Abstract
Glandular odontogenic cyst (GOC) is a rare aggressive developmental cyst of the jaw. It most commonly occurs in middle-aged people with mandible anterior region being the most affected site. This lesion can present as a unilocular or multilocular radiolucency and has high recurrence rate. The histopathologic features of the GOC are complex and often coincide with the features of dentigerous cyst, radicular cyst, and low-grade central mucoepidermoid carcinoma (CMEC). At times, the microscopic features are so similar to central low-grade mucoepidermoid carcinoma that it becomes highly impossible to distinguish the two entities even with various advanced investigations. The reported case represents one such diagnostic dilemma occurring in the maxilla which is a rare site, and the lesion/s appeared as two distinct entities, that is, GOC and CMEC on either aspects of the same side of maxilla clinically, yet showing continuity on advanced imaging and demonstrating histopathological perplexity.
Highlights
In 1987, Padayachee and Van Wyk [1] gave the first description of this kind of cyst and later the term “Glandular Odontogenic Cyst” was introduced in 1988 by Gardner et al [2]
Paraesthesia, numbness, and tooth mobility are usually occasional and late findings. They may appear as unilocular or multilocular with or without cortical plate disruption [7]. Based on their clinical behavior they are classified as highand low-grade MEC, and the present case was a low grade variant
Assessment of the cytokeratin (CK) profile of central MEC and Glandular odontogenic cyst (GOC) overlaps to a greater extent, but expression of CKs 18 and 19 could be useful in their differential diagnosis [9]
Summary
In 1987, Padayachee and Van Wyk [1] gave the first description of this kind of cyst and later the term “Glandular Odontogenic Cyst” was introduced in 1988 by Gardner et al [2]. It is known as “mucoepidermoid cyst” and “sialo-odontogenic cyst.”. Most of the reported cases have occurred in the anterior mandible They are usually multilocular cystic lesions, unilocular lesions have been reported. Central mucoepidermoid carcinoma is an extremely rare tumor, representing about 2 to 4% of all mucoepidermoid carcinomas They are histologically low-grade cancers, usually affecting the mandible as uni- or multilocular radiographic lesions [6]. An article with extensive study on histopathologic features and variants of GOC states that GOC and CMEC may possibly be related, but definitive evidence is still awaited [5]
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