Huge keratocystic odontogenic tumour in medically compromised patient–a management dilemma

Keratocystic odontogenic tumour (KCOT) is a cystic lesion of the jaws with tumourbehaviour. Its high prevalence rate makes it one of the commonest cystic lesions especially involving the lower jaw. The characteristic histologic features and aggressive nature corresponds to the high recurrence rate associated with KCOT. Lesion expands mostly in an anteroposterior direction and can cause extensive bone destruction before the appearance of any clinical symptoms. The characteristic radiological picture is that of a multilocular cystic lesion with the common differential diagnosis being dentigerous cyst and ameloblastoma. Here we are presenting a case of KCOT of the left lower jaw of size 10.9×7.86×8.54 cm. It is a huge multilocular cystic lesion extending from the right canine region to the left side involving the body, ramus, coronoid and condyle. Various management options are there ranging from enucleation and chemical cauterization to resection and reconstruction depending upon the size of the lesion. In this case we were not able to perform the ideal treatment option for the case because of the multiple drug allergy the patient was having, including most of the general anesthetic agents. Also the patient was not willing for any extensive procedure under general anesthesia. So we had to follow a compromised treatment plan aiming to reducethe size of the lesion, to improve the aesthetics and frequent follow up

Odontogenic Keratocyst-A Case Report

Odontogenic keratocyst (OKC) is a developmental, non-inflammatory chronic cyst that may be unilocular or multilocular. Histologic features of OKC are pathognomonic. A 41-year-old male patient presented for emergency evaluation of a buccal gingival swelling in the area of teeth 34 and 35. Incision and drainage were followed 3 weeks later by surgical curettage and guided tissue regeneration using allograft and resorbable membrane. Biopsy of the excised tissue revealed OKC. At 1-year follow-up, the patient was comfortable and complete resolution of the radiolucent pathology was evident. Periodic examination is required because of the high rate of recurrence of OKC.

Keratocystic Odontogenic Tumor of the Mandible – A Case Report

Odontogenic keratocyst has been renamed as KCOT (Keratocysticodontogenic tumour) by the World Health Organization in 2005. It is a benign intraosseous neoplasm of the jaw. They develop from the dental lamina remenants in the mandible and maxilla. KCOT is of particular interest because of its recurrence rate and aggressive behaviour. We are here presenting a case of KCOT in middle aged male patient.

Marsupialization as a treatment option of a large Odontogenic keratocyst: A case report with the review of literature.

The Odontogenic keratocyst (OKC) is classified as a developmental epithelial cyst and comprises approximately 11% of all cysts of the jaws. The most characteristic clinical feature of OKC is the high recurrence rate. It is because of this characteristic that a variety of treatment modalities has been suggested for this cyst. Many of the surgeons prefer a more aggressive treatment, like resection. We have tried a more conservative approach in managing a patient with a large OKC of the mandible and have had an excellent result. We would like to suggest that marsupialization can be a definitive treatment option for large OKC’s.

Clinical Study Of Odontogenic Keratocyst

PURPOSE: The purpose of this study is to investigate the clinical and histological features of odontogenic keratocyst PATIENTS AND METHODS: A retrosective review of 100 patients who were diagnosed as odontogenic keratocyst by hitological findings during the period of January 2000 and December 2005 in the Dept. of Oral and Maxillofacial surgery Pusan National University was consecuted. For each patient, age, sex, location of lesion, initial diagnosis by radiographic features, treatment procedure, hitologic findings and recurrance rate were evaluated. RESULTS: In this study, OKC has male prevalance to female by 1.38:1, and most likely occurs during third decade. The most common site of lesion was mandibular ramus region(34.6%) and the most common symptom was swelling(50%). The most common initial diagnosis by radiographic findings was OKC and cyst enucleation was the most common treatment method. The recurrance rate was 28% and existence of daugther cyst is thought to be most convincing factor for prediction of recurrence. CONCLUSION: In this study, total recurrence rate was 28% and existence of daugther cyst is thought to be most convincing factor for prediction of recurrence. But, since 97% of patients were treated by enucleation and adjuntive excision, further styudy is need about concordance of recurrence rate with surgical method.

Postoperative recurrences of odontogenic keratocyst: The behavior and proposal of critical follow-up period

Post-operative recurrence of cystic lesion is a great concern for clinician, patients, and their family, especially in case of odontogenic keratocyst, which has aggressive behavior and high recurrence rate. The purpose of this study was to evaluation clinical characters of OKC, focusing of the recurrence rate and proposed critical follow-up period. 58 cases (aged 9 to 66, 33 males and 25 females) of OKC were reviewed for sex of patients, location, size, operative procedure type, radiographic findings, histopathologic findings, post-operative recurrence time, from 2000 to 2005 at Yonsei Medical Center, were selected. The computerized statistical analysis was carried out with SAS system. 18 of 58 cases (31.03%) were recurred and this study revealed no statistically significant difference in recurrence rate for sex, location, size, radiographic findings, histopatologic findings, operative procedure type, recurrence timing. 3 out of 18 cases (16.7%) showed one or more recurrence. This was statistically significant difference (P=.0264). In this study, 15 of 18 cases (83.3%) were observed recurrence during 4 years after removal of the OKCs, we suggest critical follow-up period during 4 years after operation.

Identification of receptor activator of nuclear factor-(k)b ligand(rankl) and osteoprotegerin(opg) in odontogenic keratocyst