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Head and Neck Pathology Dec 2014As our knowledge of disease improves, its classification continually evolves. The last WHO classification of odontogenic tumors was 9 years ago and it is time for... (Review)
Review
As our knowledge of disease improves, its classification continually evolves. The last WHO classification of odontogenic tumors was 9 years ago and it is time for revision. We offer the following critique as a constructive, thought provoking challenge to those chosen to provide contemporary insight into the next WHO classification of odontogenic cysts, tumors, and allied conditions.
Topics: Humans; Odontogenic Cysts; Odontogenic Tumors; World Health Organization
PubMed: 25409849
DOI: 10.1007/s12105-014-0585-x -
Journal of Cancer Research and... 2017The odontogenic keratocyst is known for its aggressiveness, high recurrence rate, and transformation of keratinized epithelia to nonkeratinized squamous epithelium for...
INTRODUCTION
The odontogenic keratocyst is known for its aggressiveness, high recurrence rate, and transformation of keratinized epithelia to nonkeratinized squamous epithelium for which inflammation has been suggested to be responsible. B-cell lymphoma/leukemia-2 (Bcl-2) an anti-apoptotic protein, prolongs the life span of epithelial cells and allows proliferation, differentiation, and morphogenesis.
MATERIALS AND METHODS
Study was carried out comprising of 90 cases; (30 ameloblastoma, 30 keratocystic odontogenic tumor (KCOT), and 30 radicular cyst). Bcl-2 expression was determined with respect to localization, area (percentage) and intensity of stained cells in epithelium, and connective tissue stroma by counting the endothelial, round, and fusiform cells.
RESULTS
In epithelium bcl-2 expression in KCOTs was higher followed by ameloblastoma and lowest in the radicular cyst. Whereas, in connective tissue stroma bcl-2 expression was higher in KCOT and radicular cyst than ameloblastoma cases. Solid variants showed statistically higher expression as compared to the unicystic variants of ameloblastoma (P = 0.009, 0.033, 0.011, and 0.041).
CONCLUSION
High expression of bcl-2 in KCOT supports the general agreement that some features of KCOT are those of a neoplasia. The bcl-2 expression in connective tissue cells suggests that these cells may also be important as epithelial cells in the biological behavior odontogenic keratocyst.
Topics: Ameloblastoma; Apoptosis; Cell Differentiation; Epithelial Cells; Female; Gene Expression Regulation, Neoplastic; Humans; Leukemia, B-Cell; Lymphoma, B-Cell; Male; Odontogenic Cysts; Odontogenic Tumors; Proto-Oncogene Proteins c-bcl-2; Radicular Cyst
PubMed: 28862228
DOI: 10.4103/0973-1482.183197 -
The Cochrane Database of Systematic... Nov 2015The keratocystic odontogenic tumours (KCOTs) account for between about 2% and 11% of all jaw cysts and can occur at any age. They are more common in males than females... (Review)
Review
BACKGROUND
The keratocystic odontogenic tumours (KCOTs) account for between about 2% and 11% of all jaw cysts and can occur at any age. They are more common in males than females with a male:female ratio of approximately 2:1. Although they are benign, KCOTs are locally very aggressive and have a tendency to recur after treatment. Reported recurrence rates range from 3% to 60%. The traditional method for the treatment of most KCOTs is surgical enucleation. However, due to the lining of the cyst being delicate and the fact that they frequently recur, this method alone is not sufficient. Adjunctive surgical treatment has been proposed in addition to the surgical enucleation, such as removal of the peripheral bone (ostectomy) or resection of the cyst with surrounding bone (en-bloc) resection. Other adjunctive treatments proposed are: cryotherapy (freezing) with liquid nitrogen and the use of the fixative Carnoy's solution placed in the cyst cavity after enucleation; both of which attempt to address residual tissue to prevent recurrence.
OBJECTIVES
To assess the available evidence comparing the effectiveness of interventions for the treatment of KCOTs.
SEARCH METHODS
We searched the following electronic databases: the Cochrane Oral Health Group Trials Register (to 17 March 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2015, Issue 2), MEDLINE via Ovid (1946 to 17 March 2015) and EMBASE via Ovid (1980 to 17 March 2015). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
Randomised controlled trials comparing one modality of intervention with another with or without adjunctive treatment for the treatment of KCOTs. Adults, over the age of 18 with a validated diagnosis of solitary KCOTs arising in the jaw bones of the maxilla or mandible. Patients with known Gorlin syndrome were to be excluded.
DATA COLLECTION AND ANALYSIS
Review authors screened trials for inclusion. Full papers were obtained for relevant and potentially relevant trials. If data had been extracted, it would have been synthesised using the fixed-effect model, if substantial clinical diversity were identified between studies we planned to use the random-effects model with studies grouped by action provided there were four or more studies included in the meta-analysis, and we would have explored the heterogeneity between the included studies.
MAIN RESULTS
No randomised controlled trials that met the inclusion criteria were identified.
AUTHORS' CONCLUSIONS
There are no published randomised controlled trials relevant to this review question, therefore no conclusions could be reached about the effectiveness or otherwise of the interventions considered in this review. There is a need for well designed and conducted randomised controlled trials to evaluate treatments for KCOTs.
Topics: Adult; Female; Humans; Male; Mandibular Diseases; Maxillary Diseases; Odontogenic Cysts; Odontogenic Tumors
PubMed: 26545201
DOI: 10.1002/14651858.CD008464.pub3 -
Head and Neck Pathology Sep 2022Ghost cell odontogenic carcinoma (GCOC) is a rare malignant tumor of odontogenic origin, with only about 50 cases reported in the English literature so far.... (Review)
Review
Ghost cell odontogenic carcinoma (GCOC) is a rare malignant tumor of odontogenic origin, with only about 50 cases reported in the English literature so far. Histologically, it is characterized by ghost cells, dentinoid deposits, high grade malignant cellular features, and areas of necrosis and invasion. Having common histological features with other odontogenic ghost cell lesions (OGCL) like calcifying odontogenic cyst (COC) and dentinogenic ghost cell tumors, it is crucial to recognize GCOC malignant features, as it can be destructive and invasive, sometimes showing distant metastases and high recurrence rate. For this reason, it may entail more aggressive surgical approach and multimodal therapeutic regimen. Here we present a case report of GCOC arising in a previous COC, treated with surgical excision that showed persistence and recurrence after two years. The clinical and histological features of this rare occurrence are presented, in addition to the surgical approach, and a summary of literature review of OGCL.
Topics: Carcinoma; Humans; Jaw Neoplasms; Odontogenic Cyst, Calcifying; Odontogenic Cysts; Odontogenic Tumors
PubMed: 35389163
DOI: 10.1007/s12105-022-01445-6 -
Journal of the American Veterinary... Jun 2020To characterize clinical, radiographic, and histologic features of canine furcation cysts (CFCs) in dogs and to propose possible mechanisms of CFC development.
OBJECTIVE
To characterize clinical, radiographic, and histologic features of canine furcation cysts (CFCs) in dogs and to propose possible mechanisms of CFC development.
ANIMALS
20 client-owned dogs with CFCs biopsied between January 1, 2013, and December 31, 2017.
PROCEDURES
Medical records of the Center for Comparative Oral and Maxillofacial Pathology at the University of Wisconsin-Madison were retrospectively searched to identify records of dogs that had surgical biopsy specimens of mandibular or maxillary cavitary lesions diagnosed as odontogenic cysts and that met additional inclusion criteria. Biopsy sample submission records, medical records, clinical and radiographic images, and histologic samples were reviewed. Clinical, radiographic, and histologic features were evaluated.
RESULTS
Mean body weight and age of affected dogs were 23.5 kg (51.7 lb) and 8.2 years, respectively. All 20 dogs had a unilateral cyst, with the right (n = 13) or left (7) maxillary fourth premolar tooth affected and viable in all dogs. A predominant clinical sign was a fluctuant swelling of the buccal gingiva and mucosa overlying the CFC, and enucleation of the cyst lining, with or without extraction of the affected tooth, resolved the lesion in most dogs.
CONCLUSIONS AND CLINICAL RELEVANCE
Our findings indicated that CFC is an odontogenic cyst of uncertain etiopathogenesis and that complete evaluation of the clinical, radiographic, and histologic features of the lesion in affected patients is necessary to distinguish a CFC from other odontogenic cysts and tumors in dogs. Defining CFCs in terms of characteristic features permits accurate diagnosis and appropriate treatment of these previously unclassifiable odontogenic cysts in dogs.
Topics: Animals; Biopsy; Dog Diseases; Dogs; Mandible; Maxilla; Odontogenic Cysts; Retrospective Studies
PubMed: 32459593
DOI: 10.2460/javma.256.12.1359 -
Journal of Oral Science Dec 2010Calcifying odontogenic cyst (COC) is a developmental odontogenic cyst in the jaw. Because of its diverse histopathologic features and biological behavior, there has long...
Calcifying odontogenic cyst (COC) is a developmental odontogenic cyst in the jaw. Because of its diverse histopathologic features and biological behavior, there has long been confusion with regard to its nature as a cyst or neoplasm. This study evaluated the proliferative activity of 57 COC samples, including simple cyst (10 cases), cystic neoplasm (34 cases), solid neoplasm (6 cases) and combined lesion (7 cases) by p53 and PCNA immunohistochemical staining. For assessment of p53 and PCNA positivity, the number of positively stained cells with brown-stained nuclei was counted in 1000 cells from each sample. p53 and PCNA expression in the solid neoplasm subtype were significantly higher when compared to cystic neoplasm and simple cyst (P < 0.05). The lowest p53 and PCNA expression was found in the simple cyst subtype. p53 and PCNA expression in the basal and suprabasal layers was significantly higher in the solid subtype when compared to others, and the difference between COC groups was significant. The results demonstrated that within benign types of COC, the amount of p53 and PCNA in proliferative epithelium is significantly higher when compared to non-proliferative epithelium. p53 and PCNA markers are possible parameters for differentiation of COC subtypes.
Topics: Adolescent; Adult; Analysis of Variance; Child; Female; Humans; Immunohistochemistry; Jaw Neoplasms; Male; Middle Aged; Odontogenic Cyst, Calcifying; Proliferating Cell Nuclear Antigen; Retrospective Studies; Statistics, Nonparametric; Tumor Suppressor Protein p53; Young Adult
PubMed: 21206164
DOI: 10.2334/josnusd.52.609 -
Head and Neck Pathology Mar 2011The peripheral calcifying odontogenic cyst (PCOC) accounts for less than 25% of the cases of calcifying odontogenic cysts and most commonly appears as a nodule on the... (Review)
Review
The peripheral calcifying odontogenic cyst (PCOC) accounts for less than 25% of the cases of calcifying odontogenic cysts and most commonly appears as a nodule on the gingiva. This paper aims to present both a case report of a PCOC located in the left vestibular maxilla as well as a review of the English-language literature. An 11-year-old female patient presented a swelling in the vestibular region of teeth 12 and 13. Periapical and panoramic radiographs demonstrated irregular calcification. Surgical excision was performed. Microscopic examination showed an odontogenic cystic lesion lined by ameloblastoma-like epithelium, containing numerous ghost cells. Areas of calcification associated with ghost cells could also be observed. The patient was diagnosed with PCOC. The patient has been disease-free for 36 months. The review of the cases of PCOC showed 44 well-defined cases. The mean age was of 49.4 years at the time of diagnosis. The reported cases appeared as a painless swelling, with a slight predilection for females, and were more frequently located in the anterior region of the maxilla or mandible. Surgical excision is the treatment of choice, and recurrence is rare.
Topics: Child; Female; Humans; Maxillary Neoplasms; Odontogenic Cyst, Calcifying
PubMed: 20953743
DOI: 10.1007/s12105-010-0213-3 -
Biomedical Papers of the Medical... Mar 2022The detection of odontogenic keratocysts (OKC) in the oral cavity is one of the main criteria for the clinical manifestation of Gorlin-Goltz syndrome (Nevoid Basal Cell...
AIMS
The detection of odontogenic keratocysts (OKC) in the oral cavity is one of the main criteria for the clinical manifestation of Gorlin-Goltz syndrome (Nevoid Basal Cell Carcinoma Syndrome - NBCCS). From a clinical point of view, we distinguish between "syndromic" and "sporadic" OKC. Syndromic cysts, often multifocal, may be an accidental finding on X-ray examination. They can manifest gradually depending on the development of permanent dentition. Sporadic cysts are rather solitary lesions with clinical manifestation in adulthood.
METHODS
Mutations in the PTCH1 gene are thought to be the cause of the clinical manifestation of NBCCS. These abnormalities can be transmitted from one generation to another and lead to a familial occurrence of the disease. In 35-50% of cases, these are a newly arising mutations. It is necessary to take into account the typical manifestations which in the next generation begin at a younger age and the disease usually has a more serious course.
RESULTS
We found a familial manifestation of NBCCS in two pairs of patients (mother and daughter and two siblings). Odontogenic keratocysts and cutaneous basal cell carcinomas were diagnosed and genetic testing revealed mutations in the PTCH 1 gene in all four individuals.
CONCLUSIONS
With regard to the possibility of familial occurrence of NBCCS, it is necessary to pay increased attention to family history and, if necessary, to ensure clinical and genetic examination of parents and other family members. Patients of childbearing potential with evidence of NBCCS should be informed of the increased likelihood of the disease in the offspring.
Topics: Adult; Basal Cell Nevus Syndrome; Humans; Mutation; Odontogenic Cysts
PubMed: 33542540
DOI: 10.5507/bp.2020.063 -
Medicina Oral, Patologia Oral Y Cirugia... Jan 2018the objective of this study was to describe the frequency of cystic lesions in a Brazilian population of patients histopathologically diagnosed in the first and second...
BACKGROUND
the objective of this study was to describe the frequency of cystic lesions in a Brazilian population of patients histopathologically diagnosed in the first and second decade of life.
MATERIAL AND METHODS
Retrospective descriptive cross-sectional study was performed. Biopsy records were obtained from the archives of a Brazilian referral center between 1980 and 2016.
RESULTS
A total of 2.114 biopsy records of pediatric patients were analyzed with oral and maxillofacial lesions. Data such as gender, age, anatomical location, and histopathological diagnosis were collected and categorized. Among all oral and maxillofacial lesions (n=2.114), were diagnosed 294 cases of odontogenic cysts (13.9%) and 16 cases of non-odontogenic cysts (0.8%). The most frequent lesions in each group were, respectively: radicular cyst (n=145) and epidermoid cyst (n=4). These lesions were most common in female (n=158), with a mean age of 14 years. For intraosseous lesions, the mandible (n=148) was the most affected anatomic site; moreover, the floor of the mouth (n=6) was most affected by cysts in soft tissues.
CONCLUSIONS
Odontogenic cysts were relatively common in population studied, but non-odontogenic cysts were rare in these patients.
Topics: Adolescent; Brazil; Child; Child, Preschool; Cross-Sectional Studies; Epidemiologic Studies; Female; Humans; Infant; Male; Nonodontogenic Cysts; Odontogenic Cysts; Retrospective Studies; Young Adult
PubMed: 29274165
DOI: 10.4317/medoral.22138 -
Medicina Oral, Patologia Oral Y Cirugia... Jan 2012To determine the relative frequency and distribution of odontogenic and nonodontogenic cysts in a large Turkish population.
OBJECTIVE
To determine the relative frequency and distribution of odontogenic and nonodontogenic cysts in a large Turkish population.
STUDY DESIGN
A retrospective survey of jaw cysts was undertaken at the Oral Diagnosis and Radiology and Oral and Maxillofacial Surgery Department, Ondokuz Mayis University Dental School, Samsun, Turkey. Data were retrieved from clinical files, imaging, and histopathology reports from 2000 to 2008; a total of 12,350 patients were included. In each case, we analyzed age, gender, type and number of cysts, and cyst location. Imaging patterns and pathologies associated with cystic lesions were also determined.
RESULTS
The prevalence of odontogenic and nonodontogenic cysts was 3.51%; males were affected more frequently than females. There were 452 odontogenic cysts (98.5%) and seven nonodontogenic cysts (1.5%). The most frequent odontogenic cyst was radicular (54.7%), followed by dentigerous (26.6%), residual (13.7%), odontogenic keratocyst (3.3%), and lateral periodontal cyst (0.2%). Nasopalatine duct cyst (1.5%) was the only nonodontogenic cyst. By age, cysts peaked in the third decade (24.2%). Concerning location, no statistically significant difference was found between the maxilla and mandible (p>0.05). The most frequent radiological feature of these lesions was unilocular cyst (93.7%). Pathologies associated with cystic lesions occurred in 14.7%.
CONCLUSION
The prevalence of both odontogenic and nonodontogenic cysts were lower than that reported in many other studies. In our study population, cysts were mainly inflammatory in origin.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Female; Humans; Jaw Diseases; Male; Middle Aged; Nonodontogenic Cysts; Odontogenic Cysts; Prevalence; Retrospective Studies; Turkey; Young Adult
PubMed: 21743428
DOI: 10.4317/medoral.17088