CLINICOPATHOLOGICAL ANALYSIS OF ODONTOGENIC KERATOCYSTS: 10 YEARS EXPERIENCE FROM A SINGLE CENTER

Abstract

Objective: The aim of the study is to update our understanding of the clinicopathological features of odontogenic keratocysts in a series of 43 cases from a single center.

Material and Methods: This retrospective study included 51 specimens from 43 patients diagnosed between 2010 and 2020. Microscopic findings, patients’ age, gender, lesion location, and presence or absence of recurrence were noted.

Results: The study group included 22 men and 21 women with a mean age of 38.72 /year. In 37 patients, the lesion occurred in the mandible, while in 6 patients it was found in the maxilla. Three patients were associated with nevoid basal-cell carcinoma syndrome. Three patients had multiple odontogenic cysts. Satellite cysts were present on the cyst walls in 5 of the 43 cases. Epithelial islands were present in 4 of the cases. In 28 cases, moderate to severe inflammation was observed in the cyst wall. Among them, in 18 cases, classical odontogenic keratocyst features were lost in some areas in the cyst epithelium. Elongation of rete ridges and radicular cyst-like areas were observed in 12 cases. In only 41.66% of patients, the odontogenic keratocyst or keratocystic odontogenic tumor terms were given in the provisional diagnoses. Clinically, the most frequently confused lesions in the differential diagnosis were dentigerous cyst, radicular cyst, residual cyst, and ameloblastoma. No recurrence was observed in any of the patients.

Conclusion: Concomitant inflammation can cause changes in the epithelium and may hide the diagnostic features of odontogenic keratocysts. Therefore, careful examination is required for accurate diagnosis.

Keywords

• Odontogenic cysts
• pathology
• oral
• inflammation
• Basal Cell Nevus Syndrome

Odontojenik Keratokistlerin Klinikopatolojik Analizi: Tek Merkezden 10 Yıllık Deneyim

Abstract

Amaç: Çalışmanın amacı, tek merkezden 43 olguluk bir seride odontojenik keratokistlerin klinikopatolojik özelliklerine dair anlayışımızı güncellemektir.

Gereç ve Yöntemler: Bu retrospektif çalışma 2010-2020 yılları arasında tanı almış 43 hastaya ait 51 spesmeni içermektedir. Mikroskopik bulgular, hasta yaşı, cinsiyeti, lezyonun yerleşim yeri ve nüks varlığı kaydedilmiştir.

Bulgular: Çalışma grubu 22 erkek, 21 kadın hastadan oluşmakta olup ortalama yaş 38.72 /yıl idi. Lezyon hastaların 37’sinde mandibulada, 6’sında maksillada yerleşim göstermekteydi. Üç hastada nevoid bazal-hücreli karsinom sendromu mevcuttu. Hastaların 3’ünde multipl odontojenik kist saptandı. Beş hastada kist duvarında satellit kistler mevcuttu. Epitelyal adalar 4 olguda görüldü. Hastaların 28’inde kist duvarında orta derecede veya şiddetli inflamasyon saptandı. Bunların 18’inde klasik odontojenik keratokist özellikleri kist epitelinin bazı alanlarında kaybolmuştu. Retelerde uzama ve radiküler kist-benzeri alanlar 12 olguda saptandı. Hastaların sadece %41.66’sında, odontojenik keratokist veya keratokistik odontojenik tümör terimleri klinik ön tanılar arasında yer almaktaydı. Klinik olarak, ayırıcı tanıda en sık karıştırıldığı lezyonlar dentijeröz kist, radiküler kist, rezidüel kist ve ameloblastom idi. Takipteki hastaların hiçbirinde nüks görülmedi.

Sonuç: Eşlik eden inflamasyon kist epitelinde değişikliklere yol açmakta ve odontojenik keratokistlerin tanısal özelliklerini gizleyebilmektedir. Bu nedenle, doğru tanı için dikkatli değerlendirme gerekmektedir.

Keywords

• Odontojenik keratokist
• patoloji
• Bazal hücreli nevüs sendromu
• oral
• indlamasyon

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