Organization as a benign tumor, odontogenic keratocyst is an intraosseous lesion of the maxilla with a destructive and invasive behavior, high recurrence rate 25% to 62. This neoplasia is predominantly found in males and people of white origin. These cysts arise from the epithelial components of the odontogenic apparatus or its remnants that lie entrapped within bone or in the gingival tissue 1. A 10year study on the incidence of oral maxillofacial lesions in the department of oral maxillofacial. First described by philipsen in 1956, the odontogenic keratocyst is characterized by a large squamous keratinization of its border, an aggressive growth and a high recurrent rate. The majority of patients are in the age ranges of 2029 and 4059 years, 4 but cases ranging from 5 to 80 years have been reported. Formerly known as okc, keratocystic odontogenic tumor kcot is defined as a benign unicystic or multicystic, intraosseous tumor of odontogenic origin, with a characteristic lining of parakeratinized stratified squamous epithelium and potential for aggressive, infiltrative behavior. Conservative management of keratocystic odontogenic tumors of.
Recurrent keratocystic odontogenic tumor in the mandible. The odontogenic keratocyst okc is the most likely cyst to recur after treatment. It is of particular interest that relationship between keratocystic odontogenic tumors clinical and molecular features. In an analysis of loss of heterozygosity loh for several tumor suppressor genes in sporadic kcots, frequency of allelic loss was 66% for p53 and 60% for ptch gene. Multiple odontogenic keratocyst, surgical management.
Sometimes associated with nevoid basal cell carcinoma syndrome gorlin syndrome. Reconstruction of extensive jaw defects induced by. Diagnosing the most common odontogenic cystic and osseous. A reconstruction of the 60 patients local oral mucosa was also performed with skin graft. Case report keratocystic odontogenic tumor with an ectopic. Keratocystic odontogenic tumor kcot, formerly regarded as odontogenic keratocyst, is a benign neoplasm of odontogenic origin.
Intrabony cysts are most common in the jaws, because the mandible and maxilla are the only bones with epithelial components. Odontogenic keratocyst cysts of the oral and maxillofacial. Surgical management of dentigerous cyst and keratocystic. Case report keratocystic odontogenic tumor simulating lateral. The relationship between radiological features and.
Morphometric evaluation of keratocystic odontogenic tumor. Patients with larger lesions may present with pain secondary to infection of the cystic cavity. Keratocystic odontogenic tumors kcot has been defined by the world health organization as a benign intraosseous neoplasm of odontogenic origin with characteristic lining of the parakeratinized squamous epithelium 1. Odontogenic keratocyst okc has been the subject of great interest since philipsen introduced the term in 1956. Odontogenic keratocyst an overview sciencedirect topics. Keratocystic odontogenic tumor formerly odontogenic keratocysts koct is a unique cyst because of its locally aggressive behavior, high recurrence rate, and characteristic histological appearance and comprises approximately 11% of all cysts of the jaws. Histological findings were epithelioid hemangioendothelioma with indications for radical resection of both the bone affected o. The odontogenic keratocyst is a very well known odontogenic cyst.
Keratocystic odontogenic tumor odontogenic keratocyst. Keratocystic odontogenic tumor occurrence in the maxilla is unusual and its appearance in the maxillary sinus is very rare. The presentation of odontogenic keratocysts in the jaws with an. This is the most unodontogenic tumor of the group, the tumor cells do not resemble odontogenic tissue.
Giant keratocystic odontogenic tumor of the maxillary sinus. There are many types of cysts of the jaws, but what makes the odontogenic keratocyst unusual are its characteristic histopathological and clinical features, including potentially aggressive behaviour, high recurrence rate, and an association with the nevoid basal cell carcinoma syndrome. Odontogenic keratocyst okc has been a subject of great interest since philipsen introduced the term in 1956. The term odontogenic keratocyst was first used by philipsen in the year 1956. All the singular characteristics of this pathology have originated controversy in the scienti. Odontogenic cyst are a group of jaw cysts that are formed from tissues involved in odontogenesis tooth development. It has the potential for infiltration and local aggressiveness and has a high rate of recurrence. Keratocystic odontogenic tumors clinical and molecular features. Removal of the entire cyst associated with the extraction of the impacted tooth is the main treatment to prevent recurrence of odontogenic cystic lesions. Neville, keratocystic odontogenic tumor, encyclopedia of soil science, 10.
Various odontogenic cysts have been associated with. Keratocystic odontogenic tumor kcot is a odontogenic neoplasm of jaw which has high recurrence po tential. The radiographic appearance is one of a unilocular or multilocular wellcircumscribed. Keratocystic odontogenic tumor definition a benign uni or multicystic, intraosseous tumor of odontogenic origin, with a characteristic lining of parakeratinized stratified squamous epithelium and potential aggressive, infiltrative behaviour. The peak incidence is seen between 11 and 40 years of age. Intrabony cysts are most common in the jaws, because the mandible and maxilla are the only bones with epithelial. In 2005, the world health organization renamed the lesion previously known as an odontogenic keratocyst as the keratocystic odontogenic tumor.
Case report keratocystic odontogenic tumor simulating. The world health organization who has renamed the odontogenic keratocyst the odontogenic keratocystic tumor okt based mostly on the. Keratocystic odontogenic tumour kcot is considered one of the most. Odontogenic cysts are closed sacs, and have a distinct membrane derived from rests of odontogenic epithelium. Odontogenic tumors, as in normal odontogenesis, are capable of inductive interactions between odontogenic ectomesenchyme and epithelium, and the classification of odontogenic tumors is essentially. Ameloblastoma, a type of odontogenic tumor involving ameloblasts. Keratocystic odontogenic tumors kcot comprise a unique pathological entity. The okc was designated by the world health organization who in 2005 as a keratocystic odontogenic tumor kcot and is defined as a benign uni or multicystic, intraosseous tumor of odontogenic origin, with a characteristic lining of parakeratinized stratified squamous epithelium and. Keratocystic odontogenic tumors kcots are benign tumors that comprise 11% of all cysts of the jaws, worldwide 12. Keratocystic odontogenic tumor with an ectopic tooth in maxilla.
Odontogenic tumors, as in normal odontogenesis, are capable of inductive interactions between odontogenic ectomesenchyme and epithelium, and the classification of odontogenic tumors is. A 10year study on the incidence of oral maxillofacial. The usual clinical presentation includes a painless swelling with expansion of the jaws. Kcots are characterized by aggressive behavior and a high recurrence rate following surgical treatment. Although first described in 19562, its etiopathogenesis is not yet entirely clear. It is also the most controversial cyst in both terminology and in treatment. Keratocystic odontogenic tumors clinical and molecular.
Odontogenic keratocyst radiology reference article. Even though there are classical clinical features for each of the odontogenic lesions, at times, it may be difficult to arrive at a clinical. Keratocystic odontogenic tumour canadian dental association. The keratocystic odontogenic tumour kcot is a benign intraosseous.
The newly acknowledged neoplastic potential and its implications for treatment strategies are also discussed. Keratocystic odontogenic tumor, odontogenic tumor, odontogenic cysts, impacted teeth, incidence, retrospective study how to cite. The last world health organization who classification of odontogenic tumors called odontogenic. This study involved a pooled analysis of japanese individuals with nbccs and was performed with the aim of analyzing the clinical features of nbccs and the patterns of occurrence and recurrence of kcots in japanese individuals. Keratocystic odontogenic tumor kcot in the jaws arise from the cell rests of dental lamina and are usually seen during the second to fourth decades of life with a slight male predilection. The mandible or maxilla is exposed in a subperiosteal plane, taking care to excise.
Cystic lesions of the jaws a clinicopathological study of. Keratocystic odontogenic tumor kcot is a benign cystic neoplasia of jaw bone. Jaw tumors and cysts symptoms and causes mayo clinic. Multilocular giant radicular cyst of maxilla mimicking. Pdf keratocystic odontogenic tumor a diagnostic dilemma. They are the prevalent tumors of the jaws in the age group studied herein. Keratocystic odontogenic tumor of mandible bohra a, udawat v. There are many types of cysts of the jaws, but what makes the odontogenic keratocyst unusual are its characteristic histopathological and clinical features, including potentially aggressive behaviour, high recurrence rate, and an association with the nevoid basal cell carcinoma.
Cysts and tumors of the jaws treated by marsupialization roderic. Lewis key points computed tomography can be highly specific in the diagnosis of mandibular masses given an organized approach that considers both odontogenic and nonodontogenic tumors and cysts. Resection technique is the same as for most benign tumors ofthe jaws. Because of its features, the keratocystic odontogenic tumor must have more aggressive treatment, compared with odontogenic cysts, and longterm followup is mandatory. The clinical features associated with the keratocystic odontogenic tumor show it to be a unilocular or multilocular radiolucency, occurring most frequently i. Surgical conservative approach of odontogenic keratocyst. Marx, in current therapy in oral and maxillofacial surgery, 2012 odontogenic keratocyst.
Keratocystic odontogenic tumors kcots are benign tumors that comprise 11% of all cysts of the jaws, worldwide2. The odontogenic keratocyst is a relatively common developmental odontogenic cyst that represents approximately 10% to 14% of all jaw cysts. Cell proliferation and apoptosis in ameloblastomas and. Odontogenic keratocysts, keratocystic odontogenic introduction destructive lesions affecting the jaws. It is defined by its characteristic microscopic features, which include basilar nuclear palisading and the production of keratin. They have a remarkable growth capacity and manifest extensive bone resorption, showing a superior overall growth performance to other odontogenic cysts. At that time, it was believed to be a benign, but potentially aggressive and. An odontogenic tumor is a neoplasm of the cells or tissues that initiate odontogenic processes examples include. Keratocystic odontogenic tumor kcot keratocystic odontogenic tumors kcots show a slight predilection for males and are predominantly found in individuals of northern european descent. Nov 10, 2009 the keratocystic odontogenic tumor is a benign developmental tumor with many distinguishing clinical and histologic features.
The keratocystic odontogenic tumour kcot is a benign intraosseous odontogenic lesion relatively frequent in the oral cavity. Keratocystic odontogenic tumour of lesions treated in our clinic. Tumor cells are squamouslike, they even have desmosomal. Keratocystic odontogenic tumors kcots of the jaws are a common manifestation of this syndrome.
Keratocystic odontogenic tumor in the maxillary sinus. Or primordial cyst and odontogenic cysts or jaw cysts or developmental odontogenic cysts. Massive keratocystic odontogenic tumor of mandible. There were 18 lesions in the posterior mandible, 3 in the anterior mandible and. Characteristic features are i a parakeratinized surface which is typically corrugated, rippled, or wrinkled. Although kcots can occur in any part of the jaws, the vast majority of the lesions are located in the mandible, from 69% to 83% of all diagnosed cases, 14. Pindborg of denmark described four cases of an unusual odontogenic tumor that still bears his name.
In this paper, we shall present one case report of a keratocyst, which derived from an impacted canine. It has unique histopathological and clinical behavior because of. Okc was accepted as a neoplastic lesion in the 2005 who classification and it was called keratocystic odontogenic tumor kcot. The relationship between radiological features and clinical. Here, we discuss a rare case of keratocystic odontogenic tumor occurring in the maxilla with an ectopic tooth position. This tumor is so rare that it deserves little discussion. Conservative management of keratocystic odontogenic tumors of jaws. Giant keratocystic odontogenic tumor of the maxillary. Investigations continue into the lesions pathologic classification, diagnosis and. Keratocystic odontogenic tumor with an ectopic tooth in. Kcots comprise 12% of all odontogenic cysts of the jaws. Clinical manifestations and treatment for keratocystic. Jan 06, 2017 odontogenic cysts, odontogenic tumors, fibroosseous, and giant cell lesions of the jaws.
In the whoiarc classification of head and neck pathology, this clinical entity had been known for years as the odontogenic keratocyst. Treatment consisted of enucleation and curettage for 22 of the lesions, resection. Odontogenic keratocyst okc can be classified as an oral lesion representing the third most common cyst of the jaws characterized by a high rate of recurrence. Raucharernporn s, kriangcherdsak y, chaiyasamut t, prachyamuneewong j, wongsirichat n. Comprehensive management of keratocystic odontogenic tumor of. In 2017 it reverted to the earlier name, as the new whoiarc classification reclassified okc back into the cystic category. The term odontogenic keratocyst okc was first used by philipson in 1963 and its clinical and histologic features were confirmed by browne in 1970 and 1971. Aug 11, 2009 the odontogenic keratocyst is a very well known odontogenic cyst. Diagnostic and treatment features of keratocystic odontogenic tumors. The disease commonly occurs between the ages of 1030 years, predomi. Kcots are found in the mandible, especially the posterior portion of the body, approximately twice as much as in the maxilla. According to cysts size, location, and relations with surrounding structures, they are treated by enucleation. Conservative management of keratocystic odontogenic tumors.
Introduction a keratocystic odontogenic tumor kot is a benign neoplasm of the jaws that originates either from a dental lamina or from the primordial odontogenic epithelium. Cystic lesions of the jaws international journal of medical sciences. Squamous cell carcinoma arising from an odontogenic. Keratocystic odontogenic tumors can occur in any area of the maxilla or mandible. Maxillary peripheral keratocystic odontogenic tumor. A recurrence case of keratocystic odontogenic tumor. It has a locally aggressive behaviour and exhibits a high propensity to recur after treatment. Odontogenic keratocyst keratocystic odontogenic tumor figs. Keratocystic odontogenic tumour an overview sciencedirect. Kcots are twice more frequent in the mandible than in the maxilla6.
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