Long-term observation of a large keratocystic odontogenic tumour of the mandible treated by a single enucleation procedure: A case report and literature review.
Int J Surg Case Rep 2017;
34:119-122. [PMID:
28388515 PMCID:
PMC5384295 DOI:
10.1016/j.ijscr.2017.03.033]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/21/2017] [Accepted: 03/21/2017] [Indexed: 11/24/2022] Open
Abstract
Keratocystic odontogenic tumours (KCOTs) are rare, benign lesions of the jaw.
We present a 49-year-old woman with a rare, large KCOT of the mandible.
We describe a treatment method involving enucleation with Carnoy’s solution plus inserting a titanium plate.
Although the patient showed recurrence once, she has not shown recurrence since 2010.
Our approach was effective for the treatment of a large KCOT with tooth preservation.
Introduction
Keratocystic odontogenic tumours (KCOTs) are benign lesions of the jaw that are characterised by expansive growth and high rates of recurrence. Herein, we present a novel minimally invasive method for the surgical treatment of KCOTs.
Case presentation
We present a 49-year-old woman with a rare, large KCOT of the mandible extending from tooth 37 to tooth 47. A single enucleation procedure was selected as the surgical technique combined with a titanium plate. Teeth interfering with the cystic lumen were preserved. The bone surrounding the cyst was partially removed and rinsed with Carnoy’s solution. Recurrence was observed 1 year later between teeth 43 and 45, and was treated by single enucleation with Carnoy’s solution. After the second operation, the teeth interfering with the KCOT still elicited a positive response to dental pulp testing. No further signs of recurrence were observed after a total observation period of 7 years.
Discussion
Various surgical interventions have been described for KCOTs. However, a general guideline for a specific surgical intervention has not yet been established owing to the heterogeneity of these tumours.
Conclusion
Immediate enucleation in combination with a titanium plate offers an effective surgical approach for the treatment of large KCOTs of the mandible without the need for radical tooth removal or resection of the afflicted side.
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