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Li J, Jiang EH, Jiang SC, Liu B, Xiong XP, Sun YF, Deng WW. A retrospective study of the malignant change of odontogenic keratocyst. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101466. [PMID: 37030439 DOI: 10.1016/j.jormas.2023.101466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/09/2023] [Accepted: 04/05/2023] [Indexed: 04/10/2023]
Abstract
The odontogenic keratocyst (OKC) is a common cystic lesion of the maxilla and mandible. Squamous cell carcinoma (SCC) arising from OKC or dysplasia occurring in OKC is rare. This study aimed to explore the incidence and clinical features of the dysplasia and malignant transformation of OKC. In this study, 544 patients diagnosed with OKC were collected. Among them, 3 patients were diagnosed as SCC arising from OKC, and 12 patients were diagnosed as OKC with dysplasia. The incidence was calculated. Clinical features were analyzed by chi-square test. In addition, a representative case reconstructing mandible with vascularized fibula flap under general anesthesia was reported. And cases reported before were reviewed. The incidence of the dysplasia and malignant transformation of OKC, which are highly associated with the clinical features of swelling and chronic inflammation, is about 2.76%. But the relevance between the dysplasia and malignant transformation and age, gender together with pain is not statistically high. All in all, the clinical features of swelling and chronic inflammation can be considered as characteristics of the dysplasia and malignant transformation of OKC. Although the pain isn't statistically relevant, it may be a dangerous clew. Also, combined with earlier literatures, the dysplasia and malignant transformation of OKC shows unique features of radiographs and histopathology.
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Affiliation(s)
- Ji Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Er-Hui Jiang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Oral Maxillofacial-Head Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Sheng-Chao Jiang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bing Liu
- Department of Oral Maxillofacial-Head Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xue-Peng Xiong
- Department of Oral Maxillofacial-Head Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yan-Fang Sun
- Department of Oral Maxillofacial-Head Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Wei-Wei Deng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Oral Maxillofacial-Head Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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Kumchai H, Champion AF, Gates JC. Carcinomatous Transformation of Odontogenic Keratocyst and Primary Intraosseous Carcinoma: A Systematic Review and Report of a Case. J Oral Maxillofac Surg 2021; 79:1081.e1-1081.e9. [PMID: 33529609 DOI: 10.1016/j.joms.2020.12.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 01/27/2023]
Abstract
PURPOSE To assess the prognostic findings of the carcinomatous transformation of odontogenic keratocyst (OKC). METHODS A systematic review of all cases of carcinomatous transformation of OKC was completed, and a case report was included. RESULTS A total of 679 publications were screened, and 37 cases met inclusion criteria. The mean age for patients with malignant transformation of OKC was 45.1 years. Pain (67.5%) and swelling (78.3%) were the most common symptoms. The malignant transformation occurred with increased frequency in the posterior mandible and larger lesions that span greater than 2 subunits of the involved jaw. Resection was the definitive treatment in all cases and 14 cases (46%) utilized adjuvant treatment. CONCLUSIONS Patient outcomes and follow-up was variable in our study such that overall survival was difficult to determine. However, overall survival in malignant transformation of odontogenic cysts of all kinds ranges from 62 to 85% and 30 to 8% for 2 and 5 years, respectively.
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Affiliation(s)
- Hattanas Kumchai
- Resident and PhD Student, Oral & Maxillofacial Surgery Department, Thomas Jefferson University Hospital, Philadelphia, PA.
| | - Allen F Champion
- Assistant Professor, Oral & Maxillofacial Surgery Department, Thomas Jefferson University Hospital, Philadelphia, PA
| | - James C Gates
- Clinical Instructor, Oral & Maxillofacial Surgery Department, Thomas Jefferson University Hospital, Philadelphia, PA
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Juniat V, Varidel A, Badlani J, Nolan J, Sambrook P, Selva D. Recurrent odontogenic keratocyst with orbital invasion. Orbit 2020; 41:368-373. [PMID: 33356724 DOI: 10.1080/01676830.2020.1862248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Odontogenic keratocysts (OKCs) are aggressive lesions that have been variously classified as neoplasms or cysts according to the World Health Organisation (WHO). They can be challenging to surgically remove and the cysts can exhibit locally aggressive behaviour if incompletely excised. We describe a case of recurrent OKC invading the orbit requiring multidisciplinary approach for extended surgical excision, and review the current literature regarding this condition.
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Affiliation(s)
- Valerie Juniat
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Alistair Varidel
- Department of Oral Maxillofacial Surgery, Royal Adelaide Hospital, Adelaide, Australia
| | - James Badlani
- Department of Oral Maxillofacial Surgery, Royal Adelaide Hospital, Adelaide, Australia
| | - James Nolan
- Anatomical Pathology, SA Pathology, Adelaide, Australia
| | - Paul Sambrook
- Department of Oral Maxillofacial Surgery, Royal Adelaide Hospital, Adelaide, Australia
| | - Dinesh Selva
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
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Shetty P, Shetty S, Agarwal N, Srivastava P. Third molar in the orbital floor: A precarious presentation of odontogenic keratocyst-A case report and review of literature. Clin Case Rep 2018; 6:1854-1861. [PMID: 30214778 PMCID: PMC6132149 DOI: 10.1002/ccr3.1714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 06/13/2018] [Indexed: 11/29/2022] Open
Abstract
The case illuminates the likelihood of a dental pathology presenting with discrete signs and symptoms and the importance of the differential diagnosis of some incongruent clinical entities. The purpose of this article was to present a case report of odontogenic keratocyst (OKC) arising in the orbital floor, finding the common thread in rare pathology, and highlighting the aberration in our treatment plan by collating all the wealth of information published in the literature.
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Affiliation(s)
- Premalatha Shetty
- Department of Oral and Maxillofacial SurgeryManipal Academy of Higher EducationManipal College of Dental SciencesMangaloreIndia
| | - Sameep Shetty
- Department of Oral and Maxillofacial SurgeryManipal College of Dental SciencesMangaloreIndia
| | - Nancy Agarwal
- Department of Oral and Maxillofacial SurgeryManipal College of Dental SciencesMangaloreIndia
| | - Pritika Srivastava
- Department of Oral and Maxillofacial SurgeryManipal College of Dental SciencesMangaloreIndia
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Acharya S, Tayaar AS, Hallkeri K, Adirajaiah S, Gopalkrishnan K. Squamous cell carcinoma emerging in an orthokeratinized odontogenic cyst: A case report and brief review. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2014. [DOI: 10.1016/j.ajoms.2013.06.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Affiliation(s)
- Lee J Slater
- Scripps Oral Pathology Service, 5190 Governor Drive, Suite 106 San Diego, CA 92122-2848, USA
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Kaczmarzyk T, Mojsa I, Stypulkowska J. A systematic review of the recurrence rate for keratocystic odontogenic tumour in relation to treatment modalities. Int J Oral Maxillofac Surg 2012; 41:756-67. [DOI: 10.1016/j.ijom.2012.02.008] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Revised: 12/20/2011] [Accepted: 02/15/2012] [Indexed: 10/28/2022]
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Woolgar JA, Triantafyllou A, Ferlito A, Devaney KO, Lewis JS, Rinaldo A, Slootweg PJ, Barnes L. Intraosseous carcinoma of the jaws: a clinicopathologic review. Part III: Primary intraosseous squamous cell carcinoma. Head Neck 2012; 35:906-9. [PMID: 22290827 DOI: 10.1002/hed.22922] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2011] [Indexed: 11/10/2022] Open
Abstract
This is the third part of a review of the clinicopathologic features of intraosseous carcinoma of the jaws (IOCJ). In parts 1 and 2, we discussed metastatic and salivary-type and odontogenic carcinomas, respectively. This part deals with primary intraosseous squamous cell carcinoma. Again, based on a critical approach, we emphasize histopathologic features, diagnostic difficulties, discuss histogenesis, and highlight areas of uncertainty. The 3-part review also offers speculations on how future studies may refine our understanding of the unusual and interesting IOCJ.
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Affiliation(s)
- Julia A Woolgar
- Oral Pathology, School of Dental Sciences and Dental Hospital, University of Liverpool, Liverpool, United Kingdom
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Sato T, Kamiya Y, Tochihara S, Toyoda N, Asada K, Ishibashi K. Primary Intraosseous Squamous Cell Carcinoma of the Mandible: Report of a Case and Review of the Recent Literture. ACTA ACUST UNITED AC 2006. [DOI: 10.3353/omp.11.83] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bell R, Dierks EJ. Treatment options for the recurrent odontogenic keratocyst. Oral Maxillofac Surg Clin North Am 2003; 15:429-46. [DOI: 10.1016/s1042-3699(03)00043-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Dammer R, Niederdellmann H, Dammer P, Nuebler-Moritz M. Conservative or radical treatment of keratocysts: a retrospective review. Br J Oral Maxillofac Surg 1997; 35:46-8. [PMID: 9043004 DOI: 10.1016/s0266-4356(97)90009-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The paper reports our experience in the treatment of keratocysts and make recommendations for treatment in the form of a retrospective study. Thirty-eight patients with 52 keratocysts out of a total of 318 patients with 351 odontogenic cysts who presented between 1984 and 1992 were analysed. Outcome was measured by recurrence and there were three recurrences (6%) which compares favourably with published reports in which figures of up to 62% have been quoted. Based on the experience of others as well as our own series we recommend that small cysts near the alveolar process should be treated by simple excision, but large invasive cysts near the base of the skull should be treated by radical resection leaving a margin of normal tissue around the specimen. If any variables are discovered that can reliably indicate prognosis we may be able to revise these recommendations.
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Affiliation(s)
- R Dammer
- Department of Oral and Maxillofacial Surgery, University of Regensburg, Germany
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Minić A, Stajćić Z. Penetration of the skull base by dissecting keratocyst--Jackson et al. J. Craniomaxillofac. Surg. (1993) 21, 319-325. J Craniomaxillofac Surg 1994; 22:318-9. [PMID: 7798367 DOI: 10.1016/s1010-5182(05)80087-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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Williams TP, Connor FA. Surgical management of the odontogenic keratocyst: aggressive approach. J Oral Maxillofac Surg 1994; 52:964-6. [PMID: 8064461 DOI: 10.1016/s0278-2391(10)80081-3] [Citation(s) in RCA: 92] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Jackson IT, Potparic Z, Fasching M, Schievink WI, Tidstrom K, Hussain K. Penetration of the skull base by dissecting keratocyst. J Craniomaxillofac Surg 1993; 21:319-25. [PMID: 8113423 DOI: 10.1016/s1010-5182(05)80490-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The extensive destructive potential of the keratocyst has been well recognized but penetration of the keratocyst into the skull base is rare. 3 cases showing such aggressive behavior and rare location were seen and treated; 2 are reported in this paper. Both cases illustrate the importance of early radical treatment once the aggressive nature of keratocyst is recognized.
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Affiliation(s)
- I T Jackson
- Institute for Craniofacial and Reconstructive Surgery, Southfield, Michigan
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