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Gorgis R, Christian Krarup SA, Reibel J, Nørholt SE. Glandular Odontogenic Cyst: a Case Report and Literature Review. J Oral Maxillofac Res 2023; 14:e4. [PMID: 37521326 PMCID: PMC10382194 DOI: 10.5037/jomr.2023.14204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023]
Abstract
Background The glandular odontogenic cyst is now a well-known entity comprising < 0.5% of all odontogenic cysts with a recent review tabulating about 200 cases in the English literature. Glandular odontogenic cyst shows epithelial features that simulate salivary gland or glandular differentiation. The importance of glandular odontogenic cyst relates to the fact that it has a high recurrence rate and shares overlapping histologic features with central mucoepidermoid carcinoma. The purpose of this paper is to describe the clinical, radiological, and histopathological features of a case of glandular odontogenic cyst with the course of treatment and 9-years follow-up, followed by a review of the literature. Methods A 63-year-old male was referred for further investigation of a mandibular radiolucency observed by his general dental practitioner. The main complaint was a murmuring sensation in the lower jaw right side. Radiological examination revealed a well-defined, unilocular, radiolucent lesion, involving the right mandible with 17 and 68 mm in mediolaterally and anteroposterior dimension, respectively. Results A total enucleation of the cystic lesion and surgical extraction of tooth #46, #47 and #48, was performed under local anaesthesia. Histopathologic examination revealed a glandular odontogenic cyst. Conclusions Glandular odontogenic cyst shows no pathognomonic clinico-radiographic characteristics, and therefore in many cases it resembles a wide spectrum of lesions. Diagnosis can be extremely difficult due to histopathological similarities with dentigerous cyst, lateral periodontal cyst and central mucoepidermoid carcinoma. Therefore a careful histopathological examination and a long-term follow-up (preferably seven years) are required to rule out recurrences.
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Affiliation(s)
- Romario Gorgis
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, AarhusDenmark.
- Section of Oral Surgery and Oral Pathology, Institute of Odontology and Oral Health, Aarhus University, AarhusDenmark.
| | | | - Jesper Reibel
- Section of Oral Pathology and Oral Medicine, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, CopenhagenDenmark.
| | - Sven Erik Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, AarhusDenmark.
- Section of Oral Surgery and Oral Pathology, Institute of Odontology and Oral Health, Aarhus University, AarhusDenmark.
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Glandular Odontogenic Cyst in Dentigerous Relationship: An Uncommon Case Report. Case Rep Dent 2019; 2019:8647158. [PMID: 31355014 PMCID: PMC6637709 DOI: 10.1155/2019/8647158] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 06/03/2019] [Indexed: 12/17/2022] Open
Abstract
Glandular odontogenic cyst (GOC) is an uncommon cyst of the jaw. Less than 200 cases are reported in the literature, and only 22 cases are associated with an unerupted tooth (dentigerous relationship). Although it is an asymptomatic lesion, it can be destructive and has high recurrence rates. The diagnosis can be especially challenging due to the lack of distinct diagnostic clinic-radiological criteria and nonspecific microscopic features, mimicking benign and malignant lesions. Conservative surgical treatment has been the choice for most surgeons, but marginal or partial jaw resection has been reported. This report describes a rare case of GOC in a dentigerous relationship, which was treated with enucleation and peripheral osteotomy.
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3
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Chrcanovic BR, Gomez RS. Glandular odontogenic cyst: An updated analysis of 169 cases reported in the literature. Oral Dis 2017; 24:717-724. [PMID: 28744957 DOI: 10.1111/odi.12719] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 06/27/2017] [Accepted: 07/17/2017] [Indexed: 11/29/2022]
Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
| | - R S Gomez
- Department of Oral Surgery and Pathology; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
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Cousin T, Bobek S, Oda D. Glandular odontogenic cyst associated with ameloblastoma: Case report and review of the literature. J Clin Exp Dent 2017. [PMID: 28638564 PMCID: PMC5474343 DOI: 10.4317/jced.53775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
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.
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Affiliation(s)
- Timothée Cousin
- DDS candidate. University of Washington School of Dentistry, Seattle WA USA
| | - Samuel Bobek
- MD, DMD. Swedish Hospital Maxillofacial Surgery, Seattle WA USA
| | - Dolphine Oda
- BDS, MSc. Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle WA USA
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5
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Abstract
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.
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Affiliation(s)
- Gokhan Gurler
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| | - Humam Al-Ghamian
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| | - Nihan Aksakalli
- Department of Tumor Pathology and Oncological Cytology, Istanbul University Institute of Oncology, Istanbul, Turkey
| | - Cagri Delilbasi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Istanbul Medipol University, Istanbul, Turkey
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Alaeddini M, Eshghyar N, Etemad-Moghadam S. Expression of podoplanin and TGF-beta in glandular odontogenic cyst and its comparison with developmental and inflammatory odontogenic cystic lesions. J Oral Pathol Med 2016; 46:76-80. [DOI: 10.1111/jop.12475] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Mojgan Alaeddini
- Dental Research Center; Dentistry Research Institute; Tehran University of Medical Science; Tehran Iran
| | - Nosratollah Eshghyar
- Department of Oral and Maxillofacial Pathology; Tehran University of Medical Sciences; Tehran Iran
| | - Shahroo Etemad-Moghadam
- Dental Research Center; Dentistry Research Institute; Tehran University of Medical Science; Tehran Iran
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7
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Momeni Roochi M, Tavakoli I, Ghazi FM, Tavakoli A. Case series and review of glandular odontogenic cyst with emphasis on treatment modalities. J Craniomaxillofac Surg 2015; 43:746-50. [PMID: 25971944 DOI: 10.1016/j.jcms.2015.03.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 02/14/2015] [Accepted: 03/25/2015] [Indexed: 11/28/2022] Open
Abstract
Glandular odontogenic cyst is a newly determined jaw entity with aggressive behavior and a high rate of recurrence. There is histopathologic resemblance to other lesions of the jaw such as intraosseous mucoepidermoid carcinoma. Although enucleation and curettage are not the treatment of choice for this cystic lesion, they comprise the most common method. On the other hand, filling the defect is a controversial matter, especially in lesions with large size. We introduce 4 cases of GOC, of which 2 are cases of recurrence. We applied bone material substitutes in 3 of these cases with success.
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Affiliation(s)
- Mehrnoush Momeni Roochi
- Department of Oral & Maxillofacial Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Iman Tavakoli
- Department of Oral & Maxillofacial Surgery, Tehran University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Mojgan Ghazi
- Department of Oral & Maxillofacial Pathology, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Tavakoli
- Department of Oral & Maxillofacial Pathology, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
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Purohit S, Shah V, Bhakhar V, Harsh A. Glandular odontogenic cyst in maxilla: A case report and literature review. J Oral Maxillofac Pathol 2014; 18:320-3. [PMID: 25328322 PMCID: PMC4196310 DOI: 10.4103/0973-029x.140923] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 08/07/2014] [Indexed: 11/05/2022] Open
Abstract
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 behavior. The increased recurrence rate can be due to its multilocularity and incomplete removal of the lining following conservative treatment. Clinically, the most common site of occurrence is the anterior region of mandible. GOC has a slight male predilection and occurs primarily in middle-aged patients. This article presents a case of glandular odontogenic cyst in a 30-year-old female patient in the posterior region of the maxilla, which is quite rare.
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Affiliation(s)
- Sharad Purohit
- Department of Oral Pathology and Microbiology, Jodhpur Dental College and General Hospital, Boranada, Rajasthan, India
| | - Vandana Shah
- Department of Oral Pathology and Microbiology, K. M. Shah Dental College and Hospital, Vadodara, Gujarat, India
| | - Vikas Bhakhar
- Department of Oral Pathology and Microbiology, K. M. Shah Dental College and Hospital, Vadodara, Gujarat, India
| | - Ashutosh Harsh
- Department of Dentistry, Dr. Sampurnanand Medical College and Hospital, Jodhpur, Rajasthan, India
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9
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Bilateral glandular odontogenic cyst of mandible: a rare occurrence. J Maxillofac Oral Surg 2014; 14:443-7. [PMID: 25848155 DOI: 10.1007/s12663-014-0668-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 07/06/2014] [Indexed: 10/24/2022] Open
Abstract
Glandular odontogenic cysts (GOCs) of the jaw are rare with well-defined limits radiologically, unusual histopathological features and a high recurrence rate. The radiographic appearance of GOCs vary and are not pathognomonic. Definitive diagnosis of the GOC is established only by histopathological examinations. Histologically, GOC is characterized by a thin nonkeratinized squamous epithelial lining, with papillary projections, nodular thickenings, mucous (goblet) cells with intraepithelial mucous pools and intraepithelial glandular, microcystic or duct-like structures. We present an unusual case of a bilateral GOC in the mandible. This case report is also the first documented case of bilateral GOC in the mandible.
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10
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Bishop JA, Yonescu R, Batista D, Warnock GR, Westra WH. Glandular odontogenic cysts (GOCs) lack MAML2 rearrangements: a finding to discredit the putative nature of GOC as a precursor to central mucoepidermoid carcinoma. Head Neck Pathol 2014; 8:287-90. [PMID: 24647913 PMCID: PMC4126918 DOI: 10.1007/s12105-014-0534-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 03/11/2014] [Indexed: 12/14/2022]
Abstract
Glandular odontogenic cyst (GOC) is a cyst of the gnathic bones that is characterized by squamous and glandular differentiation. The histopathologic features of GOC overlap considerably with central mucoepidermoid carcinoma (MEC), suggesting that GOC could be a precursor lesion to, or even a low-grade form of, central MEC. Differentiating the two lesions may be difficult or impossible on a limited biopsy. MAML2 rearrangements have been recently found to be specific for MEC, even those arising in the jaws. An analysis of MAML2 in GOCs could help clarify its relationship with central MEC. Tissue blocks from 21 GOCs and 5 central MECs were retrieved from the surgical pathology archives of The Johns Hopkins Hospital. Each MEC exhibited solid areas and clear-cut stromal invasion. In addition, 4 of the MECs demonstrated cystic areas that were histologically similar to GOC. Break-apart fluorescence in situ hybridization for MAML2 was performed. For the MECs, analysis was performed on both the solid components and the cystic areas that resembled GOC. MAML2 rearrangements were identified in all 5 of the MECs, but in none of the 21 GOCs (100 vs. 0 %; p < 0.0001, Fisher's Exact). In the MECs, the rearrangement was present in both the solid and GOC-like cystic areas. While central MECs consistently harbor the MAML2 rearrangement, even in low-grade cystic areas that resemble a pre-existing GOC, true GOCs do not. Accordingly, GOC does not appear to represent an early or low-grade form of central MEC, but rather an unrelated lesion. The high sensitivity and specificity of MAML2 rearrangement for MECs points to its utility as a diagnostic adjunct in separating mucinous cystic lesions of the gnathic bones.
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Affiliation(s)
- Justin A Bishop
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA,
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11
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Mascitti M, Santarelli A, Sabatucci A, Procaccini M, Lo Muzio L, Zizzi A, Rubini C. Glandular odontogenic cyst: review of literature and report of a new case with cytokeratin-19 expression. Open Dent J 2014; 8:1-12. [PMID: 24624237 PMCID: PMC3950754 DOI: 10.2174/1874210601408010001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 12/13/2013] [Accepted: 12/17/2013] [Indexed: 01/03/2023] Open
Abstract
The glandular odontogenic cyst (GOC) was a rare jawbone cyst described in 1988 as a distinct entity. This lesion can involve either jaw, and the anterior region of the mandible was the most commonly affected area. Clinical and radiographic findings were not specific, and the diagnosis of GOC can be extremely difficult due to the rarity of this lesion. The cyst presented a wall constituted by fibrous connective tissue and was lined by a non-keratinized stratified squamous epithelium of variable thickness. Large areas of the lining epithelium presented cylinder cells, sometimes ciliated. A variable amount of mucina was occasionally noted. Due to the strong similarities, this cyst can be easily misdiag-nosed as a central mucoepidermoid carcinoma (CMEC). Immunohistochemistry may be an aid in diagnosis; in fact has been demonstrated that there were differences in the expression of cytokeratins (CK) in GOC and CMEC. In this study, we reported a new case of GOC in a 38 year female patient. In addition, we carried out a review of 110 previous cases reported in literature.
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Affiliation(s)
- Marco Mascitti
- Department of Clinic Specialistic and Odontostomatological Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Andrea Santarelli
- Department of Clinic Specialistic and Odontostomatological Sciences, Polytechnic University of Marche, Ancona, Italy ; Institute of Health and Science on Aging INRCA, Ancona, Italy
| | - Antonio Sabatucci
- Department of Clinic Specialistic and Odontostomatological Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Maurizio Procaccini
- Department of Clinic Specialistic and Odontostomatological Sciences, Polytechnic University of Marche, Ancona, Italy ; Institute of Health and Science on Aging INRCA, Ancona, Italy
| | - Lorenzo Lo Muzio
- Department of Sperimental and Clinical Medicine, University of Foggia, Foggia, Italy
| | - Antonio Zizzi
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona, Italy
| | - Corrado Rubini
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona, Italy
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Castro-Núñez J, González MD. Maxillary reconstruction with bone transport distraction and implants after partial maxillectomy. J Oral Maxillofac Surg 2013; 71:e137-42. [PMID: 23351767 DOI: 10.1016/j.joms.2012.08.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Revised: 08/28/2012] [Accepted: 08/28/2012] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
- Jaime Castro-Núñez
- Oral and Maxillofacial Surgery, Universidad El Bosque, Bogotá, Colombia.
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Glandular odontogenic cyst: analysis of 46 cases with special emphasis on microscopic criteria for diagnosis. Head Neck Pathol 2011; 5:364-75. [PMID: 21915706 PMCID: PMC3210226 DOI: 10.1007/s12105-011-0298-3] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Accepted: 08/24/2011] [Indexed: 10/17/2022]
Abstract
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.
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Araújo de Morais HH, José de Holanda Vasconcellos R, de Santana Santos T, Guedes Queiroz LM, Dantas da Silveira ÉJ. Glandular odontogenic cyst: case report and review of diagnostic criteria. J Craniomaxillofac Surg 2011; 40:e46-50. [PMID: 21459013 DOI: 10.1016/j.jcms.2011.03.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Revised: 01/12/2011] [Accepted: 03/01/2011] [Indexed: 11/17/2022] Open
Abstract
The glandular odontogenic cyst (GOC) is an uncommon jaw bone cyst of odontogenic origin with unpredictable and potentially aggressive behaviour. It also has the propensity to grow to a large size and tendency towards recurrence. GOC can be easily misdiagnosed microscopically as a central mucoepidermoid carcinoma. This paper reports a case of GOC in a 56-year-old male and reviews the main criteria for accurate diagnosis. The diagnosis of GOC can be extremely difficult due to the rarity of the cyst and lack of clear diagnostic criteria.
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Affiliation(s)
- Hécio Henrique Araújo de Morais
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Estado do Rio Grande do Norte University, Caicó-RN, Brazil
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Zhang L, Sun ZJ, Chen XM, Chen Z. Immunohistochemical expression of SHH, PTC, SMO and GLI1 in glandular odontogenic cysts and dentigerous cysts. Oral Dis 2011; 16:818-22. [PMID: 20561215 DOI: 10.1111/j.1601-0825.2010.01697.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate expression of the sonic hedgehog (SHH) signaling pathway components in glandular odontogenic cysts (GOCs), and dentigerous cysts (DCs). MATERIALS AND METHODS Immunohistochemical staining for SHH, patched (PTC), smoothened (SMO), and the transcriptional factor GLI1 were investigated in the 12 GOCs specimens and 20 DCs. RESULTS In GOCs and DCs, immunoreactivity for SHH, PTC, SMO, and GLI1 were detected in the epithelial cytoplasm. Each of the genes of the SHH signaling pathway was expressed in similar patterns in the epithelial lining of the cysts. The expression of SHH, PTC, SMO, and GLI1 was significantly higher in epithelia than that of subepithelial fibroblasts (P < 0.01). No statistical difference among the labeling index of the epithelial lining among the different cyst types could be revealed. CONCLUSIONS The findings suggest that the proteins of the SHH signaling pathway are predominantly located within the epithelial components of GOCs and DCs. SHH signaling pathway may play a role in epithelial lining formation.
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Affiliation(s)
- L Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China Department of Oral Pathology, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
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Abstract
Glandular odontogenic cyst (GOC) is an unusual entity of jaws, which shows features that overlap with botryoid odontogenic cyst and mucoepidermoid tumor. Glandular odontogenic cyst has an uncertain histogenesis and was recently listed by the World Health Organization as a developmental odontogenic epithelial cyst: it is characterized by an epithelial lining with cuboidal or columnar cells, both at the surface and lining, with crypts or cystlike spaces within the thickness of the epithelium. The radiographic appearance of GOC varies and is not pathognomonic. Several methods of treatment of GOC including curettage, enucleation, and en bloc excision have been used. The recurrence rate of GOC described in literature varies between 21% and 55% according to the different treatment options. We report 2 patients with GOC, describe their clinicopathologic aspects, and discuss the treatment modalities in relation to 2 different clinical situations.
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Macdonald-Jankowski DS. Glandular odontogenic cyst: systematic review. Dentomaxillofac Radiol 2010; 39:127-39. [PMID: 20203274 DOI: 10.1259/dmfr/30943934] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
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.
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Affiliation(s)
- D S Macdonald-Jankowski
- Division of Oral and Maxillofacial Radiology, Faculty of Dentistry, UBC, 2199 Wesbrook Mall, Vancouver V6T 1Z3, BC, Canada.
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Vered M, Allon I, Buchner A, Dayan D. Is maspin immunolocalization a tool to differentiate central low-grade mucoepidermoid carcinoma from glandular odontogenic cyst? Acta Histochem 2010; 112:161-8. [PMID: 19428058 DOI: 10.1016/j.acthis.2008.10.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2008] [Revised: 10/13/2008] [Accepted: 10/27/2008] [Indexed: 01/18/2023]
Abstract
Mucoepidermoid carcinoma (MEC) of the salivary glands has a low-grade variant (LGMEC), which may be found within the jawbones. LGMEC shares a number of histopathological similarities with glandular odontogenic cysts (GOC) of the jawbones. Maspin has been identified in several benign and malignant salivary gland neoplasms. We investigated the immunolocalization of maspin in LGMEC and GOC and evaluated its potential to distinguish between these two entities. Cases of LGMEC (n=6), GOC (n=8) and various odontogenic cysts with marked mucous metaplasia (OCMM, n=7), which served as controls, were immunohistochemically labeled for the binding of an antibody directed against maspin. Immunomorphometry was performed separately for maspin-immunopositive epithelial cells and epithelial-mucous cells in either their nuclear or cytoplasmic compartments. Results were presented as the volume fraction (Vv) of each element. The Vv of the maspin-immunopositive epithelial-mucous cytoplasm and nuclei was significantly higher in LGMEC than in GOC and OCMM (p<0.001 and p=0.026, respectively). In the epithelial cells, no significant differences were observed among the lesions (p>0.05). It is suggested that the high levels of maspin in the epithelial-mucous cells (in both cytoplasm and nuclei) in LGMEC may serve as a tool to distinguish it from GOC. This may be useful especially in equivocal cases and in small incisional biopsy samples.
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Affiliation(s)
- Marilena Vered
- Department of Oral Pathology and Oral Medicine, School of Dental Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
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Anterior Mandibular Swelling. J Oral Maxillofac Surg 2010; 68:436-41. [DOI: 10.1016/j.joms.2009.09.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2008] [Revised: 09/07/2009] [Accepted: 09/14/2009] [Indexed: 11/19/2022]
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Krishnamurthy A, Sherlin HJ, Ramalingam K, Natesan A, Premkumar P, Ramani P, Chandrasekar T. Glandular odontogenic cyst: report of two cases and review of literature. Head Neck Pathol 2009; 3:153-8. [PMID: 19644539 PMCID: PMC2715453 DOI: 10.1007/s12105-009-0117-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Accepted: 04/10/2009] [Indexed: 12/03/2022]
Abstract
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.
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Affiliation(s)
- Anuthama Krishnamurthy
- Department of Oral and Maxillofacial Pathology, College of Dental Surgery, Saveetha University, No: 162, Poonamallee High Road, Velapanchavadi, Chennai, Tamil Nadu, India.
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Kaplan I, Anavi Y, Hirshberg A. Glandular odontogenic cyst: a challenge in diagnosis and treatment. Oral Dis 2008; 14:575-81. [PMID: 18248589 DOI: 10.1111/j.1601-0825.2007.01428.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
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.
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Affiliation(s)
- I Kaplan
- Oral Pathology Service, Institute of Pathology, Rabin Medical Center, Petah-Tiqva, Israel.
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Vargas PA, da Cruz Perez DE, Mata GM, de Almeida OP, Jones AV, Gerhard R. Fine needle aspiration cytology as an additional tool in the diagnosis of odontogenic keratocyst. Cytopathology 2007; 18:361-6. [PMID: 17388930 DOI: 10.1111/j.1365-2303.2007.00444.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to assess the use of fine needle aspiration cytology (FNAC) in diagnosis of odontogenic keratocyst (OKC), as well as to describe the cytological and immunohistochemical features. METHODS Eight consecutive patients submitted to FNAC and diagnosed with OKC were included in this study. FNAC was performed using 24-gauge needles attached to a 10-ml syringe, supported by a mechanical-syringe holder to facilitate aspiration. All cases provided a liquid or viscous content for smears that were either air-dried for Diff-Quick staining or immediately fixed in 95% alcohol and stained by the Papanicolaou technique. Incisional biopsies were carried out to confirm the diagnosis. Immunohistochemical reactions against anti-pan-cytokeratin (CK), CK14 and CK19 were performed in 3 microm sections obtained from cell blocks and biopsy specimens. RESULTS Cytologically many isolated or groups of keratinocytes with normal or ill defined nuclei were seen, besides numerous anucleated squamous cells and keratinous debris. Immunohistochemically, the keratin lamellae were positive for pan-cytokeratin and CK19, but negative for CK14. In biopsy specimens, CK14 expression was restricted to basal cells, while only the superficial cells were positive for CK19. CONCLUSIONS In summary, FNAC is useful, reliable and safe tool for the preoperative diagnosis of OKC.
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Affiliation(s)
- P A Vargas
- Oral Pathology Division, School of Dentistry of Piracicaba, State University of Campinas-UNICAMP, Piracicaba, SP, Brazil.
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