Primary intraosseous carcinoma arising from an odontogenic cyst: a case report and review of the Japanese cases

A rare case of primary intraosseous carcinoma (PIOC) arising from an odontogenic cyst in a 58-year-old man is reported. Clinical and radiological examinations revealed an odontogenic cyst of the maxilla. Histopathologically, the lesion was composed of a cyst with a parakeratotic epithelial lining and well-differentiated squamous cell carcinoma, showing continuity between them without a connection to the oral mucosa. Twenty-eight well-documented Japanese cases of Type-1 PIOC, including the present case, were reviewed. The mean age of the 28 patients was 56.1 years, and the male to female ratio was 1.8:1.0. Compared with currently reported Japanese reviews of Type-3, foreign Type-1 and Type-3, there were no significant differences in mean patient age and sexual predominance, and no racial difference. The pathogenesis of Type-1 PIOC is also discussed.     

Ameloblastoma arising in calcifying odontogenic cyst. Report of a case.

An unusual case of an ameloblastoma with adenoid-cribriform features arising in calcifying odontogenic cyst is reported. A possible relationship between this peculiar variant of calcifying odontogenic cyst and a conventional ameloblastoma is discussed.     

Primary intraosseous squamous cell carcinoma arising in a mandibular keratocyst.

Primary intraosseous carcinoma (P1OC) of the jaws is rare. They either arise de novo or as a consequence of malignant transformation of a benign cyst or tumor. A 56-year-old patient with a P1OC of the mandible arising from an odontogenic keratocyst is described.     

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.     

Obturator after marsupialization of a recurrence of a radicular cyst of the mandible

The radicular cyst is the most common odontogenic cyst. We present the case of a 51-year-old man with an extended recurrence of a radicular cyst of the mandible that was treated with marsupialization. Subsequently, an obturator was fitted, and in 10 months a resolution (clinically and radiographically) of the cystic cavity was noticed without any signs of recurrence. The marsupialization is a well-established, nonaggressive treatment of large odontogenic cysts and shows advantages in preserving vital structures, with reduced risk of pathological mandibular fractures. The patient, however, must be compliant and accept the prolonged treatment of marsupialization.     

Primary intraosseous carcinoma of the jaws arising from an odontogenic cyst--a case report.

BACKGROUND: Squamous cell carcinoma of the jaw located purely in the bone is extremely rare. Most of these intraosseous carcinomas, also called odontogenic carcinomas are thought to arise from the epithelial lining of an odontogenic cyst. CASE REPORT: A primary intraosseous carcinoma arising from an odontogenic cyst in a 64-year-old woman is reported. No subjective symptoms were noted by the patient. Multiple retained teeth with associated presumed cystic lesions were evident in the lower jaw on a routine radiograph. Histology revealed an intraosseous carcinoma after removal of the teeth and "cystectomy". No metastasis was detected. Segmental resection of the mandible, selective neck dissection and reconstruction with an iliac bone graft was performed. The patient is free of disease after 3 years. CONCLUSION: Although primary intraosseous carcinoma is rare, this case emphasizes the importance of careful histological examination of apparently innocuous odontogenic cysts. In addition, as malignant changes in their epithelial lining are always possible, "cystic" lesions should not only be removed but as completely as possible.     

Peculiar case of orthokeratinised odontogenic cyst: a peripheral counterpart of the intraosseous entity?

We describe a case of an orthokeratinised odontogenic cyst (OOC) in a 49-year-old man, which presented as a submucosal fluctuant, non-tender, soft nodule distal to the inferior right first molar that could be considered a peripheral counterpart of the intraosseous OOC.     

Calcifying epithelial odontogenic tumor of the mandible with cyst formation

We encountered a rare case of a calcifying epithelial odontogenic tumor with cyst formation. The patient was a 28-year-old man with swelling in the anterior mandibular region. Panoramic and intraoral imaging showed a clear, unilocular, radiolucent lesion with bony boundaries. Many small radiopacities were apparent in the radiolucent area. Clinically, the lesion was thought to represent an odontogenic tumor involving calcified bodies. Multidetector row computed tomography showed small radiopaque bodies arranged in a regular circular manner on the outer rim of the radiolucent region, which showed an attenuation value of approximately +20 Hounsfield units. This appearance strongly suggested a calcifying cystic odontogenic tumor, and the final diagnosis was a calcifying epithelial odontogenic tumor with cyst formation. According to the 2005 World Health Organization Classification of Tumours, cystic changes are not seen macroscopically in calcifying epithelial odontogenic tumors. We thus consider this to be a very rare and interesting case.     

Odontogenic ghost cell carcinoma: a case report with immunohistochemical and ultrastructural characterization

Folpe AL, Tsue T, Rogerson L, Weymuller E, Oda D, True LD: Odontogenic ghost cell carcinoma: a case report with immunohistochemical and ultrastructural characterization. J Oral Pathol Med 1998; 27: 185-9. C Munksgaard, 1998. The odontogenic ghost cell tumor (OGCT) is the rare, neoplastic variant of the calcifying odontogenic cyst (COC). To date, there have been only four reports of malignant OGCTs, in five patients. We report an additional case of a malignant odontogenic ghost cell tumor that involved the right maxilla of a 20-year-old man. Our report includes its immunocytochemical and ultrastructural characterization.     

Carcinoma arising from reduced enamel epithelium

Intra-osseous squamous cell carcinomas are considered to be derived from odontogenic epithelium. Except for an associated benign odontogenic tumor or a cyst, evidence for an odontogenic origin is only circumstantial. In a 73-year-old male, an intra-osseous squamous cell carcinoma in the mandible could be shown to have originated from reduced enamel epithelium. There were no histological features substantiating the odontogenic origin, other than the continuity of tumor epithelium with reduced enamel epithelium surrounding the crown of an impacted molar tooth. Thus, it is concluded that the odontogenic derivation of an intra-osseous squamous cell carcinoma in the jaw cannot be inferred from specific histological features, but should be based on the exclusion of an oral cavity lining epithelial origin. Still more proof is the demonstration of continuity of the carcinoma with odontogenic epithelium, be it normal, cyst lining or benign odontogenic tumor.     

Carcinoma arising from reduced enamel epithelium

Intra-osseous squamous cell carcinomas are considered to be derived from odontogenic epithelium. Except for an associated benign odontogenic tumor or a cyst, evidence for an odontogenic origin is only circumstantial. In a 73-year-old male, an intra-osseous squamous cell carcinoma in the mandible could be shown to have originated from reduced enamel epithelium. There were no histological features substantiating the odontogenic origin, other than the continuity of tumor epithelium with reduced enamel epithelium surrounding the crown of an impacted molar tooth. Thus, it is concluded that the odontogenic derivation of an intra-osseous squamous cell carcinoma in the jaw cannot be inferred from specific histological features, but should be based on the exclusion of an oral cavity lining epithelial origin. Still more proof is the demonstration of continuity of the carcinoma with odontogenic epithelium, be it normal, cyst lining or benign odontogenic tumor.     

Central mucoepidermoid carcinoma. Review of the literature and report of a case associated with an apical periodontal cyst

Mucoepidermoid carcinoma arising centrally within the jaws is a rare lesion which exhibits considerable histologic variability and an unpredictable clinical course. Its specific pathogenesis is unknown, although speculation has centered on the pluripotential capabilities of the epithelial lining of odontogenic cysts. The case presented here illustrates the relationship of such a lesion arising from the cyst wall of an apical periodontal cyst.     

Neoplastic potential of odontogenic cysts

Odontogenic cysts and tumors are distinct entities and quite a common occurrence in the jaw bones. The lining of odontogenic cysts shows a potential for neoplastic transformation to non odontogenic malignancies like squamous cell carcinoma and mucoepidermoid carcinoma, and odontogenic tumors like ameloblastoma and adenoamatoid odontogenic tumor (AOT). AOT is a benign, epithelial odontogenic tumor, common site being the anterior maxilla. Its origin from a dentigerous cyst and in the mandible is rare. A case of an AOT arising from a dentigerous cyst associated with an impacted permanent mandibular left lateral incisor is reported.     

Squamous cell carcinoma arising in an odontogenic cyst

Squamous cell carcinoma arising is an odontogenic cyst is rare, Eversole finding 36 cases in his review of the literature in 1975. Since then, a further 10 have been recorded in the English literature. We now report another case and describe its management. The need to histologically examine all odontogenic cysts is stressed.     

An unusual adenomatoid odontogenic tumor presenting as a residual cyst

An unusual case of adenomatoid odontogenic tumor of a 68-year-old edentulous man is presented. Clinically the lesion appeared to be a residual cyst of the maxillary canine region. This case varies from the norm with respect to age of the patient and clinical features.     

Recurrent calcifying odontogenic cyst

This article reports a recurrence of a calcifying odontogenic cyst which occurred 5 years after the initial treatment. To date all recurrences of calcifying odontogenic cysts have been in elderly persons. The present recurrence was in an 11-year-old girl.     

Odontogenic cyst with verrucous proliferation

An unusual case of an odontogenic cyst with verrucous proliferation is described in a 13-year-old girl. This histologically distinctive odontogenic cyst variant does not appear to have been reported previously. The cyst was characterised by a series of verrucous projections in the lumen with hypergranulosis and cells resembling koilocytes, raising the possibility of a viral aetiology. However, no evidence of human papillomavirus (HPV) was found using immunohistochemistry and polymerase chain reaction (PCR) amplification.     

Case report of a pigmented dentigerous cyst and a review of the literature on pigmented odontogenic cysts

This paper reports the first case of a dentigerous cyst containing melanin-pigment and melanocytes in the lining epithelium, and the first case of a odontogenic cyst with macroscopically visible pigmentation in the cyst wall. The patient was a 29-year-old Japanese male with a cystic lesion in the left retromolar area of the mandible. Pathologic examination revealed the lesion to be a dentigerous cyst with or without mild surface keratinization, and numerous granules of melanin-pigment were distributed in the basal cells of the epithelial lining. Furthermore, dendritic melanocytes were scattered in the basal layer. Review of the literature revealed that pigmented odontogenic cysts are uncommon, and only 11 cases have been documented; eight were odontogenic keratocyst, one was a gingival cyst, one was a botryoid odontogenic cyst, and one was a lateral periodontal cyst. The possible origin of melanocytes in odontogenic lesions is discussed.     

Calcifying odontogenic cyst presenting as a lateral periodontal cyst--a case report

We report a case of the calcifying odontogenic cyst occurring on the left anterior mandible of a 41-year-old male with clinical and radiographic features which made it initially to be a lateral periodontal cyst. This unusual presentation of a calcifying odontogenic cyst is discussed and its significance for the clinician is reviewed. A calcifying odontogenic cyst may present some problems for the differential diagnosis both clinically and histopathologically. The differential diagnosis of a lesion occurring in a lateral periodontal location should include the calcifying odontogenic cyst.