Keratocystic odontogenic tumor (KCOT) of the mandible

Case contributed by Prof Oliver Hennessy


Jaw pain

Patient Data

Age: 23
Gender: Male

There is a lytic benign appearing lesion within the angle of the mandible on the right. There is well-defined with no cortical breach and no soft tissue mass.

There is no involvement of the adjacent dental anatomy. There is no unerupted tooth associated with this mandibular cystic lesion.

The appearances are those of a benign lesion probably a keratocystic odontogenic tumor.

There is a unilocular lytic lesion in the angle of the right hemimandible extending anteriorly from the lateral root of the second molar to the ascending ramus of the mandible posteriorly. The inferior alveolar nerve canal courses along the posterior aspect of the lesion with focal area of dehiscence of the canal; it then courses inferior to the canal in the body of the mandible. The internal attenuation is noted of the fluid attenuation. There is no pathological fracture, periosteal reaction or extraosseous tissue extension.

Unremarkable appearance of the remainder of the mandible with enlocated temporomandibular joints. The imaged paranasal sinuses are clear. The pituitary fossa is incompletely imaged and it contains partially imaged adipose tissue. No large mass lesion in the imaged intracranial compartment.


There is a unilocular lytic lesion in the right mandibular angle with imaging appearances of either keratocystic odontogenic tumor or a unilocular ameloblastoma.

Case Discussion

The most likely diagnosis of this cystic mandibular lesion is either a KCOT or a unilocular ameloblastoma.

Pathology confirmed the presence of a KCOT.

PlayAdd to Share

Case information

rID: 33513
Published: 18th Jan 2015
Last edited: 17th Nov 2019
System: Head & Neck
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.