It is now designated by the world health organization as a keratocystic odontogenic tumour kot. Involvement of the maxillary sinus is an unusual presentation. An odontogenic tumor is a neoplasm of the cells or tissues that initiate odontogenic processes examples include. Pdf keratocystic odontogenic tumour with extraosseal. Keratocystic odontogenic tumour of lesions treated in our clinic. What are synonyms for keratocystic odontogenic tumor. Keratocystic odontogenic tumour an overview sciencedirect. The keratocystic odontogenic tumor oral and maxillofacial surgery. Finally, treatment consists of surgical excision and follow up is characterized by a high rate of recurrence. There are many types of cysts of the jaws, but what makes the odontogenic keratocyst unusual are its characteristic histopathological and clinical features, including potentially aggressive behaviour, high recurrence rate, and an association with the nevoid basal cell carcinoma syndrome. Also known as the keratocystic odontic tumor, it is believed to be stemming from the dental lamina.
Who has chosen to rename this cyst keratocystic odontogenic tumor, but some authors like marx and stern prefer to retain old terminology 5, 6. Aug 11, 2009 many treatment modalities have been advocated for its treatment, but none in particular has been regarded as the best treatment option. The keratocystic odontogenic tumor is a benign developmental tumor with many distinguishing clinical and histologic features. Because of its features, the keratocystic odontogenic tumor must have more aggressive treatment, compared with odontogenic cysts, and longterm followup is mandatory.
Pdf keratocystic odontogenic tumor a diagnostic dilemma. Ameloblastomas and keratocystic odontogenic tumors are major aggressive odontogenic tumors in the maxillomandibular regions, but the differentiation between these 2 tumors is frequently ineffective based on only conventional ct and mr imaging findings. What is the best treatment for a type of jaw bone cyst. A keratocystic odontogenic tumor kot formerly known as an odontogenic keratocyst is a benign cystic tumor of dental origin that probably arises from. Cd166 expression in dentigerous cyst, keratocystic. Okc is now referred to by the world health organization who as a keratocystic odontogenic tumour kcot, and who defined it as a benign uni or multicystic, intraosseous tumour of odontogenic origin, with a characteristic lining of parakeratinized stratified squamous epithelium. Synonyms for keratocystic odontogenic tumor in free thesaurus. Abstract the purpose of this paper is to focus the hallmarks of the keratocystic odontogenic tumour kcot which was formerly known as odontogenic keratocyst okc. Classification of keratinizing odontogenic cysts and tumors is not entirely satisfactory to the clinician and pathologist. In 2005 the who introduced the former odontogenic keratocyst to the category of benign odontogenic tumours. Here, we evaluated diffusionweighted mr imaging for the differentiation of these 2 odontogenic tumors. Among the jaw lesions, keratocystic odontogenic tumor, ameloblastoma, dentigerous cyst forms the common ones. Keratocystic odontogenic tumor kcot has recently been recommended to describe the lesion previously named odontogenic keratocyst 15 kcot is a developmental cyst which is locally aggressive and rapidly prolifera. A keratocyst in the buccal mucosa with the features of keratocystic.
Ameloblastoma, a type of odontogenic tumor involving ameloblasts. Keratocystic odontogenic tumor article about keratocystic. Nov 10, 2009 the keratocystic odontogenic tumor is a benign developmental tumor with many distinguishing clinical and histologic features. Management of the keratocystic odontogenic tumor has been one of the most controversial entities of the maxillofacial surgery. Find out information about keratocystic odontogenic tumor. Odontogenic keratocyst is a distinctive form of developmental odontogenic cyst because of its specific histopathologic features, an aggressive biologic behavior and a high recurrence rate. Adenomatoid odontogenic tumor keratocystic odontogenic tumour. The orthokeratinizing odontogenic cyst is considered an unrelated entity without risk of recurrence or aggressive growth or association with nevoid basal cell carcinoma syndrome. Keratocystic odontogenic tumor involving the maxillary. In this paper, we shall present one case report of a keratocyst, which derived from an impacted canine. Keratocystic odontogenic tumors clinical and molecular. The keratocystic odontogenic tumor kcot, formerly known as the odontogenic keratocyst okc, received its new designation in order to better convey its neoplastic nature. It is characterized by its fast aggressive growth and high risk of recurrence. Squamous cell carcinoma arising from the lining of an odontogenic cyst is one important rare subcategory of such lesions with an incidence of 0.
We present the case of a 23yearold man with extensive kcot and impacted third molar in the right maxillary sinus. The newly acknowledged neoplastic potential and its implications for treatment strategies are also discussed. Keratocystic odontogenic tumor definition of keratocystic. It has the potential for infiltration and local aggressiveness and has a high rate of recurrence. Keratocystic odontogenic tumor kcot is a benign intraosseous neoplasm of the jaw.
Odontogenic keratocyst symptoms, treatment, pictures. We analyzed the etiopathogenetic, clinical, radiographic, and histopathologic aspects of keratocystic odontogenic tumors, particularly in association with dental anomalies of number, with the aim of providing useful information for their correct diagnosis, treatment, and prognosis within a multidisciplinary approach. Keratocystic odontogenic tumour is relatively rare benign tumour. Over 50 years later the debate continues as to their proper classi. Also referred to as keratocystic odontogenic tumor because of its tumorlike tendency to recur after surgical treatment, this slowgrowing, benign cyst can be destructive to local structures. Keratocystic odontogenic tumor in the maxillary sinus. Treatment consisted of enucleation and curettage for 22 of the lesions, resection. This condition is often encountered in young patients, who are in their 2nd or 3rd decade of life. Before i get started, let me say that in 2005, the world health organization actually changed the name of odontogenic keratocyst to keratocystic odontogenic tumor. Keratocystic odontogenic tumor synonyms, keratocystic. Pdf keratocystic odontogenic tumor invading the right. First described by philipsen in 1956, the odontogenic keratocyst is characterized by a large squamous keratinization of its border, an aggressive growth and a high recurrent rate. Keratocystic odontogenic tumour canadian dental association.
The diagnosis may be confirmed by the anatomical pathology report. Even though there are classical clinical features for each of the odontogenic lesions, at times, it may be difficult to arrive at a clinical. The mouth opening was unlimited, and there was no deviation of the mandible in habitual occlu. Keratocystic odontogenic tumor according to lopes et al. Odontogenic keratocysts okcs are developmental cysts which occur typically in the jawbones. Keratocystic odontogenic tumor kcot is one of the most common odontogenic tumors of ectodermal origin.
The distinction between keratocystic odontogenic tumor and other. Keratocystic odontogenic tumor are considered to be benign, even though they are locally aggressive and show high recurrence rates after conservative management. Pindborg and hansen were first to point out the aggressive behavior of okc. It is a benign developmental odontogenic tumor with many distinguishing clinical and histologic features. The mouth opening was unlimited, and there was no deviation of the mandible in habitual occlusion. Maxillary peripheral keratocystic odontogenic tumor.
Odontogenic cysts were not considered in the new 2005 classification, which means that the previous 1992 classification is still relevant for cysts of the jaws and maxillofacial region, with one notable exception. Presentation of a keratocystic odontogenic tumor with. Odontogenic keratocyst a case presentation purshotam nainani 1, anish gupta, pratibha kavle2, amit mathur3 abstract. The 2005 who classification now uses the term keratocystic odontogenic tumor. Jan 29, 2020 mandibular adenomatoid odontogenic tumor. Okcs have been reclassified under odontogenic tumours in 2005 by the who and have since been termed as keratocystic odontogenic tumours kcots. Odontogenic keratocysts to keratocystic odontogenic tumor. The odontogenic keratocyst can be defined as a cystic benign tumor, being localized at the level of the mandible or the maxilla. Here we report a case of a recurrent buccal lesion in a 62yearold. An odontogenic tumor is a neoplasm of the cells or tissues that initiate odontogenic processes.
Review of the literature and report of a rare case. The keratocystic odontogenic tumor kcot, formerly known as the odontogenic keratocyst okc, received its new designation in order to better convey its neoplastic nature 1. In an analysis of loss of heterozygosity loh for several tumor suppressor genes in sporadic kcots, frequency of allelic loss was 66% for p53 and 60% for ptch gene. Features of peripheral keratocystic odontogenic tumor 302 int j clin exp med 2014. Introduction odontogenic keratocyst okc was a neoplasm described by philipsen in 1956 and was confirmed by 1 browne in 1970 and 1971 2 3. The clinical, radiological, and histological features of this tumor and its surgical management are discussed. Squamous cell carcinoma arising from a keratocystic. The keratocystic odontogenic tumor is a benign odontogenic cystic neoplasia characterized by its thin, squamous epithelium with superficial parakeratosis.
Kcots are noncancerous but fastgrowing cysts closed sacs containing either fluid or air that occur mainly in the lower jawbone. Pdf on may 1, 2014, madhumati amritraj singh and others published keratocystic odontogenic tumor find, read and cite all the research. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Also distinguished by parakeratinized epithelial lining. At that time, it was believed to be a benign, but potentially aggressive and re. Diffusionweighted mr imaging of ameloblastomas and. Keratocystic odontogenic tumor, benign tumor, surgery. Reclassification and treatment of odontogenic keratocysts scielo. Pdf decompression of an enormous keratocystic odontogenic. Lewis key points computed tomography can be highly specific in the diagnosis of mandibular masses given an organized approach that considers both odontogenic and nonodontogenic tumors and cysts. Clinically, the kot is manifested by an asymptomatic growth. Jaw tumors and cysts symptoms and causes mayo clinic. Keratocystic odontogenic tumor, benign tumor, surgery, maxilla 1.
Apr, 2016 odontogenic keratocyst or keratocystic odontogengic tumor. Pdf keratocystic odontogenic tumour with extraosseal spread. Okc is now referred to by the world health organization who as a keratocystic odontogenic tumour kcot, and who defined it as a benign uni or multicystic, intraosseous tumour of odontogenic origin, with a characteristic lining of parakeratinized stratified. There were 18 lesions in the posterior mandible, 3 in the anterior mandible and 6 in the posterior maxilla fig. They present more commonly in the posterior mandible of young adults than the maxilla. Case report radiological and clinical features of peripheral. Surgical treatment of keratocystic odontogenic tumour. Furthermore, the appearance of such malignancy in an odontogenic tumor such as keratocystic odontogenic tumor is. Recently who classified okc and renamed it as keratocystic odontogenic tumor kcot based on its behavior and aggressiveness. Among the pathological entities that affect the maxillofacial region, keratocystic odontogenic tumour has been subject to a lot of debates. Organization who as a keratocystic odonto genic tumour kcot and is defined as a. The term odontogenic keratocyst was first used by philipsen in 1956. Formerly called keratocystic odontogenic tumor the orthokeratinizing odontogenic cyst is considered an unrelated entity without risk of recurrence or aggressive growth or association with nevoid basal cell carcinoma syndrome epidemiology. The parakeratinized subtype became the keratocystic odontogenic tumor kcot, which integrated the group of odontogenic epithelial tumors into its.
Keratocystic odontogenic tumor kcot, formerly referred to as odontogenic keratocyst, is a benign neoplasm of odontogenic origin which may present an aggressive and infiltrative behavior leading. Odontogenic keratocyst okc is a developmental cyst that was first described by philipsen 1956. The odontogenic keratocyst is a very well known odontogenic cyst. Keywords keratocystic odontogenic tumour kcot, benign tumor, recurrence, treatment. Most often the cyst develops in the lower jaw near the third molars. It is of particular interest that relationship between keratocystic odontogenic tumors clinical and molecular features. Odontogenic keratocyst, abbreviated okc, is an uncommon odontogenic cyst. The keratocystic odontogenic tumor is an intraosseous malignancy having a characteristic lining of parakeratinized stratified squamous epithelium originating from the primordial odontogenic epithelium. Kcot characterized by aggressive in nature and high recurrence rate.
In the whoiarc classification of head and neck pathology, this clinical entity had been known for years as the odontogenic keratocyst. The keratocystic odontogenic tumor kcot is a benign uni or multicystic, intraosseous tumor of odontogenic origin 2 that has a slight male predilection and commonly. The keratocystic odontogenic tumor kcot is a benign uni or multicystic, intraosseous tumor of odontogenic origin 2 that has a. This neoplasia is predominantly found in males and people of white origin. A large extragnathic keratocystic odontogenic tumour. Treatment consisted of enucleation and curettage for 22 of the lesions, resection for 2 and marsupialization for 3. Sometimes associated with nevoid basal cell carcinoma syndrome gorlin syndrome. Keratocystic odontogenic tumours are the third most common cysts, are great mimics, may recur after removal as well as behave aggressively and are sometimes associated with gorlin syndrome. Teeth examination revealed that teeth 22 and 23 are missing, and teeth 21 and 24 are positive at cold sensitivity test without mobility. Topical 5fluorouracil is a novel targeted therapy for the. Ive gotten a few questions about odontogenic keratocysts lately, so i figured it would be good to write an article detailing what we know about them. It was known as keratocystic odontogenic tumour, abbreviated kot, from 2005 to 2017.
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