Orthokeratinized odontogenic cyst Report of three cases
Panos CHRISTOPOULOS, Fotios TZERBOS, Evangelia PIPERI, Georgios KAMPEROS, Alexandra SKLAVOUNOU
Department of Oral and Maxillofacial Surgery (Head: Professor I. Iatrou), Department of Oral Pathology (Head: Professor A. Sklavounou), Dental School, National and Kapodistrian University of Athens
Hellenic Archives of Oral & Maxillofacial Surgery (2015) 2, 57-63
SUMMARY: Orthokeratinized Odontogenic Cyst (OOC) is a lesion characterized histologically by the presence of orthokeratinized cystic epithelium, believed to be a distinct clinical entity from the widely known odontogenic keratocyst (Odontogenic Keratocystic Tumor -OKT). The aim of this study is to present three cases of OOC and discuss their clinical and histopathological features. All patients were males aged 37, 57 and 65 years respec- tively. Two of the lesions were located in the posterior mandible and the third one in the posterior maxilla. Radiographically, they presented either as unilocular (2/3) or as multilocular radiolucencies (1/3). Enucleation was the treatment of choice. Histopathological analysis revealed in all cases a cystic cavity lined by thin and flat or- thokeratinized multilayered squamous epithelium, with a prominent granular cell layer and absence of basal cell palisading. The final diagnosis was OOC and the follow-up period 6-18 months postsurgically has been uneventful. CONCLUSIONS: OOC is not a histological variant of odontogenic keratocyst but a distinct clinical entity. Enucleation of the lesion is the treatment of choice. OOC shows a benign biological behavior with a low risk for recurrence.
KEY WORDS: keratocystic odontogenic tumor, odontogenic cyst, orthokeratinized odontogenic cyst.
REFERENCES
Brannon RB: The odontogenic keratocyst. A clinicopathologic study of 312 cases. Part II. Histologic features. Oral Surg Oral Med Oral Pathol 43: 233-255, 1977
Cheng YS, Liang H, Wright J, Teenier T: Multiple orthokeratinized odontogenic cysts: a case report. Head Neck Pathol 9: 153-157, 2015
Chirapathomsakul D, Sastravaha P, Jansisyanont P: A review of odon- togenic keratocysts and the behavior of recurrences. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101: 5-9, 2006
da Silva MJ, de Sousa SO, Corrêa L, Carvalhosa AA, De Araújo VC: Immunohistochemical study of the orthokeratinized odontogenic cyst: a comparison with the odontogenic keratocyst. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 94: 732-737, 2002
Deyhimi P, Hashemzadeh Z: Study of the biologic behavior of odon- togenic keratocyst and orthokeratinized odontogenic cyst using TGF-alpha and P53 markers. Pathol Res Pract 210: 201-204, 2014 Dong Q, Pan S, Sun LS, Li TJ: Orthokeratinized odontogenic cyst: a clinicopathologic study of 61 cases. Arch Pathol Lab Med 134:
271-275, 2010
Gani F, Mahomed F, Meer S: Evaluation of Ki-67 and cyclin D1 expres- sion in odontogenic keratocysts and orthokeratinised jaw cysts. SADJ 67: 370-373, 2012
Li TJ, Kitano M, Chen XM, Itoh T, Kawashima K, Sugihara K, Nozoe E, Mimura T: Orthokeratinized odontogenic cyst: a clinicopatholog- ical and immunocytochemical study of 15 cases. Histopathology 23: 242-251, 1998
Li TJ: The odontogenic keratocyst: a cyst, or a cystic neoplasm? J Dent Res 90: 133-142, 2011
Lo Muzio L, Santarelli A, Caltabiano R, Rubini C, Pieramici T, Fior A, Trevisiol L, Carinci F, Leonardi R, Bufo P, Lanzafame S, Piattelli A: p63 expression in odontogenic cysts. Int J Oral Maxillofac Surg 34: 668-673, 2005
Macdonald-Jankowski DS: Orthokeratinized odontogenic cyst: a sys- tematic review. Dentomaxillofac Radiol 39: 455-467, 2010
Nayak MT, Singh A, Singhvi A, Sharma R: Odontogenic keratocyst: What is in the name? J Nat Sci Biol Med 4: 282-285, 2013
Philipsen HP: Keratocystic odontogenic tumour, In: Barnes, Eveson, Re- ichart, Sidransky: World Health Organization Classification of Tu- mours. Pathology and Genetics of Head and Neck Tumours. IARC Press 2005, pp. 306-307
Philipsen HP: Om keratocyster (kolesteatom) i kaeberne. Tandlaege- blated 60: 963-981, 1956
Rangiani A, Motahhary P: Evaluation of bax and bcl-2 expression in odontogenic keratocysts and orthokeratinized odontogenic cysts: A comparison of two cysts. Oral Oncol 45: 41-44, 2009
Roy S, Garg V: Evaluation of stromal myofibroblasts expression in kera- tocystic odontogenic tumor and orthokeratinized odontogenic cysts: A comparative study. J Oral Maxillofac Pathol 17: 207-211, 2013
Vered M, Shohat I, Buchner A, Dayan D: Myofibroblasts in stroma of odontogenic cysts and tumors can contribute to variations in the biological behavior of lesions. Oral Oncol 41: 1028-1033, 2005
Wright JM: The odontogenic keratocyst: orthokeratinized variant. Oral Surg Oral Med Oral Pathol 51: 609-618, 1981
Department of Oral and Maxillofacial Surgery (Head: Professor I. Iatrou), Department of Oral Pathology (Head: Professor A. Sklavounou), Dental School, National and Kapodistrian University of Athens
Hellenic Archives of Oral & Maxillofacial Surgery (2015) 2, 57-63
SUMMARY: Orthokeratinized Odontogenic Cyst (OOC) is a lesion characterized histologically by the presence of orthokeratinized cystic epithelium, believed to be a distinct clinical entity from the widely known odontogenic keratocyst (Odontogenic Keratocystic Tumor -OKT). The aim of this study is to present three cases of OOC and discuss their clinical and histopathological features. All patients were males aged 37, 57 and 65 years respec- tively. Two of the lesions were located in the posterior mandible and the third one in the posterior maxilla. Radiographically, they presented either as unilocular (2/3) or as multilocular radiolucencies (1/3). Enucleation was the treatment of choice. Histopathological analysis revealed in all cases a cystic cavity lined by thin and flat or- thokeratinized multilayered squamous epithelium, with a prominent granular cell layer and absence of basal cell palisading. The final diagnosis was OOC and the follow-up period 6-18 months postsurgically has been uneventful. CONCLUSIONS: OOC is not a histological variant of odontogenic keratocyst but a distinct clinical entity. Enucleation of the lesion is the treatment of choice. OOC shows a benign biological behavior with a low risk for recurrence.
KEY WORDS: keratocystic odontogenic tumor, odontogenic cyst, orthokeratinized odontogenic cyst.
REFERENCES
Brannon RB: The odontogenic keratocyst. A clinicopathologic study of 312 cases. Part II. Histologic features. Oral Surg Oral Med Oral Pathol 43: 233-255, 1977
Cheng YS, Liang H, Wright J, Teenier T: Multiple orthokeratinized odontogenic cysts: a case report. Head Neck Pathol 9: 153-157, 2015
Chirapathomsakul D, Sastravaha P, Jansisyanont P: A review of odon- togenic keratocysts and the behavior of recurrences. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101: 5-9, 2006
da Silva MJ, de Sousa SO, Corrêa L, Carvalhosa AA, De Araújo VC: Immunohistochemical study of the orthokeratinized odontogenic cyst: a comparison with the odontogenic keratocyst. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 94: 732-737, 2002
Deyhimi P, Hashemzadeh Z: Study of the biologic behavior of odon- togenic keratocyst and orthokeratinized odontogenic cyst using TGF-alpha and P53 markers. Pathol Res Pract 210: 201-204, 2014 Dong Q, Pan S, Sun LS, Li TJ: Orthokeratinized odontogenic cyst: a clinicopathologic study of 61 cases. Arch Pathol Lab Med 134:
271-275, 2010
Gani F, Mahomed F, Meer S: Evaluation of Ki-67 and cyclin D1 expres- sion in odontogenic keratocysts and orthokeratinised jaw cysts. SADJ 67: 370-373, 2012
Li TJ, Kitano M, Chen XM, Itoh T, Kawashima K, Sugihara K, Nozoe E, Mimura T: Orthokeratinized odontogenic cyst: a clinicopatholog- ical and immunocytochemical study of 15 cases. Histopathology 23: 242-251, 1998
Li TJ: The odontogenic keratocyst: a cyst, or a cystic neoplasm? J Dent Res 90: 133-142, 2011
Lo Muzio L, Santarelli A, Caltabiano R, Rubini C, Pieramici T, Fior A, Trevisiol L, Carinci F, Leonardi R, Bufo P, Lanzafame S, Piattelli A: p63 expression in odontogenic cysts. Int J Oral Maxillofac Surg 34: 668-673, 2005
Macdonald-Jankowski DS: Orthokeratinized odontogenic cyst: a sys- tematic review. Dentomaxillofac Radiol 39: 455-467, 2010
Nayak MT, Singh A, Singhvi A, Sharma R: Odontogenic keratocyst: What is in the name? J Nat Sci Biol Med 4: 282-285, 2013
Philipsen HP: Keratocystic odontogenic tumour, In: Barnes, Eveson, Re- ichart, Sidransky: World Health Organization Classification of Tu- mours. Pathology and Genetics of Head and Neck Tumours. IARC Press 2005, pp. 306-307
Philipsen HP: Om keratocyster (kolesteatom) i kaeberne. Tandlaege- blated 60: 963-981, 1956
Rangiani A, Motahhary P: Evaluation of bax and bcl-2 expression in odontogenic keratocysts and orthokeratinized odontogenic cysts: A comparison of two cysts. Oral Oncol 45: 41-44, 2009
Roy S, Garg V: Evaluation of stromal myofibroblasts expression in kera- tocystic odontogenic tumor and orthokeratinized odontogenic cysts: A comparative study. J Oral Maxillofac Pathol 17: 207-211, 2013
Vered M, Shohat I, Buchner A, Dayan D: Myofibroblasts in stroma of odontogenic cysts and tumors can contribute to variations in the biological behavior of lesions. Oral Oncol 41: 1028-1033, 2005
Wright JM: The odontogenic keratocyst: orthokeratinized variant. Oral Surg Oral Med Oral Pathol 51: 609-618, 1981
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