Kcots differ from other odontogenic cysts because of its aggressive behavior, specific histopathological features and tendency to recurrence. At the time of writing 2016, it is still the most widely used classification system although a new revision is due to come up in 2017. Study 52 odontogenic tumors flashcards from dental s. Since the lesion was located only to the maxillary jaw, ameloblastoma would be more likely than myxoma, central giant cell lesions, and nevoid basal carcinoma. The keratocystic odontogenic tumor kot is a benign odontogenic tumor that was formally known as an odontogenic keratocyst okc. Some are composed only of odontogenic epithelium, while many are mixed i. Ameloblastic carcinoma is a rare malignant odontogenic tumor and is the malignant counterpart of ameloblastoma. The keratocystic odontogenic tumor is an intraosseous malignancy having a characteristic lining of parakeratinized stratified squamous epithelium originating from the primordial odontogenic epithelium. This book greatly expands the body of knowledge in the field of odontogenic tumor pathology.
The keratocystic odontogenic tumor was the most prevalent histological type 30%, followed by the ameloblastoma 23,7%. According to their size, location, and relations with surrounding structures, they are treated by cyst enucleation or enucleation after either marsupialization or decompression. Maxillary keratocystic odontogenic tumor with sinus. Benign odontogenic epithelial tumors ameloblastoma squamous odontogenic tumor calcifying epithelial odontogenic tumor adenomatoid odontogenic tumor keratocystic odontogenic tumor odontogenic keratocyst odontogenic epithelial ectomesenchymal ameloblastic. Keratocystic odontogenic tumour wikipedia republished. This report describes a rare case of bilateral ciliated epitheliumlined odontogenic keratocyst in the maxilla of a 15yearold male. This epithelial tumor has an inductive effect on the odontogenic ectomesenchyme with dentinoid frequently being produced. Cd166 expression in dentigerous cyst, keratocystic. Odontogenic and non odontogenic tumors of the jaws are a relatively rare and heterogeneous group of benign and malignant neoplasms, hamartomas, and other bonerelated lesions that demonstrate great variability in etiology, biologic behavior, and clinical significance. Odontogenic tumours manifesting in the first two decades of life in a.
Keratocystic odontogenic tumor according to lopes et al. It has sheets and strands of odontogenic epithelial cells. Panoramic radiography showed two lytic lesions on both sides of the maxilla associated with impacted third. Odontogenic keratocysts okc, previously known as keratocystic odontogenic tumors kcot or kot, are benign cystic lesions involving the mandible or maxilla and are believed to arise from dental lamina. Odontogenic tumors in an iranian population journal of oral science. They may arise from the epithelial part of the tooth germ, the mesenchymal part or from both.
Odontogenic tumours these tumors are unique to the jaws and originate from remnants of epithelium, ectomesenchyme or mesenchyme associated with tooth development, the abnormal tissue in each of these tumors can often be correlated with similar tissue in normal odontogenesis dr. Previously classified under developmental odontogenic cyst. The odontogenic keratocyst is a very well known odontogenic cyst. A keratocystic odontogenic tumour also keratocystic odontogenic tumor, kcot is a rare and benign but locally aggressive developmental cystic neoplasm. Odontogenic tumors comprise a complex group of lesions with varied histopathological and clinical features. Chapter 21 odontogenic and non odontogenic tumors of the jaws introduction. Keratocystic odontogenic tumor formerly odontogenic keratocysts koct is a unique cyst because of its locally aggressive behavior, high recurrence rate, and characteristic histological appearance and comprises approximately 11% of all cysts of the jaws. Keratocystic odontogenic tumors clinical and molecular.
The islands look identical to ameloblastoma, but that stroma is mature and dense whereas this ct is loose and resembles primitive dental papilla. While the aot is primarily an epithelial tumor, it does produce dentinoid, clearly not a product of odontogenic epithelium. Adenomatoid odontogenic tumor keratocystic odontogenic tumour. The 2005 who histological classification of odontogenic tumors lays out a classification system for neoplasms and other tumors related to the odontogenic apparatus. Keratocystic odontogenic tumor kcot is a benign intraosseous neoplasm of the jaw. A keratocystic odontogenic tumor kot formerly known as an odontogenic keratocyst is a benign cystic tumor of dental origin that probably arises from primitive dental lamina, most commonly occurs in the posterior mandible, and almost certainly represents the lesion that used to. Ameloblastoma was the most frequent benign tumour 43% followed by keratocystic odontogenic tumour 19% and adenomatoid odontogenic tumour 10%. The change in the name was done to differentiate this lesion from the more common keratinizing odontogenic cyst and to. Jan 22, 2014 adenomatoid odontogenic tumor aot formerly called an adenoameloblastoma, a somewhat deceptive term that should be discarded, the aot represents about 37 % of all odontogenic tumors. Keratocystic odontogenic tumor kcot is defined as a benign uni or multicystic intraosseous tumor of odontogenic origin, with a characteristic lining of parakeratinized stratified squamous epithelium and potentially aggressive, infiltrative behavior. Premalatha b r, patil s, rao r s, reddy n p, indu m. An aggressive intraosseous lesion derived from embryonic connective tissue associated with odontogenesis and primarily consisting of a mucoid ground substance with widely scattered undifferentiated spindled mesenchymal cells.
It is predominantly found in young and female patients, located more often in the maxilla in. Odontogenesis, odontogenic cysts, and odontogenic tumors. We present a case of aot in a 14yearold male who was misdiagnosed as dentigerous cyst. This lesion is categorised into three variants of which the more common variant is follicular type which is often mistaken for dentigerous cyst. It has the potential for infiltration and local aggressiveness and has a high rate of recurrence. Surgical management of dentigerous cyst and keratocystic. Formally known as cyst keratocystic odontogenic tumor calcifying odontongenic tumor. Calcifying odontogenic cyst coc and gorlins cyst derived from odontogenic epithelial cell rest commonly found in the incisor and canine region of the jaws 2nd an 3rd decades of life can be associated with odontomas teeth can be pushed out of the way because of this lesion. An odontogenic keratocyst is a rare and benign but locally aggressive developmental cyst. Keratocystic odontogenic tumor 40 51 ameloblastoma 18 23 odontoma 17 odontogenic myxoma 2 3 calcifying cystic odontogenic tumor 2 3 cementoblastoma 1 central odontogenic fibroma 1 1 calcifying epithelial odontogenic tumor 1 1 total 78 100 table 2 cases diagnosed distributed by gender. It is a benign developmental odontogenic tumor with many distinguishing clinical and histologic features. Pdf keratocystic odontogenic tumor invading the right.
Predictive factors of recurrence by ki67 and agnor labelling. Keratocystic odontogenic tumor kot represents form 515% of all maxillar cystic lesions. The keratocystic odontogenic tumor kcot is a benign uni or multicystic, intraosseous tumor of odontogenic origin 2 that has a slight male predilection and commonly. Primordial odontogenic tumor pot is a new entity, first reported in 2014 in the british journal histopathology. Treatment consisted of enucleation and curettage for 22 of the lesions, resection. Keratocystic odontogenic tumour of lesions treated in our clinic. Keratocystic odontogenic tumor kcot presents most frequently in the second, third and fourth decades of life 54. Keratocystic odontogenic tumors can occur in any area of the maxilla or mandible. Keratocystic odontogenic tumor in the maxillary sinus. Notch signaling affects oral neoplasm cell differentiation. Keratocystic odontogenic tumor associated with an ectopic. The orthokeratinizing odontogenic cyst is considered an unrelated entity without risk of recurrence or aggressive growth or association with nevoid basal cell carcinoma syndrome epidemiology 4 12% of all odontogenic cysts often compared to odontogenic cysts even though who classifies as tumor.
Keratocystic odontogenic tumor kcot has recently been recommended to describe the lesion previously named odontogenic keratocyst 15 kcot is a developmental cyst which is locally aggressive and rapidly prolifera. Maxillary peripheral keratocystic odontogenic tumor. We present the case of a 23yearold man with extensive kcot and impacted third molar in the right maxillary sinus. Review article a rare case of multilocalcalcifying epithelial. Diagnoses male female n % n % keratocystic odontogenic. Who has chosen to rename this cyst keratocystic odontogenic tumor, but some authors like marx and stern prefer to retain old terminology 5, 6.
Case discussion the most likely diagnosis of this cystic mandibular lesion is either a kcot or a unilocular ameloblastoma. Odontogenic tumor an overview sciencedirect topics. Odontogenic keratocyst keratocystic odontogenic tumor figs. It describes the epidemiologic, radiologic, and histopathologic features of presently known neoplasms and hamartomatous or tumor like lesions arising from the toothforming structures, as well as a number of distinctive jaw lesions that must be distinguished from odontogenic tumors. In this chapter, only those composed of both odontogenic epithelium and mesenchyme will be dealt with, separate chapters being devoted to the. Pindborg and hansen were first to point out the aggressive behavior of okc. The lesion gave the appearance of a keratocystic odontogenic tumor. We analyzed the etiopathogenetic, clinical, radiographic, and histopathologic aspects of keratocystic odontogenic tumors, particularly in association with dental anomalies of number, with the aim of providing useful information for their correct diagnosis, treatment, and prognosis within a multidisciplinary approach. Here, we evaluated diffusionweighted mr imaging for the differentiation of these 2 odontogenic tumors. A keratocystic odontogenic tumor kot is a benign neoplasm of the jaws that originates either from a dental lamina or from the primordial odontogenic epithelium. These epithelial islands will be cytopathologically benign without evidence of dysplasia. The who histological typing of odontogenic tumors, jaw cyst and allied lesions 2005 has defined aot as a tumor of odontogenic epithelium with ductlike.
The keratocystic odontogenic tumor is a benign odontogenic cystic neoplasia characterized by its thin, squamous epithelium with superficial parakeratosis. This neoplasia is predominantly found in males and people of white origin. A keratocystic odontogenic tumor is a benign but locally aggressive developmental odontogenic tumor that derives from dental lamina or form their remains and is most commonly located in the mandibular ramus and body. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Learn vocabulary, terms, and more with flashcards, games, and other study tools. A rare entity author kiran kumar mallela1, kapil jhajharia2, raj rai3, amol ashok dhokar4, sameer hemant runwal5, shahram karami6, simranjit singh7, rose kanwaljeet kaur. Odontogenic tumors encompass a group of lesions that share a common origin from odontogenic tissues. Over 50 years later the debate continues as to their proper classi. Reconstruction of extensive jaw defects induced by. Clinicopathological analysis of odontogenic tumors over 22 years.
Most common pathology in the mandible was dentigerous cyst followed by keratocystic odontogenic tumor while adenomatoid odontogenic tumor was observed more commonly in maxillary anterior region figure 2. Keratocystic odontogenic tumor kcot of the mandible. Odontogenic tumors are those lesions which originate from odontogenic epithelium. Tumor markers, odontogenic tumors, ameloblastoma, keratocystic odontogenic tumor how to cite this article. Ameloblastoma, a type of odontogenic tumor involving ameloblasts. Formerly called keratocystic odontogenic tumor the orthokeratinizing odontogenic cyst is considered an unrelated entity without risk of recurrence or aggressive growth or association with nevoid basal cell carcinoma syndrome epidemiology. As in all common odontogenic cysts, squamous odontogenic tumorlike proliferations may be seen in longstanding lesions. Although rare, because of its variable presentation calcifying cystic odontogenic tumor should be included in the differential diagnosis of jaw lesions. There are many types of cysts of the jaws, but what makes the odontogenic keratocyst unusual are its characteristic histopathological and clinical features, including potentially aggressive behaviour, high recurrence rate, and an association with the nevoid basal cell carcinoma syndrome. Review of the literature and report of a rare case. Odontogenic keratocysts make up around 19% of jaw cysts.
In this paper, we shall present one case report of a keratocyst, which derived from an impacted canine. It most often affects the posterior mandible and most commonly presents in the third decade of life. Calcifying cystic odontogenic tumor ccot is an uncommon odontogenic tumor. There is a unilocular lytic lesion in the right mandibular angle with imaging appearances of either keratocystic odontogenic tumor or a unilocular ameloblastoma. No recurrence was observed during 57month followup. Istanbul university, dentistry faculty, department of oral and maxillofacial surgery, istanbul, turkey. Aot accounts for about 1% until 9% of all odontogenic tumors.
Keratocystic odontogenic tumor mimicking lateral periodontal. Diffusionweighted mr imaging of ameloblastomas and. In the whoiarc classification of head and neck pathology, this clinical entity had been known for years as the odontogenic keratocyst. An odontogenic keratocyst is a benign tumor of the jaw thats why the new name, keratocystic odontogenic tumor makes sense. Keratocystic odontogenic tumor kcot is an odontogenic tumor which has the highest rate of recurrence. A keratocystic odontogenic tumor kot formerly known as an odontogenic keratocyst is a benign cystic tumor of dental origin that probably arises from primitive dental lamina, most commonly occurs in the posterior mandible, and almost certainly represents the lesion that used to be known as a primordial cyst. Firat selvi 1, merva soluk tekkesin 2, sirmahan cakarer 1, s.
Involvement of the maxillary sinus is an unusual presentation. An odontogenic tumor is a neoplasm of the cells or tissues that initiate odontogenic processes. Conservative management of keratocystic odontogenic tumors of. Ameloblastomas and keratocystic odontogenic tumors are major aggressive odontogenic tumors in the maxillomandibular regions, but the differentiation between these 2 tumors is frequently ineffective based on only conventional ct and mr imaging findings. The orthokeratinizing odontogenic cyst is considered an unrelated entity without risk of recurrence or aggressive growth or association with nevoid basal cell carcinoma syndrome. Presentation of a keratocystic odontogenic tumor with.
Topical 5fluorouracil is a novel targeted therapy for the. The keratocystic odontogenic tumor was the most prevalent histological type 30 %, followed by the ameloblastoma 23,7%. First described by philipsen in 1956, the odontogenic keratocyst is characterized by a large squamous keratinization of its border, an aggressive growth and a high recurrent rate. The keratocystic odontogenic tumor kcot, formerly known as the odontogenic keratocyst okc, received its new designation in order to better convey its neoplastic nature 1. D, frcpath assistant prof of general pathology senior lecturer of oral pathology and oral histology slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Keratocystic odontogenic tumor kcot, formerly referred to as odontogenic keratocyst, is a benign neoplasm of odontogenic origin which may present an aggressive and infiltrative behavior leading to high recurrence rates. It is of particular interest that relationship between keratocystic odontogenic tumors clinical and molecular features. Some tumors are true neoplasms, while some are hamartomas developmental malformations. The biology, epidemiology, presentation, diagnosis and evaluation, treatment, and outcomes of odontogenic tumors are presented in this chapter. Lewis key points computed tomography can be highly specific in the diagnosis of mandibular masses given an organized approach that considers both odontogenic and nonodontogenic tumors and cysts. There were 18 lesions in the posterior mandible, 3 in the anterior mandible and 6 in the posterior maxilla fig. Adenomatoid odontogenic tumor aot is a wellrecognised slow growing benign tumor derived from complex system of dental lamina or its remnants.
The 2005 who classification now uses the term keratocystic odontogenic tumor. Aug 24, 2005 adenomatoid odontogenic tumor aot is a rare odontogenic tumor which is often misdiagnosed as odontogenic cyst. Correct diagnosis and treatment should include a careful assessment of clinical, radiological and histopathological. Multilocalcalcifying epithelial odontogenic tumor 17080 int j clin exp med 2016. Keratocystic odontogenic tumor involving the maxillary. In an analysis of loss of heterozygosity loh for several tumor suppressor genes in sporadic kcots, frequency of allelic loss was 66% for p53 and 60% for ptch gene. The clinical, radiological, and histological features of this tumor and its surgical management are discussed.
Aug 11, 2009 many treatment modalities have been advocated for its treatment, but none in particular has been regarded as the best treatment option. Morphometric evaluation of keratocystic odontogenic tumor. Keratocystic odontogenic tumour an overview sciencedirect. The radiographic appearance is one of a unilocular or multilocular wellcircumscribed. Teeth examination revealed that teeth 22 and 23 are missing, and teeth 21 and 24 are positive at cold sensitivity test without mobility. The purpose of this retrospective study was to evaluate the clinicopathological features of 64 patients with keratocystic odontogenic tumor kcot. Nov 20, 2014 the adenomatoid odontogenic tumor is an example of the difficulties of classifying odontogenic tumors by their developmental histogenetic origin. Odontogenic tumor definition of odontogenic tumor by. It is associated with an unerupted tooth about onethird of the time. If squamous odontogenic cystlike proliferations are noted, they should essentially be ignored and are of no prognostic.
The keratocystic odontogenic tumor is a benign developmental tumor with many distinguishing clinical and histologic features. Odontogenic keratocyst radiology reference article. The newly acknowledged neoplastic potential and its implications for treatment strategies are also discussed. Enucleation is performed when cysts are not large and when only minor damage to adjacent anatomical structures is expected. An odontogenic tumor is a neoplasm of the cells or tissues that initiate odontogenic processes examples include. Odontogenic tumors at university of colorado health sciences. Odontogenic tumors ots are uncommon neoplastic lesions of the maxilla and mandible, which present difficult diagnosis and therapeutics. Introduction the frequency of odontogenic cysts in children is relatively low. Odontogenic tumors of the jaw can originate from odontogenic epithelium, odontogenic mesenchyme or from both the cell lines. Keratocystic odontogenic tumor associated with an ectopic tooth in the maxillary sinus. Squamous odontogenic tumor sot is a benign odontogenic tumor classified according to the world health organization who in. Whether these lesions are developmental or neoplastic is controversial, with the 2017 who classification placing it back into the development lesion category. Odontogenic tumors questions and study guide quizlet. Developed by renowned radiologists in each specialty, statdx provides comprehensive decision support you can rely on keratocystic odontogenic tumor odontogenic keratocyst.
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