Ki-67 expression in dentigerous cysts, unicystic ameloblastomas, and ameloblastomas arising from dental cysts

This study investigated whether or not an ameloblastoma developing in the wall of a dentigerous cyst is a distinct lesion from the unicystic ameloblastoma. An immunohistochemical evaluation of Ki-67 in dentigerous cysts, unicystic ameloblastomas, and ameloblastomas arising in dentigerous cysts was done. The values of Ki-67 positivity were 3.14 for the dentigerous cyst, between 5.32 and 16.56 for unicystic ameloblastoma, and 11.77 for ameloblastoma arising in a dentigerous cyst. Statistically significant differences were found between the dentigerous cyst and the unicystic ameloblastoma and between the dentigerous cyst and the ameloblastoma arising from a dentigerous cyst. No statistically significant difference was present between unicystic ameloblastoma and ameloblastoma arising from dentigerous cyst. These immunohistochemical data confirm the hypothesis that an ameloblastoma arising from a dentigerous cyst has a similar biological behavior to the unicystic ameloblastoma and should be considered as merely a histologic variant.     

Application of cross-sectional imaging in the differential diagnosis of apical radiolucency

A case is described in which exact localization of a cystic lesion associated with the apices of the maxillary central incisor teeth was sought to aid diagnosis and pre-surgical planning. The area was imaged using cross-sectional tomographic slices in the sagittal plane produced by a Scanora® multimodal tomographic unit (Orion Corporation Soredex, Helsinki, Finland). The images demonstrated the cystic lesion arising within the incisive canal, confirming a diagnosis of naso-palatine duct cyst. Surgery was therefore performed via a palatal approach giving direct access to the cyst. Histological examination of the enucleated cyst confirmed a naso-palatine duct cyst.     

MRI of nasoalveolar cyst: case report

Nasoalveolar cyst is a rare nonodontogenic cyst arising in the nasoalar region of the face. In this case, a 39-year-old female had a nontender, fluctuant, soft, round, and bluish lesion in the right anterior gingiva of the right maxilla. Panoramic and magnetic resonance imaging examinatioins were performed. No abnormality was evident on the radiograph. The lesion was hypointense signal intensity on T1-weighted images and hyperintense on T2-weighted images. On sagittal T2-weighted images, a septum could be seen within the lesion. After injection of contrast medium and acquisition of T1-weighted images, enhancement was not observed in the lesion, but was evident at the periphery. The lesion did not enhance with contrast on T1-weighted images, but the periphery was enhanced. The lesion was surgically excised. Histopathologic examination showed the lesion to be a nasoalveolar cyst.     

Aneurysmal bone cyst of the maxilla

An aneurysmal bone cyst of the maxilla is a nonneoplastic, uncommon, solitary bone lesion recognized by distinct radiographic and histopathological characteristics. It is described as a localized and quickly expandable benign tumor, which can reach a considerable size. It is characterized by the replacement of bone by spongy fibro-osseous tissue and a locally destructive and multicystic lesion filled with blood. It is attributed to a circulatory disturbance leading to locally increased venous pressure but with an unclear etiology. It takes place mainly in the long bones and in patients less than 20 years old, with no sex predilection. Its treatment is by surgical excision. An aneurysmal bone cyst in the facial bone is rare. The present case describes the lesion arising in the maxilla of a 14-year-old girl.     

A case of an ameloblastic fibro-odontoma arising from a calcifying odontogenic cyst

This case report describes an ameloblastic fibro-odontoma arising from a calcifying odontogenic cyst (COC) in the mandible of a twenty-three-year old male. The patient was referred to the Department of Oral Surgery, Tokyo Dental College, on March 30th, 2000, complaining of a painful swelling, which had appeared three weeks earlier on his left mandibular molar region. In a pathological view, the lesion was a round cyst the size of a chicken-egg, dark red in color, and surrounded by a thick membrane. The cyst had an epithelium of varying thickness which included many ghost cells and an enamel-like structure on the inside, and a thick wall of connective tissue with an ameloblastic fibro-odontoma on the outside. Enamel organ-like epithelial islands were structured radially in the form of strands with immature dentin. Cytokeratin 19 was strongly immunoreactive in the epithelium of the lesion; osteopontin and osteocalcin reacted in the mesenchymal cells and weakly in the epithelial element of this tumor.     

Radicular cyst associated with a primary first molar: A case report

Radicular cysts arising from deciduous teeth are rare. This report presents a case of radicular cyst associated with a primary molar following pulp therapy and discusses the relationship between pulp therapy and the rapid growth of the cyst. The treatment consisted of enucleation of the cyst sac and extraction of the involved primary teeth and 20 months follow up of the patient. Early diagnosis of the lesion would have lead to a less aggressive treatment plan.     

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.     

Simultaneous occurrence of sublingual dermoid cyst and oral alimentary tract cyst in an infant: a case report and review of the literature

The simultaneous occurrence of sublingual dermoid cyst and oral alimentary tract cyst is very rare. A literature search revealed only two previous cases and one other, where a dermoid cyst was associated with a gastrointestinal microcyst in its cyst wall. We report a case of a six-week-old Caucasian boy, who presented with swelling of the tongue and floor of mouth, which interfered with his normal feeding and swallowing. The swelling was rapidly increasing in size and had become an airway threat. Magnetic resonance imaging (MRI) scans revealed the presence of a lobulated lesion arising in the region of the floor of the mouth on the left and a further lobule which actually invaded the soft tissues of the inferior aspect of the tongue. These two cystic lesions were excised surgically via an intraoral approach and the infant made a complete recovery postoperatively, with resumption of normal feeding and swallowing. The differential diagnoses and approach to sublingual swellings are discussed and the importance of prompt treatment is emphasized.     

Epidermoid cyst of the floor of the mouth: a case report

Dermoid cysts are malformations that are rarely observed in the oral cavity. Histologically, they can be further classified as epidermoid, dermoid or teratoid. We report a case in which a 25-year-old man developed an epidermoid cyst presenting as a large sublingual swelling causing speech and swallowing difficulties. The differential diagnosis for dermoid cysts includes infections, tumours, mucous extravasation phenomena and abnormalities arising during embryonic development. In this case, aspiration of the cyst produced a keratin-containing liquid, which proved to be useful in preoperative diagnosis. The lesion was surgically excised using an intraoral approach. Microscopic examination revealed a dermoid cyst of the epidermoid type. After 12 months of follow up, the cyst had not recurred. This case shows that dermoid cysts may be successfully diagnosed and managed using a series of simple yet effective clinical manoeuvres.     

Aneurysmal bone cyst of the jaws. Report of a case associated with fibrous dysplasia and review of the literature

A case of aneurysmal bone cyst (ABC) of the mandible, recurring for the third time and arising in conjunction with fibrous dysplasia, is reported. A comprehensive review of the literature and analysis of over 50 cases of ABC of the jaws yielded the following results: ABCs of the jaws constitute 1.5 % of all non-odontogenic and non-epithelial cysts of the jaws, and 1.9 % of all ABCs of the skeleton. The mandible was affected in 55 % of the cases, the maxilla in 45 % of the patients. Females represented 53 % of the patients and males the remaining 47 %. Seventy-four percent of the ABCs occurred in patients 20 years old and younger. This lesion is regarded as non-neoplastic and as most likely secondary to a pre-existing bone lesion. Our review established that 21 % of the reported cases in the jaws had developed in association with various primary lesions of bone, including fibro-osseous lesions. The primary bone lesion initiates an osseous, arteriovenous fistula which, through its hemodynamic forces, creates a secondary reactive lesion, that is an aneurysmal bone cyst. We also established a recurrence rate of 26 %, based upon previously reported cases as well as our own. The treatment of choice is surgical curettage with cryosurgery and immediate packing with bone chips.     

Ghost cell odontogenic carcinoma arising in the background of a calcifying odontogenic cyst

Ghost cell odontogenic carcinoma (GCOC) is a rare malignant neoplasm, representing 3% of all ghost cell lesions of the jaws. They can arise de novo or from a pre-existing calcifying odontogenic cyst (COC) or dentinogenic ghost cell tumour (DGCT). A systematic review of the literature reported only 12 cases of a GCOC arising from a pre-existing COC. This report highlights an additional case of a GCOC arising from a pre-existing COC after 3 years in an adolescent male. The patient initially presented with a painless swelling of the right mandibular corpus. Panoramic radiographic examination showed an expansive unilocular radiolucent lesion. After 3 years, the radiographic features appeared more aggressive with increased expansion and cortical perforation. A wide surgical resection was performed, whereby the lesion was diagnosed as a GCOC. Due to the rarity of these malignant neoplasms, limited information is available regarding their biological behaviour. One-year follow-up revealed no clinical signs of recurrence.

     

A radiolucent lesion crossing the midline in maxilla: a rare presentation of odontogenic keratocyst in young patient

Odontogenic Keratocyst (OKC) is a developmental non-inflammatory odontogenic cyst which is proposed to be arising from cell rests of dental lamina. Among the jaw cysts OKCs account for third most common following radicular and dentigerous cyst. Most of the studies have stated that posterior part of the mandible is the most common site, but there are inconsistencies regarding the prominent location of OKCs in the maxilla. Very few studies and cases are reported with OKCs crossing maxillary midline. If do occur they are in older individuals. According to WHO reclassification, this cyst is considered as Keratocystic Odontogenic Tumour (KCOT) because of its neoplastic nature. This article describes a rare site of occurrence of this lesion especially in young patient.     

Aneurysmal bone cyst of the mandible--a case report

Aneurysmal bone cysts originating in the craniofacial region have seldom been reported in Taiwan. A case of aneurysmal bone cyst arising in the right mandible of a 15-year-old Chinese boy was presented with both the roentgenographic and microscopic findings. In view of the high recurrent rate and the large destructive mandibular lesion, segmental resection with immediate bone grafting for reconstruction and a conscientious follow up regimen was employed. The etiology and pathogenesis of this interesting lesion remained unclear but several theories were reviewed and the differential diagnosis of this lesion was also discussed. Furthermore, immunoperoxidase staining for Factor VIII related antigen was performed to help differentiate between the aneurysmal bone cyst and a central hemangioma and then to elucidate the pathogenesis of the former.     

Ameloblastic Carcinoma of the mandible

Odontogenic carcinomas are rare lesions arising from dental embryogenic residues and have been designated by a variety of terms like malignant ameloblastoma, ameloblastic carcinoma, metastatic ameloblastoma or primary intra-alveolar epidermoid carcinoma. Ameloblastic carcinoma combines the histological features of ameloblastoma with cytological atypia, even in the absence of metastasis. The lesion has been reported to arise either from the odontogenic cyst or the ameloblastoma. Majority originate de novo and the remaining are malignant transformation of an ameloblastoma.     

Zystische Halslymphknotenmetastasen als Hinweis auf ein okkultes Tonsillenkarzinom

Background. Cystic carcinomas of the neck without evidence of a primary tumor are diagnostically challenging lesions. Differentiation between a cystic lymph node metastasis of an occult primary tumor and a carcinoma arising in a branchiogenic cyst is frequently not possible even with histological examination. In order to clarify the diagnosis, an intensive search for a primary lesion in the upper aerodigestive tract must be carried out. Diagnosis. An occult carcinoma might be situated in Waldeyer’s ring, especially in the tonsillar crypts. These tumors tend to produce cystic metastases in the jugulodigastric region. Therefore, multiple biopsies have to be taken from the tissue of Waldeyer’s ring. In the case of a positive histological result, adequate therapy of both the primary and the metastasis can be carried out. The diagnosis of a malignant branchiogenic cyst is only permissible after a primary lesion has been thoroughly excluded.     

Cystic ameloblastoma. A clinicopathologic analysis

Thirty-three cases of ameloblastoma arising from odontogenic cyst linings are presented. Lesions of this nature have been referred to as "unicystic ameloblastoma." Our data support the findings of others in that this lesion differs from the solid invasive varieties of ameloblastoma, as the former occurs in a younger age group and exhibits a low rate of recurrence following enucleation or curettage. On the basis of histopathologic features we provide evidence that these lesions represent mural and luminal ameloblastomatous change in a pre-existing cyst rather than cystic degeneration of a solid tumor.     

Paradental cyst: report of two cases

BACKGROUND: The paradental cyst is an odontogenic lesion of inflammatory origin that has few clinical signs and symptoms apart from recurring acute episodes. A well-defined radiolucency associated with the roots or distal to the crown may be seen radiographically. The purpose of this article is to report on different aspects of two cases involving paradental cysts. In the first case, the patient complained about recurring pericoronitis. A semilunar-shaped radiolucency on the distal aspect of the mandibular third molar was noted on the periapical radiograph. In the second case, the patient's main complaint was chronic trauma of the overlying mucosa. Radiographs revealed an enlarged pericoronal space. METHODS: In both cases, the mandibular third molar was extracted due to a lack of space. Lesional samples were sent for histopathologic analysis. RESULTS: In the first case, the drainage of cystic fluid and a regular concavity were found during tooth removal. In the second case, a nodular lesion was found adhering to the disto-buccal surface of the tooth arising from the distal wall of a periodontal pocket. The histopathologic analysis revealed a hyperplastic stratified squamous epithelium with arcading lining a fibrous capsule with inflammatory infiltrate, resulting in a final diagnosis of a paradental cyst. CONCLUSIONS: The presence of a paradental cyst should be considered when recurrent inflammatory periodontal processes are associated with partially erupted vital teeth, even when characteristic radiographic findings are absent. Definitive diagnosis requires a clinicopathologic correlation incorporating surgical, radiographic, and histologic findings.     

Primary intraosseous squamous carcinoma. Report of two cases.

Two cases of primary intraosseous squamous carcinoma (PIOSC) are reported. One PIOSC is in the mandible of a 24-year-old man and appears to be a keratinizing PIOSC arising de novo. The other PIOSC presented in the edentulous maxilla of a 56-year-old man and was diagnosed as a PIOSC arising from an odontogenic cyst. The 2nd tumor subsequently metastasized to a cervical lymph node. Previous reports have noted a favorable prognosis for PIOC arising in odontogenic cysts, and only 3 other instances of metastases of a PIOSC in an odontogenic cyst have been documented.     

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.