• Imaging Science in Dentistry
• /
• 제47권2호
• /
• pp.135-140
• /
• 2017

Squamous cell carcinoma (SCC) arising within the lining of an odontogenic keratocyst (OKC) is a rare occurrence. Although potentially locally destructive, OKC is a benign odontogenic process that typically presents with clinical and radiographic features characteristic of a benign intraosseous neoplasm. We present the clinical and radiographic features of a maxillary mass that demonstrated SCC arising from the lining of an OKC. Although the initial clinical and radiographic presentation suggested an infection or malignant neoplasm, biopsies revealed an infiltrative well-differentiated SCC contiguous with and arising from the focus of a pre-existing OKC. The patient subsequently underwent a type II hemi-maxillectomy with neoadjuvant chemoradiation. This report discusses the clinical and radiographic features associated with intraosseous malignancies, especially those arising from an otherwise benign odontogenic lesion. While the majority of OKCs are benign, the current report illustrates the potential for carcinomatous transformation within the lining of an OKC.

• Archives of Plastic Surgery
• /
• 제37권6호
• /
• pp.819-822
• /
• 2010

Purpose: Basal cell nevus syndrome (BCNS), also known as Gorlin syndrome, is a rare autosomal dominant disorder. It is characterized by complex neoplastic syndrome with multisystemic manifestations, involving six major features. This article presents a rare genetic disorder and usage of the author's methods for odontogenic keratocyst, developed in the maxillary sinus. Methods: A 67-year-old man was presented with large calcified maxillary mass and multisystemic manifestations and findings that matched with basal cell nevus syndrome. The calcified maxillary mass was removed via the versatile maxillary window and maxillary bone segment was repositioned. Results: Histopathologic findings revealed that maxillary and mandibular lesions were odontogenic keratocysts and the skin lesions were basal cell carcinoma. Conclusion: Basal cell nevus syndrome is a rare genetic disease that requires surveillance and care for basal cell carcinoma and multisystemic problems. The author's method was satisfactory for maxillary odontogenic keratocyst in the aspect of the approach and reconstruction.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제32권1호
• /
• pp.81-85
• /
• 2010

Multiple jaw cysts are one of the most constant features of the basal cell nevus syndrome. Basal cell nevus syndrome is inherited as an autosomal dominant trait with variable expressiveness. This syndrome comprises a number of abnormalities such as multiple nevoid basal cell carcinomas of the skin, skeletal abnormalities as bifid rib and fusion of vertebrae, central nervous system abnormalities as mental retardation, eye abnormalities with multiple jaw cysts. The odontogenic keratocysts in patients with this syndrome are often associated with the crowns of unerupted teeth and huge size; on radiographs they may mimic dentigerous cysts. The most important feature of the cyst is its extraordinary recurrence rate. Since recurrence may be long delayed in this lesion, follow-up of any case of odontogenic keratocyst with roentgenograms and clinical examination of basal cell carcinoma are essential for at least five years after surgery. We report the result of 7-year follow up after cyst enucleation associated with basal cell nevus syndrome with the literature of review.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제40권5호
• /
• pp.225-232
• /
• 2014

Objectives: The purpose of this retrospective study is to find the differentiating characteristics of cystic and cystic-appearing lesions that involve the impacted mandibular third molar by analyzing panoramic radiographs and computed tomography images, and to aid the preoperative diagnosis. Materials and Methods: Eighty-one patients who had a mandibular cystic or cystic-appearing lesion that involved impacted mandibular third molar and underwent cyst enucleation were included in the study. The preoperative panoramic radiograph and computed tomography findings were analyzed in accordance to the histopathologic type. Results: Most of the cystic lesions containing the mandibular third molar were diagnosed as a dentigerous cyst (77.8%). The occurrence of mesio-distal displacement of the third molar was more frequent in the odontogenic keratocyst (71.4%) and in the ameloblastoma (85.7%) than in the dentigerous cyst (19.1%). Downward displacement was primarily observed in each group. Odontogenic keratocyst and ameloblastoma showed more aggressive growth pattern with higher rate of bony discontinuity and cortical bone expansion than in dentigerous cyst. Conclusion: When evaluating mandibular cystic lesions involving the impacted mandibular third molar, dentigerous cyst should first be suspected. However, when the third molar displacement and cortical bone absorption are observed, then odontogenic keratocyst or ameloblastoma should be considered.

• Imaging Science in Dentistry
• /
• 제36권4호
• /
• pp.177-182
• /
• 2006

Purpose: To evaluate the diagnostic ability in differentiating between ameloblastoma and odontogenic keratocyst according to the imaging modalities and observers. Materials and Methods: We evaluated thirty-six cases of ameloblastomas and forty-seven cases of odontogenic keratocysts all histologically confirmed. Six oral and maxillofacial radiologists diagnosed the lesions by 3 methods: using panoramic radiograph, using computed tomograph (CT), and using panoramic radiograph and CT. The observers were classified by 3 groups: group 1 had experienced over 10 years in oral and maxillofacial radiologic field, group 2 had experienced for 3-4 years, and group 3 was in the process of residentship. After over 2 weeks, the observers diagnosed them by the same methods. Results: The ROC curve areas except for group 3 were the highest with interpretation using panoramic radiograph and CT, followed by interpretation using CT only, and the lowest with interpretation using panoramic radiograph only. The overall difference was not found in diagnostic ability among groups in using panoramic radiograph only, but there was difference in diagnostic ability of group 1 and 2 vs 3 in using CT only, and combination panoramic radiograph and CT. Conclusions: To differentiate between ameloblastoma and odontogenic keratocyst more accurately, the experienced oral and maxillofacial radiologist should diagnose with combination of panoramic radiograph and CT.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제31권6호
• /
• pp.499-504
• /
• 2009

We investigated 52 cases of 42 patients who were diagnosed as odontogenic keratocyst in the department of Oral and maxillofacial Surgery of Kyungpook National University from 2006 to 2008, and following results were obtained. 1. Among 52 cases of OKCs, all cases were parakeratinzied. 2. Among 52 cases of OKCs, 42 cases were type I, 9 cases were type II and 1 case was type V. 3. Among 52 cases of OKCs, there were bud-like proliferation of basal cell layer on connective tissue area on 10 cases, satellite cysts on overlying oral mucosa or connective tissue area on 6 cases and rests of epithelium on connective tissue area on 6 cases. 4. Among 52 cases of OKCs, there were focal inflammation on the epithelium of the OKCs on 6 cases and diffuse inflammation on 8 cases. 5. Among 52 cases of OKCs, cytokeratin-10 was expressioned on superficial and intermediate layer on all cases. Accordingly, the presence or absence of cytokeration-10 on the epithelium of the cyst will be good differential diagnosis of between OKC and dentigerous cyst.

• 대한치과의사협회지
• /
• 제55권7호
• /
• pp.481-488
• /
• 2017

The aim of this study is to examine the incidence of odontogenic tumors and to review the clinical and radiological findings for the most frequent three types in Korea. Odontoma, ameloblastoma and keratocystic odontogenic tumors are the most frequent odontogenic tumors in Korea. We provide an overview of these tumors based on clinical and radiographic findings.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제46권4호
• /
• pp.288-291
• /
• 2020

Angiosarcoma is a rare malignant mesenchymal tumor of vascular or lymphatic origin and represents less than 1% of all malignant tumors. Radiation therapy is a standard treatment in many head and neck cancer cases, but ionizing radiation is associated with radiation carcinogenesis including radiation-induced angiosarcoma. In this article, we report a rare case of radiation-induced angiosarcoma found in a 58-year-old female patient who was previously diagnosed with an odontogenic keratocyst and mucoepidermoid carcinoma.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제32권5호
• /
• pp.431-436
• /
• 2010

Purpose: It is estimated that the odontogenic keratocyst (OKC) makes up 10% to 12% of all developmen-tal odontogenic cysts. The lesion has been of particular interest because of its specific histopathologic fea-ture, high recurrence rate, and aggressive behavior. Materials and Methods: We investigated 266 OKCs of Korean patients for the sex of patient, the age of the patient, the location of OKC, the recurrence rate related to radiographic impression. Results: The male-to-female ratio was 1.47:1, showing a slight male predilection. Odontogenic keratocysts had a peak of occurrence in the third decade of life. The mandibular angle and ascending ramus area (49.6%) is the most frequent site of OKCs in the jaws. Fourteen cases of unilocular (12%) and 5 cases of multilocular (20%) OKCs recurred. Thirteen cases of smooth (12.9%) and 6 cases of lobulated (14.6%) OKCs recurred. Seventeen cases of OKCs without perforation of cortical bone (12.5%) and 2 cases of OKCs with perforation of cortical bone (33.3%) recurred. Fifteen people of patients with single lesion (12.2%) and 4 people of patients with multiple lesions (66.7%) recurred. Conclusion: In this resul, we consider multiple odontogenic keratocysts can recur more easily. So we have to treat them more carefully and need long-time follow-ups.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제44권3호
• /
• pp.107-111
• /
• 2018

Objectives: A keratocystic odontogenic tumor (KOT) is a type of odontogenic tumor that mainly occurs in the posterior mandible. Most KOTs appear as solitary lesions; however, they sometimes occur as multiple cysts. This study analyzed the clinical features of multiple KOTs. Materials and Methods: The participants were diagnosed with KOT by biopsy with multiple surgical sites, and were patients at the Pusan National University Hospital and the Pusan National University Dental Hospital from January 1, 2005 to March 31, 2016. Charts, records, images and other findings were reviewed. Results: A total of 31 operations were conducted in 17 patients. The mean patient age was $28.4{\pm}20.1years$. Multiple KOTs were found to occur at a young age (P<0.01). The predominant sites were in the posterior mandible (28.6%). Most cases of multiple lesions appeared in both the upper and lower jaw, and 40.3% of lesions were associated with unerupted and impacted teeth. The overall recurrence rate measured by operation site was 10.4% (8/77 sites). No patients were associated with nevoid basal cell carcinoma syndrome. Conclusion: The pure recurrence rate was lower than estimated, but there was a higher possibility of secondary lesions regardless of the previous operation site; therefore, long-term follow-up is necessary.