A multicentre study of 268 cases of calcifying odontogenic cysts and a literature review

Extraosseous Calcifying Odontogenic Cyst Initially Interpreted as a Parulis

Extraosseous variants of odontogenic cysts are an infrequent clinical finding, although they have a relatively indolent biological behavior compared to their intraosseous counterparts; due to their nature and clinical appearance, these lesions can be confused with multiple entities that affect soft tissues, so their diagnosis can only be achieved through surgical removal and subsequent histopathological analysis. The extraosseous/peripheral variant of calcifying odontogenic cyst (E/PCOC) has a heterogeneous clinical presentation mainly in terms of size and involvement or not of adjacent anatomical structures such as bone and teeth; in addition, there are few cases reported to date; thus, there are still clinical features to be elucidated. This report presents a child affected by E/PCOC in an unusual location, as well as its therapeutic management, which at first time was suspected of endodontic nature, due to a history of dental trauma.

Peripheral calcifying odontogenic cyst: a case report and comprehensive review of 60 years of literature

Peripheral Calcifying Odontogenic Cyst (PCOC) is the extraosseous form of calcifying odontogenic cyst that is limited to peripheral soft tissue without bony involvement. This case report presents a case of PCOC manifested as a progressive growth of gingival mass in a young male treated with excisional biopsy. Histological examination confirmed diagnosis of PCOC with presence of characteristic ghost cells and sporadic calcifications. No recurrence of the lesion and no complication were noted at three-year follow-up. Review of available literature on PCOC noted a predilection of occurrence in the mandible (61%) and in the anterior area of the jaws (58%). Mean age of patients was 41.7 ± SD25.43 (7-83) and 95% CI [33.6, 49.8] yrs. Mean size of the lesions was 1.38 ± SD1.1 (0.5-4.3) and 95% CI [0.93, 1.83] cm. Gender distribution was noted to be 51.3% male and 48.7% female.

Cystic Lesions of the Jaws: The Top 10 Differential Diagnoses to Ponder

BACKGROUND

Cystic lesions of the gnathic bones present challenges in differential diagnosis. This category includes a smorgasbord of odontogenic and non-odontogenic entities that may be reactive or neoplastic in nature. While most cystic jaw lesions are benign, variability in biologic behavior makes distinction between these entities absolutely crucial.

METHODS

Review.

RESULTS

Two clinical cases are presented in parallel and are followed by an illustrated discussion of the ten most likely differential diagnoses that should be considered when confronted with a cystic jaw lesion. Strong emphasis is placed on the histologic differences between these entities, empowering readers to diagnose them with confidence. Perhaps even more importantly, the more common diagnostic pitfalls in gnathic pathology are discussed, recognizing that a definitive diagnosis cannot be rendered in every situation. The histologic diagnoses for the two clinical cases are finally revealed.

CONCLUSION

Cystic lesions of the maxilla and mandible may be odontogenic or non-odontogenic. The most common cystic lesions are the reactive periapical cyst, and the dentigerous cyst (which is developmental in nature). It is important to note that cystic neoplasms also occur in the jaws, and that the presence of inflammation may obscure the diagnostic histologic features of lesions like odontogenic keratocyst and unicystic ameloblastoma. Ancillary testing is of limited diagnostic value in most scenarios. However, both clinical and radiographic information (such as the location, size, duration, associated symptoms, and morphology of the lesion in its natural habitat) are significantly useful.

Calcifying odontogenic cyst of anterior maxillary: Case report and review

INTRODUCTION AND IMPORTANCE

Calcifying odontogenic cyst (COC) is a rare lesion of jawbone. It is classified among development cyst in the new WHO classification of tumors of the head and neck in 2017. It is a rare pathology, which is found more in the upper maxillae, with a predominance in women in the second or third decade. The diagnosis is based on the analysis of clinical, radiological and histological features.

CASE PRESENTATION

We report the case of a 17-year-old patient referred by his orthodontist following the fortuitous discovery of a mixed radiolucent/radiopaque image in the right jaw ranging from the tooth 11 to the tooth 16, for whom the clinical, radiological examination associated with fine needle aspiration cytology suggested a cystic lesion.

CLINICAL DISCUSSION

Management initially consisted of decompression of the lesion and complete enucleation after nine months. Histopathological examination gave the diagnosis of calcifying odontogenic cyst. The follow-up showed favorable evolution.

A Calcifying Odontogenic Cyst Associated with Compound Odontoma Mimicking a Tooth Germ

Calcifying odontogenic cyst (COC) is a rare cyst that affects mainly the anterior region of the jaws. Generally, it appears as a unilocular radiolucent lesion containing peripheral foci of calcification, but with radiographic variations depending on the type of presentation. Here, we report an atypical case of COC associated with odontoma, initially diagnosed as a tooth germ, in the posterior region of the mandible of a 10-year-old male patient. Interestingly, the radiographic aspect appeared as a unilocular radiolucent lesion without peripheral foci of calcification in the edentulous region, having its size increased after traction of the impacted tooth adjacent to that area. Thus, the case presented in this study is aimed at calling dentists' attention to its developmental changes and related pathologies.

Calcifying odontogenic cysts: A 20-year retrospective clinical and radiological review

OBJECTIVE

Calcifying odontogenic cysts (COCs) exhibit diverse clinical behaviours and may be associated with other benign odontogenic tumours. In this study, the clinical and radiological features of COCs were analysed according to subtypes based on the classification by Praetorius et al. Emphasis was placed on cases exhibiting atypical or aggressive radiological appearances. This information may assist the clinician to better understand the radiological spectrum of COCs.

METHODS

Histologically confirmed cases of COCs were retrospectively reviewed in a 20-year period from three tertiary institutions. The following clinical information was reviewed: patient demographics, main complaint, clinical duration, anatomical site and detailed radiological features.

RESULTS

Twenty-seven cases of COCs were included in the study. Asymptomatic swelling was the main clinical presentation with infrequent reports of associated pain. COCs had an anterior mandibular predilection. Well-demarcated borders were seen in all cases with isolated cases showing focal areas with loss of demarcation. Unilocular lesions were more common than multilocular variants. Internal calcifications were frequent and six cases presented with associated odontomas. Maxillary COCs resulted in the displacement of the maxillary sinus and/or nasal cavity walls. Radiological signs of aggression, including cortical destruction, were noted in a few cases.

CONCLUSION

Given the fact that COCs can present with a spectrum of clinical behaviours and radiological presentations, the academic debate regarding the cystic versus neoplastic nature of the entity is justifiable. The cases in the current sample presented with diverse presentations, ranging from indolent to lesions with significant growth and aggression.

A Brazilian multicentre study of 2,497 isolated cases of odontogenic keratocysts

We present the frequency of cases of isolated odontogenic keratocysts submitted to microscopic examination at 10 Brazilian referral centres in Oral and Maxillofacial Pathology. In a retrospective (1953-2017) analysis, data on clinicoradiographic features and treatment of these lesions were collected and analysed descriptively. Among the 258,867 cases retrieved, 2,497 (0.96%) were isolated odontogenic keratocysts. In summary, an overview of individuals affected with isolated odontogenic keratocysts is reported herein. This lesion showed predilection for the posterior mandible of young adult men.

Adenoid ameloblastoma in the posterior maxilla: a case report and review of the literature

INTRODUCTION

Adenoid ameloblastoma is a rare benign odontogenic tumor that favors a slight predilection for male patients, fourth and fifth decades of life, and posterior regions of the jaws. To date, less than 40 cases have been reported in the English language literature. The radiographic aspects of adenoid ameloblastoma vary from unilocular and well-defined lesions to diffuse and multilocular lesions. Most of the lesions exhibit a radiolucent image and are usually large, with a mean size of 3.5 cm. Microscopically, pseudoductal structures composed of columnar cells in a palisaded arrangement formed from the parenchyma of the tumor were observed.

CASE PRESENTATION

We describe a case of adenoid ameloblastoma in a 54-year-old woman, who presented with no symptoms. Panoramic radiography showed a well-circumscribed, unilocular radiolucency in the left posterior maxilla.

CONCLUSION

As odontogenic tumors are rare, some entities are infrequently encountered, making the diagnosis more difficult. Clinicians, oral and maxillofacial surgeons and oral pathologists should be familiar with the adenoid ameloblastoma and its differential diagnosis for accurate diagnosis and management.

Peripheral Calcifying Odontogenic Cyst: A rare case report

The Calcifying Odontogenic Cyst (COC) is a simple cyst lined by ameloblastoma-like epithelium with ghost cells. The peripheral COC is a rare lesion and few reports have been published considering its clinical and histopathological features. This article aimed to report on a case of a peripheral COC, discussing its clinical, imaginological and histopathological features. A 9-year-old male patient presented a 10x5 mm painless nodule in the palatal mucosa of the left central incisor. Panoramic, occlusal and periapical radiographs did not show alterations. A computed tomography exam showed a slight soft tissue swelling located in the palatal mucosa of the left maxillary central incisor. An excisional biopsy was performed. The histopathological analysis showed a cystic lesion adhered to an oral mucosa fragment and lined by an ameloblastoma-like epithelium with ghost cells. The diagnosis of peripheral COC was established and the patient has been disease-free for 5 years. Although rare, peripheral COC is an important lesion that should be considered as a differential diagnosis of gingival hyperplastic lesions.

Key words:Calcifying odontogenic cyst, odontogenic tumors, peripheral calcifying odontogenic cyst.