Diagnosis and treatment of keratocystic odontogenic tumor mimicking a dentigerous cyst in panaromic radiography

Year 2017, , 28 - 31, 16.03.2017

Alime Okkesim , Mehmet Zahit Adışen Melda Mısırlıoğlu Umut Tekin

https://doi.org/10.18663/tjcl.298239

Abstract

Keratocystic
odontogenic tumor (KCOT) is a cystic lesion of odontogenic origin, which is
classified as a developmental tumor derived from the dental lamina. KCOT may
occur in any part of both maxillaries, most commonly in the angle and the ramus
region of the mandible.  It has an aggressive
behavior and high recurrence rate. Radiographically, lesions may appear as
round or ovoid in shape, often with a scalloped, multilocular appearance that
may involve an impacted tooth. In this case report, a unilocular radiolucent large
lesion with relatively well-circumscribed margins involving the left mandibular
impacted third molar was detected incidentally on panoramic radiographic
examination. Cone beam computed tomography (CBCT) was used for advanced
imaging. The radiographic appearance of the lesion resembled a dentigerous
cyst. Patient was consulted to Oral and Maxillofacial Surgery Department for
possible treatment options. Initially an intraoral surgical operation with
marsupialization was made under local anesthesia.  After four months, the dimension of the
lesion was reduced, previous marsupialization followed by surgical enucleation.
The histopathological report revealed a parakeratinized epitel surrounding the
lesion that means a KCOT.

Keywords

Keratocyst, dentigerous cyst, cone-beam computed tomography

Panaromik radyografide dentigeröz kiste benzeyen keratokistik odontojenik tümörün teşhis ve tedavisi

Abstract

Keratokistik odontojenik tümör (KKOT)
odontojenik kaynaklı, dental laminadan gelişen ve tümör olarak sınıflandırılan
kistik bir lezyondur. KKOT orofasiyal bölgede maxilla ve mandibulada, sıklıkla da
mandibulanın ramus ve angulus bölgelerinde görülür. Agresif davranış gösteren
ve nüksetme oranı yüksek benign bir neoplazmdır. Radyografik olarak lezyonlar
yuvarlak veya oval şekilli, bazen de tarak şeklinde multiloküler görüntü
sergiler ve gömülü bir diş ile ilişkili olabilir. Bu vaka raporunda, sol alt gömülü
üçüncü molar diş ile ilişkili, iyi sınırlı ve geniş uniloküler radyolüsent bir
lezyon rutin panoramik radyografik incelemede tesadüfen tespit edildi. İleri
görüntüleme amacıyla bölgeden konik ışınlı bilgisayarlı tomografi (KIBT)
görüntüleri alındı. Lezyonun radyografik özelliklerine göre dentigeröz kist ön
tanısı kondu. Hasta olası tedavi seçenekleri için Ağız Diş ve Çene Cerrahisi
Anabilim Dalı’na konsülte edildi. Tedavide ilk olarak lokal anestezi altında
marsupializasyon işlemi gerçekleştirildi. İlk operasyondan 4 ay sonra lezyon
boyutları küçüldüğünde, cerrahi olarak enükleasyon yapıldı. Histopatolojik incelemede
lezyonun parakeratinize epitel ile çevrili olmasından dolayı kesin teşhis
olarak KKOT olduğu rapor edildi. 

Keywords

Keratokist, dentigeröz kist, konik ışınlı bilgisayarlı tomografi

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