC, 15 RCM, 9 MEPCa. Immunostaining of archival specimens for p53, Ki67, PCNA. Twenty-nine articles (1987-2004) with detailed histopathological descriptions of GOC, analyzed for frequency of histopathological characteristics. Mean p53 labeling index (LI) was higher in GOC (3.0+/-4.3%) and MEPCa (4.9+/-7.4%) than in RCM (0.4+/-1.2%, p=0.048). Ki67 LI was higher in GOC (4.4+/-4.7%) and RCM (3.7+/-6.7%) than in MEPCa (0.7+/-1.6%, p=0.03). There were no significant differences in the expression of PCNA. In the literature, the most consistent histopathological characteristics of GOC included epithelial spherules/"knobs"/whorls (82.8%), cuboidal eosinophilic cells (65.5%), goblet cells (65.5%), intraepithelial glandular/microcystic ducts (58.6%), variations in lining width (55.2%), ciliated cells (51.7%) and mucous pools/mucous-lined crypts (41.4%). These histopathological features were divided into major and minor signs. The diagnosis of GOC should be based on at least the focal presence of the major signs. Measurement of p53 and Ki67 may aid in the differential diagnosis of GOC.

Glandular odontogenic cyst: Treatment and recurrence

PURPOSE

To investigate the correlation between clinical characteristics, radiologic features, treatment modalities, and treatment outcome of glandular odontogenic cyst, and to suggest a treatment protocol based on these results.

PATIENTS AND METHODS

The study included a total of 56 cases, 49 from the literature and 7 new cases. Demographic data, locularity and radiographic extension, cortical plate integrity, treatment modalities, follow-up, and recurrence were analyzed.

RESULTS

There were 34 male and 22 female patients aged 14 to 74 years (mean, 48 years). The mandible was involved in 41 cases (73.2%) and the maxilla in 15 (26.8%), predominantly in the anterior region; 53.6% of the lesions were unilocular and 46.4% multilocular. Large lesions were found in 78.5% of cases. Cortical integrity was compromised in 53.6% (cortical perforation in 39.3% and thinning or erosion of the cortical plate in 14.3%). Recurrence occurred at a rate of 29.2%, within 0.5 to 7 years (mean, 2.9 years). Mean follow-up was also 2.9 years. Two patients had 3 recurrences each. Recurrence was associated with minor surgery such as enucleation or curettage; none of the patients treated by peripheral ostectomy, marginal resection, or partial jaw resection had a recurrence. Compared with the patients without recurrence, the recurrence group had a higher frequency of multilocularity than the nonrecurrent group (64.3% vs 41.2%) and of compromised cortical integrity (71.4% vs 47.1%).

CONCLUSION

Glandular odontogenic cyst is an aggressive lesion. Treatment by enucleation or curettage alone is associated with a high recurrence rate. Small unilocular lesions can be treated by enucleation. In large uni- or multilocular lesions, an initial biopsy is recommended. Surgical treatment of large lesions should include enucleation with peripheral ostectomy for unilocular cases and marginal resection or partial jaw resection in multilocular cases. Marsupialization followed by second phase surgery is an option for lesions approaching vital structures. Follow-up should continue for at least 3 years (up to 7 years in cases with features associated with increased risk).

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.

Radiological features of glandular odontogenic cyst

OBJECTIVES

To present five new cases of glandular odontogenic cyst (GOC) and to review the radiological features at presentation as reported in the English literature.

METHODS

From 1993 to 2002, five patients in our department were diagnosed with GOC based on histopathological findings and supported by radiography and CT. The radiographic features of the new GOC cases were analysed in addition to 51 literature cases.

RESULTS

There were 31 male and 25 female patients, aged 14-90 years (mean 50 years). The mandible was involved in 80% and the maxilla in 20%; most of the lesions were located in the anterior jaw. Radiographically, 52% of the lesions were unilocular and 48% were multilocular; 94.5% showed well defined borders, which were sclerotic in 7.7% and scalloped in 13%. Information on cortical plate integrity was available in only 24 cases: 50% showed perforation, 8.3% erosion of the cortical plates and 8.3% thinning of the cortical plates. Root resorption was reported in 22% of patients and tooth displacement in 24.4%.

CONCLUSIONS

Data collected indicate that GOC has potentially aggressive behaviour, with expansion and perforation in a significant number of cases. We recommend the use of multiple plane radiographs, with CT reserved for large lesions, especially those that are multilocular or involve extragnathic structures.

The glandular odontogenic cyst: clinical and radiological features; review of the literature and report of nine cases

Nine cases with glandular odontogenic cysts (GOC's) are presented bringing the total number reported in the literature to 54. Our study confirmed that most GOC's occur in the mandible, whereas maxillary lesions present only in the globulo-maxillary region. The radiological features were found to be non-distinctive and presented as well-defined radiolucencies with uni- and multilocular appearances. Most of the mandibular GOC's were unilocular, involved the symphysis region and only one extended into the ramus. All GOC's larger than 6 cm in diameter showed perforated margins radiologically. Our two multilocular GOC's demonstrated microscopic features supporting their infiltrative radiological appearance. The invasive clinical and radiological features of GOC support the notion of a possible histo-pathologic overlap between GOC and low-grade central mucoepidermoid carcinoma of the jaw.

Glandular odontogenic cyst (sialo-odontogenic cyst): report of two cases and literature review of 45 previously reported cases

The clinical, radiological, histopathological and immunohistochemical (cytokeratin) features of two cases of glandular odontogenic cyst (GOC) are presented and discussed in a review of 45 cases of GOC hitherto reported. Of cases with available information, 34 occurred in the mandible and 6 in the maxilla; the male:female ratio was 19:28, and the mean age was 46.7 years in males and 50.0 years in females. Six cysts recurred once after 2-8 years (mean 2 years 8 months) and 2 (5.3%) recurred twice after 2 and 5 years and after 3 and 5 years, respectively, giving a rate of recurrence of 21%. The identification of osteodentin in one of the present cases and the co-expression of cytokeratins (CK) 13, 19 and 8 strongly support the concept of odontogenic differentiation in the GOC. Careful surgical removal of the lesion succeeded by a 5-year follow-up period is recommended.

Glandular odontogenic cyst: report of a case and review of the literature

The glandular odontogenic cyst is a rare jawbone cyst of odontogenic origin, first described in 1988 by Gardner et al. We describe a previously unreported case of a combined cyst composed of glandular odontogenic cyst and ghost cell keratinization that was present for 33 years. We also reviewed the published 38 cases of glandular odontogenic cyst found in the world literature and add this additional case.

Glandular odontogenic cyst: a case report and clinicopathologic analysis of the relationship to central mucoepidermoid carcinoma

Glandular odontogenic cyst (GOC), an unusual multilocular cystic lesion of jaws exhibiting the features of both botryoid odontogenic cyst and mucoepidermoid tumor has been reported recently as a new entity with uncertain histogenesis. The World Health Organization named GOC as an independent pathologic entity and classified it as a developmental odontogenic epithelial cyst. We report an additional case, describe its clinicopathologic features, and discuss the similarity to the central mucoepidermoid carcinoma.

Glandular odontogenic cyst: report of a case with cytokeratin expression

The glandular odontogenic cyst is a rare lesion that was recognized as a distinct entity in the latest WHO typing of odontogenic tumors. We report a glandular odontogenic cyst that recurred after surgical removal from the anterior mandible of a 54-year-old white man. Immunohistochemical study showed that the cystic epithelium reacted positively to antibodies directed against cytokeratins (CKs) 7, 13, 14, and 19 and negatively to CKs 8 and 18.

Glandular odontogenic cyst. Report of seven cases

This study describes the clinical, radiographic and histopathological features of seven glandular odontogenic cysts. These cysts comprised 0.012% of 5800 jaw cysts diagnosed in a 19-year period. There was strong predilection for the mandible (five of the seven cases). Both clinical and radiographic features were nonspecific. The main histological findings were a nonkeratinized, stratified squamous epithelium lining to the cyst cavity which varied in thickness with superficial eosinophilic cuboidal cells and mucous pools within the spinous cell layer. Daughter cysts were found in the wall of 2 cysts. At surgery, most walls were found to be thin and lumen to contain a serous, low viscosity exudate. Because of the high rate of recurrence found in three cases out of the seven after conservative surgical treatment, careful clinical and radiographic follow-up is recommended.

Mucoepidermoid carcinoma in a salivary duct cyst of the parotid gland. Contribution to the development of tumours in salivary gland cysts

Concerning the hypothesis that distinct types of salivary gland cysts may be the starting point of a salivary gland tumour, a histological examination of 1,661 salivary gland cysts was performed in order to analyse the cell types and their proliferative activity. Epithelial alterations were found especially in salivary duct cysts of parotid gland and in mucous retention cysts of minor salivary glands. Characteristic cellular changes were epithelial metaplasias (goblet cells, clear cells, squamous cells) and focal epithelial proliferations with plump or papillary plaques projecting into the cyst lumen. Only in one case had a mucoepidermoid carcinoma developed in the wall of a parotid duct cyst. The epithelial metaplasia and focal proliferative activity in salivary duct cysts is comparable to similar alterations in odontogenic cysts as possible early manifestation of a tumour, especially of an ameloblastoma or mucoepidermoid carcinoma. The differential diagnosis of salivary duct cysts must take primarily cystadenomas and cystic mucoepidermoid carcinomas of well-differentiated type into account.

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.

Glandular odontogenic cyst with hyaline bodies: an unusual dentigerous presentation

We present an unusual case of glandular odontogenic cyst (GOC) enclosing the crown of an impacted canine that developed in the anterior mandible in a 54-year-old woman. Microscopically, it contained numerous glandular structures and hyaline bodies in the epithelial lining. The present rare case is sufficiently distinctive to be considered a dentigerous variant of GOC.