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

Year 2022, Volume: 24 Issue: 1, 47 - 54, 30.04.2022
https://doi.org/10.24938/kutfd.1003955

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.

References

  • 1. Philipsen HP. On keratocysts in the jaws. Tandlaegebladet. 1956;60:963-80.
  • 2. Shear M, Speight P. Cysts of the Oral and Maxillofacial Regions. 4th ed. Oxford. Blackwell Munksgaard, 2007.
  • 3. El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ. WHO Classification of Head and Neck Tumours. 4th ed. Lyon. IARC, 2017.
  • 4. Brannon RB. The odontogenic keratocyst: A clinicopathologic study of 312 cases. Part II. Histologic features. Oral Surg Oral Med Oral Pathol. 1977;43(2):233-55.
  • 5. Myoung H, Hong SP, Hong SD, Lee JI, Lim CY, Choung PH et al. Odontogenic keratocyst: Review of 256 cases for recurrence and clinicopathologic parameters. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;91(3):328-33.
  • 6. Brannon RB. The odontogenic keratocyst: A clinicopathologic study of 312 cases. Part I. Clinical features. Oral Surg Oral Med Oral Pathol. 1976;42(1):54-72.
  • 7. Yang SI, Park YI, Choi SY, Kim JW, Kim CS. A retrospective study of 220 cases of keratocystic odontogenic tumor (KCOT) in 181 patients. Asian Journal of Oral and Maxillofacial Surgery. 2011;23(3):117-21.
  • 8. Woolgar JA, Rippin JW, Browne RM. The odontogenic keratocyst and its occurrence in the nevoid basal cell carcinoma syndrome. Oral Surg Oral Med Oral Pathol. 1987;64(6):727-30.
  • 9. Woolgar JA, Rippin JW, Browne RM. A comparative histological study of odontogenic keratocysts in basal cell naevus syndrome and control patients. J Oral Pathol. 1987;16(2):75-80.
  • 10. Dominguez FV, Keszler A. Comparative study of keratocysts, associated and non-associated with nevoid basal cell carcinoma syndrome. J Oral Pathol. 1988;17(1):39-42.
  • 11. Payne TF. An analysis of the clinical and histopathologic parameters of the odontogenic keratocyst. Oral Surg Oral Med Oral Pathol. 1972;33(4):538-46.
  • 12. Rodu B, Tate AL, Martinez MG Jr. The implications of inflammation in odontogenic keratocysts. J Oral Pathol. 1987;16(10):518-21.
  • 13. Pindborg JJ, Philipsen HP, Henriksen J. Studies on odontogenic cyst epithelium. In: Sognnaes RF, ed. Fundamentals of Keratinization (Vol. 1). Washington, DC. American Association of the Advancement of Science, 1962:151–60.
  • 14. Shear M. Primordial cyst. Journal of the Dental Association of South Africa 1960;15(2):211-7.
  • 15. Kramer IR, Pindborg JJ, Shear M. The WHO Histological Typing of Odontogenic Tumours. A Commentary on the Second Edition. Cancer. 1992;70(12):2988-94.
  • 16. Barnes L, Eveson JW, Reichart P, Sidransky D. World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of the Head and Neck. 3rd ed. Lyon. IARC, 2005.
  • 17. Wright JM, Vered M. Update from the 4th Edition of the World Health Organization Classification of Head and Neck Tumours: odontogenic and maxillofacial bone tumors. Head and Neck Pathology. 2017;11(1):68-77.
  • 18. Pogrel MA, Jordan RC. Marsupialization as a definitive treatment for the odontogenic keratocyst. J Oral Maxillofac Surg. 2004;62(6):651-5
  • 19. Diniz MG, Galvão CF, Macedo PS, Gomes CC, Gomez RS. Evidence of loss of heterozygosity of the PTCH gene in orthokeratinized odontogenic cyst. J Oral Pathol Med. 2011;40(3):277-80.
  • 20. Pavelić B, Levanat S, Crnić I, Kobler P, Anić I, Manojlović S et al. PTCH gene altered in dentigerous cysts. J Oral Pathol Med. 2001;30(9):569-76.

Odontojenik Keratokistlerin Klinikopatolojik Analizi: Tek Merkezden 10 Yıllık Deneyim

Year 2022, Volume: 24 Issue: 1, 47 - 54, 30.04.2022
https://doi.org/10.24938/kutfd.1003955

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.

References

  • 1. Philipsen HP. On keratocysts in the jaws. Tandlaegebladet. 1956;60:963-80.
  • 2. Shear M, Speight P. Cysts of the Oral and Maxillofacial Regions. 4th ed. Oxford. Blackwell Munksgaard, 2007.
  • 3. El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ. WHO Classification of Head and Neck Tumours. 4th ed. Lyon. IARC, 2017.
  • 4. Brannon RB. The odontogenic keratocyst: A clinicopathologic study of 312 cases. Part II. Histologic features. Oral Surg Oral Med Oral Pathol. 1977;43(2):233-55.
  • 5. Myoung H, Hong SP, Hong SD, Lee JI, Lim CY, Choung PH et al. Odontogenic keratocyst: Review of 256 cases for recurrence and clinicopathologic parameters. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;91(3):328-33.
  • 6. Brannon RB. The odontogenic keratocyst: A clinicopathologic study of 312 cases. Part I. Clinical features. Oral Surg Oral Med Oral Pathol. 1976;42(1):54-72.
  • 7. Yang SI, Park YI, Choi SY, Kim JW, Kim CS. A retrospective study of 220 cases of keratocystic odontogenic tumor (KCOT) in 181 patients. Asian Journal of Oral and Maxillofacial Surgery. 2011;23(3):117-21.
  • 8. Woolgar JA, Rippin JW, Browne RM. The odontogenic keratocyst and its occurrence in the nevoid basal cell carcinoma syndrome. Oral Surg Oral Med Oral Pathol. 1987;64(6):727-30.
  • 9. Woolgar JA, Rippin JW, Browne RM. A comparative histological study of odontogenic keratocysts in basal cell naevus syndrome and control patients. J Oral Pathol. 1987;16(2):75-80.
  • 10. Dominguez FV, Keszler A. Comparative study of keratocysts, associated and non-associated with nevoid basal cell carcinoma syndrome. J Oral Pathol. 1988;17(1):39-42.
  • 11. Payne TF. An analysis of the clinical and histopathologic parameters of the odontogenic keratocyst. Oral Surg Oral Med Oral Pathol. 1972;33(4):538-46.
  • 12. Rodu B, Tate AL, Martinez MG Jr. The implications of inflammation in odontogenic keratocysts. J Oral Pathol. 1987;16(10):518-21.
  • 13. Pindborg JJ, Philipsen HP, Henriksen J. Studies on odontogenic cyst epithelium. In: Sognnaes RF, ed. Fundamentals of Keratinization (Vol. 1). Washington, DC. American Association of the Advancement of Science, 1962:151–60.
  • 14. Shear M. Primordial cyst. Journal of the Dental Association of South Africa 1960;15(2):211-7.
  • 15. Kramer IR, Pindborg JJ, Shear M. The WHO Histological Typing of Odontogenic Tumours. A Commentary on the Second Edition. Cancer. 1992;70(12):2988-94.
  • 16. Barnes L, Eveson JW, Reichart P, Sidransky D. World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of the Head and Neck. 3rd ed. Lyon. IARC, 2005.
  • 17. Wright JM, Vered M. Update from the 4th Edition of the World Health Organization Classification of Head and Neck Tumours: odontogenic and maxillofacial bone tumors. Head and Neck Pathology. 2017;11(1):68-77.
  • 18. Pogrel MA, Jordan RC. Marsupialization as a definitive treatment for the odontogenic keratocyst. J Oral Maxillofac Surg. 2004;62(6):651-5
  • 19. Diniz MG, Galvão CF, Macedo PS, Gomes CC, Gomez RS. Evidence of loss of heterozygosity of the PTCH gene in orthokeratinized odontogenic cyst. J Oral Pathol Med. 2011;40(3):277-80.
  • 20. Pavelić B, Levanat S, Crnić I, Kobler P, Anić I, Manojlović S et al. PTCH gene altered in dentigerous cysts. J Oral Pathol Med. 2001;30(9):569-76.
There are 20 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Fatih Yılmaz 0000-0001-8216-1753

Ömür Dereci 0000-0003-0468-1096

Nesrin Saruhan 0000-0003-1160-4179

Fuat Açıkalın 0000-0003-1708-467X

Publication Date April 30, 2022
Submission Date October 7, 2021
Published in Issue Year 2022 Volume: 24 Issue: 1

Cite

APA Yılmaz, F., Dereci, Ö., Saruhan, N., Açıkalın, F. (2022). CLINICOPATHOLOGICAL ANALYSIS OF ODONTOGENIC KERATOCYSTS: 10 YEARS EXPERIENCE FROM A SINGLE CENTER. The Journal of Kırıkkale University Faculty of Medicine, 24(1), 47-54. https://doi.org/10.24938/kutfd.1003955
AMA Yılmaz F, Dereci Ö, Saruhan N, Açıkalın F. CLINICOPATHOLOGICAL ANALYSIS OF ODONTOGENIC KERATOCYSTS: 10 YEARS EXPERIENCE FROM A SINGLE CENTER. Kırıkkale Uni Med J. April 2022;24(1):47-54. doi:10.24938/kutfd.1003955
Chicago Yılmaz, Fatih, Ömür Dereci, Nesrin Saruhan, and Fuat Açıkalın. “CLINICOPATHOLOGICAL ANALYSIS OF ODONTOGENIC KERATOCYSTS: 10 YEARS EXPERIENCE FROM A SINGLE CENTER”. The Journal of Kırıkkale University Faculty of Medicine 24, no. 1 (April 2022): 47-54. https://doi.org/10.24938/kutfd.1003955.
EndNote Yılmaz F, Dereci Ö, Saruhan N, Açıkalın F (April 1, 2022) CLINICOPATHOLOGICAL ANALYSIS OF ODONTOGENIC KERATOCYSTS: 10 YEARS EXPERIENCE FROM A SINGLE CENTER. The Journal of Kırıkkale University Faculty of Medicine 24 1 47–54.
IEEE F. Yılmaz, Ö. Dereci, N. Saruhan, and F. Açıkalın, “CLINICOPATHOLOGICAL ANALYSIS OF ODONTOGENIC KERATOCYSTS: 10 YEARS EXPERIENCE FROM A SINGLE CENTER”, Kırıkkale Uni Med J, vol. 24, no. 1, pp. 47–54, 2022, doi: 10.24938/kutfd.1003955.
ISNAD Yılmaz, Fatih et al. “CLINICOPATHOLOGICAL ANALYSIS OF ODONTOGENIC KERATOCYSTS: 10 YEARS EXPERIENCE FROM A SINGLE CENTER”. The Journal of Kırıkkale University Faculty of Medicine 24/1 (April 2022), 47-54. https://doi.org/10.24938/kutfd.1003955.
JAMA Yılmaz F, Dereci Ö, Saruhan N, Açıkalın F. CLINICOPATHOLOGICAL ANALYSIS OF ODONTOGENIC KERATOCYSTS: 10 YEARS EXPERIENCE FROM A SINGLE CENTER. Kırıkkale Uni Med J. 2022;24:47–54.
MLA Yılmaz, Fatih et al. “CLINICOPATHOLOGICAL ANALYSIS OF ODONTOGENIC KERATOCYSTS: 10 YEARS EXPERIENCE FROM A SINGLE CENTER”. The Journal of Kırıkkale University Faculty of Medicine, vol. 24, no. 1, 2022, pp. 47-54, doi:10.24938/kutfd.1003955.
Vancouver Yılmaz F, Dereci Ö, Saruhan N, Açıkalın F. CLINICOPATHOLOGICAL ANALYSIS OF ODONTOGENIC KERATOCYSTS: 10 YEARS EXPERIENCE FROM A SINGLE CENTER. Kırıkkale Uni Med J. 2022;24(1):47-54.

This Journal is a Publication of Kırıkkale University Faculty of Medicine.