Report of a Case-An uncommon calcifying odontogenic cyst [ameloblastomatous type]

ABSTRACT

Calcifying odontogenic cyst is an uncommon odontogenic lesion that demonstrates variable clinical behaviour and considerable histopathologic diversity and accounts for only [1%] of jaw cysts reported. This cyst is derived from odontogenic epithelial remants within the gingiva or within the mandible or maxilla and it may be associated with the recognized odontogenic tumors most commonly odontoma but rarely, ameloblastoma, Adenomatoid odontogenic tumor, or odonto Amelobalstoma. This case is presented here for its rarity and difference between ameloblastomatous calcifying odontofenic cyst and ameloblastoma along with calcifying odontogenic cysts. Because the prognosis and treatment procedures are different in Ameloblastomatous COC and COC with Amelobalstoma, their differential diagnosis is necessary. The patient was a 22-year old male referred to dental office for filling of surface caries 6, 7. A painless swelling that had been present for approximately 2 months was observed. Panoramic radiography showed a well defined multilocular radiolucency. Microscopic examination reported calcifying odontogenic cyst [ameloblastomatous type]. Treatment was done with simple enucleation. In 11 month follow up, no recurrence was reported. Calcifying odontogenic cyst [Ameloblastomatous] microscopically resembles unicystic Ameloblastoma except for the ghost ceils and dystropic calcifications within the proliferative epithelium. There has always been confusion about its nature as a cyst, neoplasm or hamartoma. This cyst, microscopically, shows ameloblastic proliferation in the connective tissue but no characteristics of Basal cell hyperchromatism, vacuolization and nuclear polarization which is often seen in ameloblastoma, are present here. Ameloblastoma ex COC and ameloblastomatous COC are morphologically entirely different and easily distinguishable