Introduction
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History
33 yo, F
Mild swelling on the left mandible
Gross Findings
The specimen consisted of multiple small strips of sac-like tissue. The specimen was entirely submitted.
Microscopic Findings
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Final Diagnosis:
ODONTOGENIC KERATOCYST
- 10–20% of odontogenic cysts
- The third most common cyst of the jawsa peak incidence in the second to third decades of life and a second, smaller peak among patients aged 50–70 years
- A slight male predilection
- As many as 5% of all OKCs occur as part of Gorlin syndrome: tend to be multiple and effect younger patients
- 80% of cases in the mandible, ramus-angle
Treatment
- Most often by enucleation, or by surgical resection for large lesions
- Prior to definitive cystectomy, many cysts are decompressed/marsupialized.
Take-Home Message
- The histopathology of odontogenic keratocyst is pathognomonic and the diagnosis is easy.
- With significant inflammation in the cyst or if marsupialization has been attempted, the typical features are lost, and the diagnosis may be impossible.
- Multiple lesions can be associated with nevoid basal cell carcinoma syndrome.
- It has a relatively higher recurrence rate than other odontogenic cysts.