A pigmented dentigerous cyst in a patient with multiple dentigerous cysts of the jaws: a case report

AIM: The aim of this article is to report an unusual and interesting case of non-syndromic multiple dentigerous cysts of the maxilla and mandible associated with melanin pigment and melanocytes in the epithelial lining in one of the cysts. In addition, embryologic aspect and origin of melanocytes are briefly discussed. BACKGROUND: Dentigerous cysts are the second most common odontogenic cysts after radicular cysts. They are usually solitary with multiple cysts reported on occasion in association with syndromes. While melanocytes and melanin-pigment are widely distributed in the skin, the nervous system, certain types of mucosa, uveal tract, and other areas, they are not normally present within bone in mammals. REPORT: A 37-year-old Iranian male was referred to an oral surgeon by his dentist for evaluation and treatment of multiple cyst-like radiolucent lesions around the crowns of some unerupted permanent teeth in both maxillary and mandibular anterior areas. The biopsy revealed numerous granules of melanin-pigment distributed throughout the epithelial lining of one of these cysts in addition to the characteristic histopathologic features of adentigerous cyst. Histochemical analysis confirmed the pigment was melanin, and many of the cells containing melanin were immunohistochemically positive for s-100 protein. SUMMARY: Although the specific origin and pathologic significance of the melanocytes described here cannot be explained, it may be of interest for future investigations.     

Calcifying odontogenic cyst: case report and review of literature

A case of calcifying odontogenic cyst is presented. An analysis of the previously reported cases indicates the variable clinical, radiographic and histopathologic features of the lesion.     

Glandular odontogenic cyst: A case report and literature review

In 1992, the World Health Organization (WHO) named glandular odontogenic cyst (GOC) as an independent pathologic entity and classified it as a developmental odontogenic epithelial cyst.^1,2 The WHO defined this lesion as “a cyst arising in the tooth-bearing areas of the jaws and characterized by an epithelial lining with cuboidal or columnar cells both at the surface and lining crypts or cyst-like spaces within the thickness of the epithelium.”¹GOCs occur over a wide age range in both sexes and in either jaw, and have the propensity to recur and to become large. Radiographically, the GOC appears as an intrabony, unilocular or multilocular, sometimes honeycomblike, well-defined radiolucent lesion. Histologically, the lining epithelium may be partly squamous, without distinctive features.¹ However, in many areas, the stratified epithelium has a surface layer of eosinophilic cuboidal or columnar cells, often forming irregular papillary projections.¹ A variable number of ciliated and mucus-producing cells may also be interspersed in the surface layer.¹ Within the thickness of the epithelium there may be crypts and glandular or cystlike spaces lined by cells similar to those seen in the epithelial surface.¹ Pools of mucous material within the intraepithelial spaces and within the main cyst cavity are a prominent feature. Plaquelike and whirlpoollike epithelial thickenings also may be present.¹ The fibrous capsule is usually free of inflammatory cells.¹ Multicystic or botryoid varieties also occur.¹ Because this lesion has been characterized only recently, and only a few cases have been reported in the literature,^3–8 its biologic nature is uncertain.^1,2 However, the aggressive behavior and the recurrent tendencies of this lesion have been suggested,^1,2 even in the limited number of reported cases.^3–8We report a case of GOC that exhibited histologic features suggesting the aggressive and somewhat neoplastic nature of this lesion. Furthermore, the clinicopathologic features of 17 cases reported in the literature^3–8 are reviewed, and the differential diagnosis of this rare lesion, especially from central low-grade mucoepidermoid carcinoma (MEC), as well as its treatment, are also discussed.     

Glandular odontogenic cyst: case report and review of the literature.

Glandular odontogenic cyst (GOC) is a rare developmental cyst of the jaws. It is included in the World Health Organization (WHO) histologic typing of odontogenic tumors under the terms glandular odontogenic cyst or sialo-odontogenic cyst. The most common site of occurrence is the anterior mandible, and it occurs mostly in middle-aged people. A predilection for men is observed. Clinical findings are not specific, and an asymptomatic swelling is frequently observed. A unilocular or multilocular, well-defined radiolucency is usually seen. The microscopic features of GOC, particularly the morphology of the epithelium, strongly suggest an origin from the remains of dental lamina. GOC has an unpredictable and potentially aggressive nature, which may indicate a high tendency of recurrence. The treatment of choice is still controversial, varying from a curettage to local block excision. A long-term follow-up should be carried out. The aim of this article is to report a case of glandular odontogenic cyst that recurred four times and to emphasize the importance of long-term follow-up. The origin, epidemiology, clinical and radiographic aspects, and treatment of the GOC are also discussed.     

下颌骨多发性含牙囊肿1例报告

含牙囊肿属牙源性囊肿中的一种,又称滤泡囊肿。发生于牙冠或牙根形成之后,在残余釉上皮与牙冠面之间出现液体渗出而形成。多发性含牙囊肿是口腔颌面部的一种少见疾病,同时发生在颌骨的不同区域更是罕见。本文报告1例多发性含牙囊肿病例,并结合相关文献对其病因、病理分型、鉴别诊断和治疗方案等进行探讨。     

Prevalence of developmental odontogenic cysts in children and adolescents with emphasis on dentigerous cyst and odontogenic keratocyst (keratocystic odontogenic tumor)

Objective. To investigate the incidence and prevalence of developmental odontogenic cysts in children and adolescents and compare the features of the two most common types, dentigerous cyst and keratocystic odontogenic tumor (KCOT). Study design. A retrospective review in a series of 369 patients with all histological diagnoses of developmental odontogenic cysts in children (≤12 years) and adolescents (13–18 years) was conducted. Results. Among these, 361 (97.8%) patients were diagnosed as dentigerous cyst (n = 281) and KCOT (n = 80), with the male-to-female ratios of dentigerous cyst and KCOT both being 2:1. The average age of the patients with KCOT was older than that of those with dentigerous cyst (14.7 years vs 11.8 years, p < 0.001). Dentigerous cyst (59.1%) was more common in children, but KCOT (78.8%) was more common in adolescents (p < 0.001). Dentigerous cyst (57.6%) predominantly located on the maxilla, but KCOT (60.3%) predominantly located on the mandible (p = 0.010). Conclusions. Adolescent patients with lesions located on the mandible would favor KCOT over dentigerous cyst. This study aids in better knowledge of the prevalence of developmental odontogenic cysts in a large pediatric population, and shows that a well-supported early diagnosis is indispensable for a more adequate treatment.     

Extraosseous calcifying odontogenic cyst: report of case and review of literature

A case report of an extraosseous calcifying odontogenic cyst (COC) that appeared clinically to be a reactive lesion is presented. Review of the 28 previously published extraosseous COC cases and the current case report showed a mean age of 45.2 years at the time of diagnosis. No predilection for either gender or the maxilla or mandible was ascertained. A majority (51.9%) of cases occurred between the canines and none was posterior to the first molar. Because recurrences of an extraosseous COC have not been reported, the recommended treatment for an extraosseous COC is conservative surgical excision.     

Central calcifying odontogenic cyst. Case report

A case of central (intraosseous) calcifying odontogenic cyst affecting the mandible is reported. The clinical, radiographic, and histological features are reviewed and discussed.     

Adenomatoid odontogenic tumour (adenoameloblastoma). Case report and review of the literature

An adenomatoid tumour was found in the anterior maxillary region of a 15 year old female patient. Two impacted teeth were found in the tumour. The lateral incisor found in the tumour was dilacerated, and the roots of the first premolar were resorbed. A review of the English literature indicated that 294 similar cases have been reported.     

Calcifying odontogenic cyst associated with complex odontoma: case report and review of the literature

We report a calcifying odontogenic cyst associated with odontoma (COCaO) and an included permanent canine in the superior maxilla, in a 19 year-old-man. The calcifying odontogenic cyst (COC) was first described as a distinct entity by Gorlin et al in 1962. The lesion is a mixed odontogenic benign tumor, and although most of the cases present cystic characteristics, a few are of the solid type (15%), and its rare malignant transformation is well documented. The COC may occur in association with other odontogenic tumors, the most common is the odontoma, occurring in about 24% of the cases. For this association the term Odontocalcifying odontogenic cyst has been suggested. Radiographically is a well defined mixed lesion and histologically consists of a large cyst. In the central area of the cyst enamel and dentin deposits can be found, irregularly distributed in areas and in other parts it takes on a well defined organoid aspect. A thorough review of literature takes place and the pathogenesis is discussed.