Odontogenic Keratocyst: Difference between revisions
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(Created page with "* Benign but aggressive intraosseous lesions of odontogenic origin * Account for 5-10% of jaw cysts * Reclassified back to odontogenic keratocyst in the WHO 2017 classificatio...") |
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* Benign but aggressive intraosseous lesions of odontogenic origin | * Benign but aggressive intraosseous lesions of odontogenic origin | ||
* Reclassified back to odontogenic keratocyst in the WHO 2017 classification (previously classified as keratocystic odontogenic tumour [KCOT] from 2005 to 2017)<ref>El-Naggar AK, Chan JK, Grandis JR. WHO classification of head and neck tumours. 2017. [https://books.google.co.uk/books?vid=ISBN9789283224389 ISBN: 9789283224389]</ref> | * Reclassified back to odontogenic keratocyst in the WHO 2017 classification (previously classified as keratocystic odontogenic tumour [KCOT] from 2005 to 2017)<ref>El-Naggar AK, Chan JK, Grandis JR. WHO classification of head and neck tumours. 2017. [https://books.google.co.uk/books?vid=ISBN9789283224389 ISBN: 9789283224389]</ref> | ||
==Epidemiology== | ==Epidemiology== | ||
* | * Account for 5-10% of jaw cysts | ||
* ♀ | * Peak incidence 20-30yrs | ||
* ♂ > ♀ (slightly) | |||
* Commonest site — angle of the mandible | |||
** 70-80% occur in the mandible | |||
** 50% at the angle of the mandible | |||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 13:13, 1 December 2021
- Benign but aggressive intraosseous lesions of odontogenic origin
- Reclassified back to odontogenic keratocyst in the WHO 2017 classification (previously classified as keratocystic odontogenic tumour [KCOT] from 2005 to 2017)[1]
Epidemiology
- Account for 5-10% of jaw cysts
- Peak incidence 20-30yrs
- ♂ > ♀ (slightly)
- Commonest site — angle of the mandible
- 70-80% occur in the mandible
- 50% at the angle of the mandible
Clinical Features
- Clinical features
Differential Diagnosis
- Differential Diagnosis
Aetiology and Pathogenesis
- Aetiology and pathogenesis
Investigations
Laboratory Investigations
Aspiration may be helpful for protein content (biochemistry) and keratinization (cytology)
Imaging
Radiographically usually multilocular 40% in a ‘dentigerous’ position
Histopathology
Lined by ortho- (10%) or parakeratinized (83%) epithelium (7% have both)— fluid has protein content <4g/ dL Histologically high mitotic activity: growth is neoplastic with invasion of the medulla and not by bony expansion
Management
- Management
Treatment = enucleation ± Carnoy’s solution (decreases recurrence)
Prognosis and Complications
- Prognosis and Complications
Follow-up
Satellite cysts or daughter cysts increase the likelihood of recurrence, as does an association with Gorlin– Goltz syndrome Orthokeratinizing keratocysts are much less aggressive. Review for recurrence (up to 60%) particularly in Gorlin– Goltz syndrome
References
- ↑ El-Naggar AK, Chan JK, Grandis JR. WHO classification of head and neck tumours. 2017. ISBN: 9789283224389
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