Keratocystic odontogenic tumor

Case contributed by Dr Saad Ahmed Saad Hassan

Presentation

Extensive radiolucency of the right mandible on OPG that is associated with right facial swelling.

Patient Data

Age: 45 years
Gender: Male
CT

There is a huge expansile unilocular cystic lesion involving the angle and ramus of the right hemimandible. The lesion abuts the root of the right lower molar tooth anteriorly then it extends posteriorly and superiorly along the long axis of the mandible to involve the whole coronoid process and reaches the articular region of the condylar process. There are no matrix calcifications or soft tissue components. The adjacent cortex is scalloped and thinned out with multiple areas of cortical dehiscence, but the lesion remains sharply defined with no definite invasion of the adjacent masseter or the medial pterygoid muscles. The alveolar canal is involved.

Case Discussion

Histology results:

These are pieces of a cyst lined by parakeratotic odontogenic epithelium. The odontogenic epithelium has a surface, undulating parakeratosis. No inflammatory activity is present. The features favor an odontogenic keratocyst.

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Case information

rID: 70477
Published: 28th Aug 2019
Last edited: 2nd Sep 2019
System: Head & Neck
Inclusion in quiz mode: Included
Excluded from licensing
Institution: Poole NHS Foundation Trust

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