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Attouchi I, Oualha L, Belkacem Chebil R, Ben Youssef S. Calcifying Odontogenic Cyst Associated with Complex Odontoma: Report of a Rare Case. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2024; 17:11795476241277660. [PMID: 39247517 PMCID: PMC11378199 DOI: 10.1177/11795476241277660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Accepted: 08/08/2024] [Indexed: 09/10/2024]
Abstract
Calcifying odontogenic cyst, also known as Gorlin cyst is a rare benign cystic lesion primarily found in the jawbones, accounting less than 1% of odontogenic cysts. It can be associated with odontogenic tumors such as odontomas. We report a rare case of COC associated with complex odontoma in a young patient and discuss its clinical features, diagnosis, and treatment options. An 18-year-old female patient presented with a painless radiopaque lesion of the right mandibular bone at Oral Medicine and Oral Surgery department. Radiographs revealed irregular tooth-like structures in the canine-premolar area. The lesion was surgically removed, and histopathology confirmed COC with a complex odontoma. As of the World Health Organization's 2022 definition, COC is a developmental odontogenic cyst characterized by calcified ghost cells. It typically affects individuals during their second and third decades of life, with no gender preference, almost equally in the maxilla and the mandible. The main treatment is total enucleation, with a generally favorable prognosis. Histopathology is essential for diagnosis due to its mimicry of other jaw conditions. Long-term follow-up is needed to prevent recurrences.
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Affiliation(s)
- Ikram Attouchi
- Oral Medicine and Oral Surgery Department, Sahloul University Hospital, Sousse, Tunisia
| | - Lamia Oualha
- Oral Medicine and Oral Surgery Department, Farhat Hached Hospital, Sousse, Tunisia
| | | | - Souha Ben Youssef
- Oral Medicine and Oral Surgery Department, Farhat Hached Hospital, Sousse, Tunisia
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Moradzadeh Khiavi M, Mahdavi N, Awudu A. Developing odontoma arising from calcifying odontogenic cyst: A case report. Clin Case Rep 2021; 9:e05011. [PMID: 34849223 PMCID: PMC8609189 DOI: 10.1002/ccr3.5011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/30/2021] [Accepted: 10/12/2021] [Indexed: 11/12/2022] Open
Abstract
Developing odontoma is a rare mixed odontogenic tumor that can arise with other odontogenic lesions. The association of COC with ameloblastic fibro-odontoma is extremely rare. We report an extremely rare case of developing odontoma arising from a calcifying odontogenic cyst in a 17-year-old girl.
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Affiliation(s)
- Monir Moradzadeh Khiavi
- Department of Oral and Maxillofacial PathologySchool of DentistryTehran University of Medical SciencesTehranIran
| | - Nazanin Mahdavi
- Department of Oral and Maxillofacial PathologySchool of DentistryTehran University of Medical SciencesTehranIran
| | - Asoma Awudu
- School of DentistryInternational CampusTehran University of Medical SciencesTehranIran
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Samir MC, Lamiae G, Bassima C. Calcifying odontogenic cyst of anterior maxillary: Case report and review. Int J Surg Case Rep 2021; 85:106267. [PMID: 34388904 PMCID: PMC8358629 DOI: 10.1016/j.ijscr.2021.106267] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/29/2021] [Accepted: 08/01/2021] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION AND IMPORTANCE Calcifying odontogenic cyst (COC) is a rare lesion of jawbone. It is classified among development cyst in the new WHO classification of tumors of the head and neck in 2017. It is a rare pathology, which is found more in the upper maxillae, with a predominance in women in the second or third decade. The diagnosis is based on the analysis of clinical, radiological and histological features. CASE PRESENTATION We report the case of a 17-year-old patient referred by his orthodontist following the fortuitous discovery of a mixed radiolucent/radiopaque image in the right jaw ranging from the tooth 11 to the tooth 16, for whom the clinical, radiological examination associated with fine needle aspiration cytology suggested a cystic lesion. CLINICAL DISCUSSION Management initially consisted of decompression of the lesion and complete enucleation after nine months. Histopathological examination gave the diagnosis of calcifying odontogenic cyst. The follow-up showed favorable evolution.
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Affiliation(s)
- Mainassara Chekaraou Samir
- Faculty of Dentistry-Rabat, Mohammed V University, Rabat, Morocco,Corresponding author at: Ecole Royale du Service de Santé Militaire, Bp:1044, Morocco.
| | - Gamra Lamiae
- Hassan Pathological Anatomy Center, Rabat, Morocco
| | - Chami Bassima
- Faculty of Dentistry-Rabat, Mohammed V University, Rabat, Morocco
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Rodrigues Neto HL, Marlière DAA, Silvares MG, Asprino L, Pereira RA. Perfil clínico e histopatológico do cisto odontogênico calcificante: relato de caso. HU REVISTA 2019. [DOI: 10.34019/1982-8047.2017.v43.13876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
O cisto odontogênico calcificante (COC) foi primeiramente descrito em 1962, considerado como condição patológica benigna de ocorrência rara em maxila e mandíbula, caracterizado por revestimento cístico de células epiteliais odontogênicas contendo células fantasmas com propensão a regiões de calcificação. Neste artigo, descreveu-se a configuração clínica e histopatológica do COC por meio de relato de caso submetido a tratamento cirúrgico e acompanhamento pós-operatório. Uma paciente de 11 anos apresentou um aumento de volume em região maxilar a esquerda próxima ao sulco nasolabial sem sintomatologia dolorosa. Os exames radiográficos indicaram lesão radiolúcida, bem circunscrita e expansiva em maxila, que foi submetida a enucleação associada a ostectomia marginal das paredes corticais ósseas. O quadro histopatológico foi caracterizado por revestimento cístico com epitélio odontogênico ameloblástico, ninhos espalhados de células fantasmas e regiões eosinofílicas de material compatível com dentinóide. O relato de caso apresentou perfil clínico de COC, que pode ser confundido com outras lesões císticas ou tumorais, sendo essencial diagnóstico por meio de análise histopatológica. A abordagem cirúrgica proporcionou diagnóstico e tratamento. Após acompanhamento clínico e radiográfico, não houve recorrência do COC.
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Calcifying Odontogenic Cyst with Extensive Areas of Dentinoid: Uncommon Case Report and Update of Main Findings. Case Rep Pathol 2018; 2018:8323215. [PMID: 29862107 PMCID: PMC5971271 DOI: 10.1155/2018/8323215] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 04/05/2018] [Indexed: 12/15/2022] Open
Abstract
The calcifying odontogenic cyst (COC) is a benign odontogenic cyst that occurs in the gnathic bones. This cyst is part of a spectrum of lesions characterized by odontogenic epithelium containing “ghost cells,” which may undergo calcification. Areas of an eosinophilic matrix material compatible dentinoid also may present adjacent to the epithelial component. However, these areas of dentinoid commonly do not appear so abundant in COCs. In this study, we report a case of intraosseous COC with extensive areas of dentinoid and perform an update regarding the clinical, radiographical, histopathological, and differential diagnosis, treatment, and prognosis of this cystic lesion.
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Gamoh S, Akiyama H, Furukawa C, Matsushima Y, Iseki T, Wato M, Tanaka A, Morita S, Shimizutani K. Calcifying cystic odontogenic tumor accompanied by a dentigerous cyst: A case report. Oncol Lett 2017; 14:5785-5790. [PMID: 29113208 PMCID: PMC5661555 DOI: 10.3892/ol.2017.6993] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 07/05/2017] [Indexed: 11/26/2022] Open
Abstract
A calcifying cystic odontogenic tumor (CCOT) is a proliferation of odontogenic epithelium and scattered nests of ghost cells and calcifications that may form the lining of a cyst, or present as a solid mass. It was previously described by Gorlin et al in 1962 as a calcifying odontogenic cyst. Dentigerous cysts are developmental odontogenic jaw cysts, commonly manifesting in the second and third decades of life. The present study reports an asymptomatic case in a 13-year-old boy who was referred to the outpatient clinic of the Osaka Dental University Hospital (Osaka, Japan) for additional investigation of an area of radiolucency in the lower right jaw. X-ray demonstrated a unilocular, well-circumscribed, radiolucent lesion in the mandible, which measured 30×20 mm, with radiopaque structures within it. Enucleation of the lesion with tooth extraction was performed, which histopathologically revealed features of a CCOT and a cyst. To the best of our knowledge, the occurrence of such a lesion has not been previously identified. The present study examined the significance of the case with a brief review of the literature.
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Affiliation(s)
- Shoko Gamoh
- Department of Oral Radiology, Osaka Dental University, Osaka 540-0008, Japan
| | - Hironori Akiyama
- Department of Oral Radiology, Osaka Dental University, Osaka 540-0008, Japan
| | - Chisato Furukawa
- First Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka 540-0008, Japan
| | - Yuki Matsushima
- First Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka 540-0008, Japan
| | - Tomio Iseki
- First Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka 540-0008, Japan
| | - Masahiro Wato
- Department of Oral Pathology, Osaka Dental University, Osaka 573-1121, Japan
| | - Akio Tanaka
- Department of Oral Pathology, Osaka Dental University, Osaka 573-1121, Japan
| | - Shosuke Morita
- First Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka 540-0008, Japan
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Abstract
AIM This study aimed at evaluating histological features of 52 cases of calcifying odontogenic cyst (COC), which is an uncommon benign odontogenic lesion. The World Health Organization (WHO) classified COC as a neoplasm and used the term calcifying cystic odontogenic tumor (CCOT) for benign cystic type and the dentinogenic ghost cell tumor (DGCT) for the benign solid-type lesions. There is no agreement regarding COC classification. MATERIALS AND METHODS A total of 52 cases of COC were selected and reviewed from the archive of the Pathology Department of Taleghani Educational Hospital, Tehran, Iran. To better understand the pathogenesis of COC, the cases were classified. RESULTS There were 52 cases (31 males and 21 females). The lesion was found in all age groups, and patients' age from 8 to 61 years. Nineteen cases affected the maxilla, and 33 cases affected the mandible. Except two cases, all were intraosseous lesions. Radiographically, 30 cases showed a unilocular radiolucent area, and 22 cases showed a mixed radiolucent/ radiopaque region. Histopathologically, 43 cases were cystic type and 9 cases were neoplastic. CONCLUSION There are two different histopathological entities. In view of these findings, it is very difficult to determine every lesion that has a cystic architecture is truly cystic or is a neoplastic one in nature. It is believed that the solid variants may be neoplastic. CLINICAL SIGNIFICANCE A better understanding of the histological type of the lesion can provide a classification across patients. This can help in treatment planning to improve patient outcomes.
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Affiliation(s)
- Soussan Irani
- Department of Oral Pathology, Dental Faculty, Dental Research Centre, Research Centre for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran, Phone: +988138354250, e-mail:
| | - Forough Foroughi
- Department of Pathology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Dutra SN, Pires FR, Armada L, Azevedo RS. Immunoexpression of Wnt/β-catenin signaling pathway proteins in ameloblastoma and calcifying cystic odontogenic tumor. J Clin Exp Dent 2017; 9:e136-e140. [PMID: 28149478 PMCID: PMC5268103 DOI: 10.4317/jced.53100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 08/07/2016] [Indexed: 12/13/2022] Open
Abstract
Background Wnt/β-catenin signaling pathway is essential for the beginning of odontogenesis and may be involved in the development and progression of some odontogenic tumors. Thus, the aim of this study was to comparatively evaluate the immunohistochemical expression of Wnt/β-catenin signaling pathway proteins in a series of AME and CCOT. Material and Methods Immunohistochemical reactions were performed using antibodies against Wnt1, Wnt5a and β-catenin in 17 cases of solid AME and 6 cases of CCOT. Results In the AME group, Wnt1 and Wnt5a were identified in the epithelium in most of the cases, and β-catenin was mainly identified in the cytoplasm of the tumoral cells. In the CCOT group, Wnt1 and Wnt5a were identified in the epithelium and in the ghost cells in almost all the cases, and β-catenin was mainly identified in the cytoplasm and in the nuclei of the tumoral cells. Conclusions These results contribute to support the importance of Wnt/β-catenin signaling pathway proteins in AME and CCOT tumorigenesis. The abnormal expression of cytoplasmic and/or nuclear β-catenin appears to contribute to the development of both AME and CCOT. In addition, it is possible that Wnt1 and Wnt5a expression in ghost cells can contribute to its histogenesis in CCOT. Key words:Ameloblastoma, β-catenin, calcifying cystic odontogenic tumor, immunohistochemistry, Wnt.
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Affiliation(s)
- Sabrina-Nogueira Dutra
- PhD, Oral Pathology, Piracicaba Dental School, State University of Campinas, Piracicaba/SP, Brazil
| | - Fábio-Ramôa Pires
- Professor, Oral Pathology, School of Dentistry, State University of Rio de Janeiro, Brazil; Professor, Post-graduate program in Dentistry, Estácio de Sá University, Rio de Janeiro/RJ, Brazil
| | - Luciana Armada
- Professor, Post-graduate program in Dentistry, Estácio de Sá University, Rio de Janeiro/RJ, Brazil
| | - Rebeca-Souza Azevedo
- Professor, Patologia Oral, Faculdade de Odontologia, Universidade Federal Fluminense, Nova Friburgo, Rio de Janeiro/RJ, Brazil
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Araki M, Namaki S, Amemiya T, Matsumoto K, Honda K, Yonehara Y, Matsumoto N, Asano M. Diverse calcification patterns of ameloblastic fibro-odontoma on radiographic examination. J Oral Sci 2016; 58:533-537. [PMID: 28025437 DOI: 10.2334/josnusd.16-0194] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The occurrence of ameloblastic fibro-odontoma (AFO) in the oral region is unusual and accounts for 1-3% of all odontogenic tumors. AFO presents mixed radiopaque patterns within the lesion with diverse findings; therefore, it is important to compare this tumor with other odontogenic tumors that radiographically present with calcified bodies. Herein, we observed the calcification patterns within the lesion in seven AFO cases (five males, two females; mean age, 8.3 years; age range, 4-13 years). Periapical and panoramic radiographs were obtained from all seven cases. Five cases underwent conventional computed tomography (CT) scanning, and one underwent cone beam CT. Classification of the calcifications primarily involved the following two characteristics on the X-rays: appearance and location of the lesions. All seven cases were located in the molar regions of the mandible in association with impacted teeth. The calcification patterns of these AFOs were mixed or inhomogeneous within the lesion with various findings, including complex odontoma-like calcifications. However, the patterns differed between panoramic radiography and CT in some cases. The radiolucent lesions in AFO demonstrated varying calcification patterns and were associated with impacted teeth on the CT images.(J Oral Sci 58, 533-537, 2016).
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Affiliation(s)
- Masao Araki
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
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Two unique cases of calcifying cystic odontogenic tumor in the maxillary posterior region. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:497-504. [DOI: 10.1016/j.oooo.2014.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 04/21/2014] [Accepted: 06/16/2014] [Indexed: 11/23/2022]
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