Khan AA, Qahtani SA, Dawasaz AA, Saquib SA, Asif SM, Ishfaq M, Kota MZ, Ibrahim M. Management of an extensive odontogenic keratocyst: A rare case report with 10-year follow-up.
Medicine (Baltimore) 2019;
98:e17987. [PMID:
31860950 PMCID:
PMC6940056 DOI:
10.1097/md.0000000000017987]
[Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION
The odontogenic keratocyst (OKC), previously known as keratocystic odontogenic tumor has been the most disputable pathologies of the maxillofacial region. Patients with OKC are often asymptomatic but may present with pain, swelling, or discharge. Despite the aggressive nature, previous literature as early as 1970s reported the fact that parakeratinized OKC can be treated by means of marsupialization alone.
PATIENTS CONCERNS
The patient had reported with a complaint of pain and swelling in relation with a tooth in mandibular right quadrant.
DIAGNOSIS
This case report discusses features of a rare, extensive, panmandibular OKC that is only second of its kind mentioned in the literature.
INTERVENTION
As a usual treatment protocol, marsupialization was attempted first. Immunohistochemical analysis revealed reduced expression of Ki-67 and B cell lymphoma 2 (bcl-2) markers after marsupialization from 2 separate sites. However, due to incomplete resolution in the lower right anterior region, an aggressive approach was taken by curetting it out surgically along with associated teeth and cortical plate followed by application of Carnoy's solution.
OUTCOME
Postsurgery uneventful healing of the lesion was noted on regular follow-up visits with complete resolution at 40 months. The case has been followed for 10 years with no sign of relapse and reoccurrence.
CONCLUSIONS
Based on the expression of markers it can thus be concluded that Ki-67 and bcl-2 are site specific and bear strong relationship with the recurrence of OKCs.
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