Calcifying Odontogenic Cyst Associated With Dentigerous Cyst in a 15-Year-Old Girl

Calcifying odontogenic cyst combined with odontogenic keratocyst: report of a case and review of the literature

INTRODUCTION AND IMPORTANCE

Odontogenic lesions composed of two or more separate odontogenic cysts are uncommon. The calcifying odontogenic cyst (COC) and odontogenic keratocyst (OKC) are odontogenic cysts that exhibit some neoplastic features. Concurrence of these lesions is extremely rare. We report a rare case of COC combined with OKC in a patient and review the relevant literature systemically.

CASE PRESENTATION

In this article, we present a case report of an 18-year-old boy patient with no medical history whose chief complaint was facial asymmetry. A painless swelling in the right side of the posterior mandible was observed. Histopathological and radiographic investigations revealed a combined odontogenic lesion composed of inflamed OKC with COC.

CLINICAL DISCUSSION

Long-lasting debates on the true nature of OKC and COC, whether cystic or neoplastic, has been existed so far. Their genetic-derived mechanisms can justify the concurrent occurrence of these cysts in a patient. The treatment plan for this lesion included decompression followed by enucleation, curettage, and application of Carnoy's solution.

CONCLUSION

We reported a rare case of an inflamed OKC with COC-like features. Based on the literature, the coincidence of these two odontogenic cysts has been reported for the third time here.

Calcifying odontogenic cyst: Report of an uncommon entity with a brief literature review

The aim of this clinical report is to document a rare and unusual case of calcifying odontogenic cyst (COC) in the maxillary anterior region in a 13-year-old girl.

A COC is an extremely uncommon developmental, odontogenic entity and accounts for 0.3%–0.8% of odontogenic cysts. The lesion presents as an array of varied radiographic and clinicopathological characteristics and biological attributes and exists in three histomorphologic patterns – benign cystic, solid (neoplastic) and aggressive (malignant) forms. Thus, several nomenclatures and classifications have been put forth to explain the nature of the clinical entity. However, ambiguities regarding the exact nature of the lesion still prevail. Due to nonspecific clinicoradiographic features, histopathological interpretation remains the key for diagnosis. We report an uncommon occurrence of COC in a 13-year-old female who reported to our Outpatient Department with an asymptomatic right midfacial swelling. The clinical and radiographic findings were suggestive of adenomatoid odontogenic tumor and dentigerous cyst. The decision to enucleate the lesion was considered, and histopathological features were compatible with the diagnosis of COC. Re-ossification with no recurrence was noticed after a 1-year follow-up. COC is an unusual developmental odontogenic cyst that clinically and radiologically simulates other more common jaw entities. Thorough knowledge of the bizarre presentation and biological attributes of such lesions are imperative for an early diagnosis and definitive treatment. Long-term follow-up is advocated to prevent recurrences.