IADR Abstract Archives
Gorlin cyst and odontogenic keratocyst: reclassification from cyst to tumor
Objectives: The aim of this work is to report two uncommon clinical cases of OKC and Gorlin cyst while reviewing the clinical, radiographic and histological features of the lesions and the different aspects of management.
Methods: Thefirst case was about a 48-year-old male patient who was admitted to our department with a chief complaint of painful swelling of the left maxilla since two weeks. Intraoral examination revealed a swelling involving buccal cortical bone and extending antero-posteriorly from 21 to 26. Panoramic radiograph and Computed tomography scan showed a well-defined periapical radiolucent lesion in relation to 25 and 26 and a mixed lesion in the anterior region in relation with 21, 22 and 23. Surgical enucleation of the lesion was performed. The histopathologic diagnosis was Gorlin cyst associated with complex odontoma. The second case was about a 40-year-old female patient who was referred to our department for surgical extraction of impacted lower third molar. Panoramic radiograph and computed tomography scan showed a radiolucent lesion involving the right mandibular wisdom tooth. Surgical enucleation of the lesion was conducted and histological examination confirmed the diagnosis of OKC.
Results: For the first case, after one year we have noticed that there was recurrence of the Gorlin cyst and a second intervention was conducted with wider enucleation of the lesion. For the second case, after 9 months, the OKC has recidivated and a second enucleation was performed.
Conclusions: Due to their local aggression and high potential for recurrence, OKC and Gorlin cyst have been classified as tumors and no more as cysts. Nevertheless, in the new 4th edition of the WHO classification, the consensus group agreed to revert back to the original terminology and classify them again as cysts. However, a regular follow‑up protocol should be established to rule out any evidence of relapse
Methods: Thefirst case was about a 48-year-old male patient who was admitted to our department with a chief complaint of painful swelling of the left maxilla since two weeks. Intraoral examination revealed a swelling involving buccal cortical bone and extending antero-posteriorly from 21 to 26. Panoramic radiograph and Computed tomography scan showed a well-defined periapical radiolucent lesion in relation to 25 and 26 and a mixed lesion in the anterior region in relation with 21, 22 and 23. Surgical enucleation of the lesion was performed. The histopathologic diagnosis was Gorlin cyst associated with complex odontoma. The second case was about a 40-year-old female patient who was referred to our department for surgical extraction of impacted lower third molar. Panoramic radiograph and computed tomography scan showed a radiolucent lesion involving the right mandibular wisdom tooth. Surgical enucleation of the lesion was conducted and histological examination confirmed the diagnosis of OKC.
Results: For the first case, after one year we have noticed that there was recurrence of the Gorlin cyst and a second intervention was conducted with wider enucleation of the lesion. For the second case, after 9 months, the OKC has recidivated and a second enucleation was performed.
Conclusions: Due to their local aggression and high potential for recurrence, OKC and Gorlin cyst have been classified as tumors and no more as cysts. Nevertheless, in the new 4th edition of the WHO classification, the consensus group agreed to revert back to the original terminology and classify them again as cysts. However, a regular follow‑up protocol should be established to rule out any evidence of relapse