Conservative surgical treatment of an aggressive calcifying cystic odontogenic maxillary tumor in the young permanent dentition

Calcifying cyst odontogenic tumor (CCOT) is a rare benign cystic neoplasm of odontogenic origin whose treatment depends on the lesion's localization and histological type. The purpose of this report was to describe a case of extensive calcifying cyst odontogenic tumor involving the maxilla of a 12-year old female patient and the treatment option adopted. The lesion was associated with an impacted first premolar, and the roots of the canine and second premolar were divergently displaced. An incisional biopsy revealed the presence of a highly cellular, densely fibrous connective tissue, with diffuse infiltration of mononuclear inflammatory cells. Cystic marsupialization and extraction of the impacted premolar were performed. No signs of lesion recurrence were noted after 28 months. Therefore, marsupialization should be considered when planning CCOT treatment, primarily in young patients with large lesions, to avoid mutilations and tooth loss.