Odontogenic keratocyst: Review of 256 cases for recurrence and clinicopathologic parameters

Odontogenic keratocyst (OKC) is of particular interest because of its high recurrence rate and aggressive behavior. Two hundred fifty-six cases of OKC were reviewed for the age of the patient at diagnosis, sex of the patient, OKC location, and radiographic findings, and 132 patients with OKC were observed to estimate recurrence, which was analyzed for age, sex, location, and several histopathologic findings. OKCs occurred more frequently in men (58.6%) than in women (41.4%), and they occurred in patients within a wide age range, most commonly in patients in the third decade of life (28.9%), followed by those in the second decade (25.0%); the mean age of patients with OKC was 30.8 years. One hundred ninety-six of the 256 cases (76.5%) occurred in the mandible, and the other 60 cases (23.5%) occurred in the maxilla. The mandibular molar and the premolar areas (51.2%) were the most common sites, and the most frequent clinical manifestations at first admission were swelling, pain, or both (82.4% of total cases). Radiographic impressions included dentigerous cyst (27.3%), OKC (25.4%), primordial cyst (14.8%), ameloblastoma (11.7%), residual cyst (9.8%), and radicular cyst (3.1%). The frequency of recurrence at the follow-up examination was 58.3%. There was no significant difference in the recurrence rate on the basis of the sex of the patient. However, OKCs had a significantly higher recurrence rate in patients in the fifth decade of life than in patients in the other age groups (P = .005).Recurrence rates were significantly dependent on the sites of involvement, and OKCs in the mandibular molar region had significantly higher recurrence rates than those in other sites (P = .001). The histopathologic presence of one or more daughter cysts was significantly related to recurrence (P = .03).     

Development of a keratocyst in the facial soft tissues

The clinical signs, diagnosis, and therapy of a keratocyst of the soft tissues in a 27-year-old man are described. Part of the keratocyst lining probably grew through the bony window after extraoral biopsy or was implanted in the soft tissue during the procedure, accounting for the location of the lesion.     

DNA-ploidy studies in a keratocyst undergoing subsequent malignant transformation

Using techniques that allow flow cytometry to be performed on tissue stored in paraffin wax, we have examined the DNA content of cells from an odontogenic keratocyst which underwent malignant transformation. On histological examination, the primary lesion was an odontogenic keratocyst showing dysplastic changes within the squamous epithelium. Flow cytometry revealed a prominent, abnormal DNA stemline, which was also present in the subsequent squamous cell carcinoma.     

Maxillary reconstruction for a huge odontogenic keratocyst

A range of different entities may be responsible for cystic lesions in the maxillary region. However, sometimes an accurate diagnosis cannot be made based on clinical or radiologic presentation. In this case, the surgeon should evaluate the clinical situation so that a comprehensive surgical plan that addresses the patient's complaints can be made. We present a 25-year-old female patient with a huge maxillary cyst causing obvious cheek protrusion. For cosmetic concern, she received surgical excision of the cystic lesion and reconstruction of anterior maxillary defect. No recurrence was seen at 18 months' follow-up, and the patient was quite satisfied with the aesthetic result. We reported the case to provide an effective procedure for benign maxillary cysts that result in cosmetic concerns with simple excision and reconstruction.     

DNA-ploidy studies in a keratocyst undergoing subsequent malignant transformation

Using techniques that allow flow cytometry to be performed on tissue stored in paraffin wax, we have examined the DNA content of cells from an odontogenic keratocyst which underwent malignant transformation. On histological examination, the primary lesion was an odontogenic keratocyst showing dysplastic changes within the squamous epithelium. Flow cytometry revealed a prominent, abnormal DNA stemline, which was also present in the subsequent squamous cell carcinoma.     

Interposed bone-graft augmentation of the atrophic mandible (a progress report).

A follow-up study on 41 patients who had augmentation of the atrophic mandible by interposed bone graft is presented. Special emphasis has been put on the prosthetic implications. The rapid reduction in height measured postoperatively appeared almost to cease after 6 months. Some of the possible causes of this phenomenon are discussed.     

Clinicopathological study of odontogenic keratocyst

Fifty-five cases of odontogenic keratocyst in the mandible were classified into two subtypes according to the histopathologic characteristics of the epithelium (Group-1; the epithelium was parakeratotic with cuboidal or columnar, accentuated and palisadelike arranged basal cells, Group-2; the epithelium was orthokeratotic with a distinct stratum granulosum.) and were examined for the following four factors; 1) age distribution, 2) size of bone destruction, 3) degree of lateral bone expansion, and 4) features of the cyst contents. Most cases of Group-1 indicated radiographically lateral bone expansion and large cystic bone destruction and had fluid cyst content. On the contrary, the majority of Group-2 cases indicated no lateral bone expansion, were relatively small lesions, and their cystic cavities were filled with caseous materials.     

Peripheral odontogenic keratocyst: a report of 2 cases

BACKGROUND: Occurrence of a gingival cyst in adults that exhibits the histopathologic hallmarks of an odontogenic keratocyst (OKC) is rare. METHODS: Two cases of primary soft tissue OKC in an adult female are described. Both presented as an asymptomatic small nodule on the buccal gingiva of the anterior mandible. RESULTS: After simple excision, no recurrence was observed. CONCLUSIONS: All available data indicate that, irrespective of the nomenclature, peripheral OKC should be included under the histopathological spectrum of gingival cysts in the adult.     

Odontogenic keratocyst of the maxilla: a case report

Remnants of odontogenic epithelium persist in oral tissues after odontogenesis is complete, and from these remnants a variety of tumours and cysts can arise. Squamous metaplasia can occur in this epithelium which in turn may produce keratin. Although keratin production is a feature of many odontogenic cysts, a specific entity, the odontogenic keratocyst has been defined. The term was first introduced by Philipsen in 1956 and has been used synonymously with that of the primordial cyst. Its capacity for aggressive growth and recurrence even after many years makes it of special interest. In this case report these behavioural characteristics are well demonstrated. The long natural history of the condition in this case and its site and size involved oral, ophthalmic and ultimately otolaryngologic surgeons.     

Giant cell epulis presenting as a recurrent odontogenic keratocyst

A bstract — The unusual occurrence of a giant cell epulis presenting as a recurrent odontogenic keratocyst is reported and the implications of this case briefly discussed.     

Odontogenic keratocyst in an infant.

Odontogenic keratocysts occur as solitary lesions or in association with the basal cell naevus syndrome (BCNS), and have been documented in the age range 5 to 83 years. A rare case of an odontogenic keratocyst in a one-year-old girl is presented. Its characteristic tendency to recur, and its association with BCNS present important clinical implications.     

Solid variant of odontogenic keratocyst

A case of an unusual lesion from the maxilla is presented. Macroscopically, the lesion was solid and histologically consisted of 'multiple separate keratocysts' of varying size that infiltrated into the surrounding bone and soft tissues. Panoramic image and CT scans showed a multilocular honeycomb ill-defined radiolucency with infiltration into the maxillary sinus and floor of orbit. This lesion should be differentiated from similar odontogenic lesions, such as keratoameloblastoma and papilliferous keratoameloblastoma. As there was no evidence of follicles, islands of ameloblastoma, or papilliferous structures in the entire specimen, the lesion could not be diagnosed as either a keratoameloblastoma or a papilliferous keratoameloblastoma. The invasive and destructive growth behavior, the histopathological features, and the histochemical pattern of the collagen stroma imply that this solid lesion is a neoplasia. It is suggested that the proper term for this lesion is solid variant of odontogenic keratocyst.