Melanin Pigmented Odontogenic Lesions- Report of a Dentigerous Cyst and Review of the Literature

Abstract

<h3>Introduction</h3> The presence of melanocytes in the oral cavity, especially in the gingiva and buccal mucosa is a well documented finding, especially in dark complexioned individuals. Melanocytes are quite rare in odontogenic cysts and tumors. The melanotic neuroectodermal tumor of infancy was initially considered to be the only pigmented jaw tumor in existence. This was until 1961 when Lurie et al reported the first melanin pigmented calcifying odontogenic cyst. In 1964, Grand and Marwah reported the first case of a pigmented odontogenic cyst, that of a gingival cyst. Although most pigmented odontogenic cyst are odontogenic keratocysts, pigmented dentigerous cyst are second in frequency with three cases reported to date. <h3>Materials and Methods</h3> A case of a macroscopic and microscopic melanin pigmented dentigerous cyst is presented with histological and immunohistochemical findings. A pubmedline search of the literature was conducted to review all cases of melanin pigmented odontogenic cysts and neoplasms reported to date. <h3>Results</h3> The pigment in the lesion was confirmed to be melanin by Masson- Fontana staining. The presence of dendritic melanocytes within the lesion was demonstrated by S-100 immunostaining. Since 1961, sixty-three melanin pigmented odontogenic cysts and tumors have been reported. The odontogenic pigmented lesions found in the literature differ in type, histochemical, Immunohistochemical and ultrastructural methods used and have demonstrated that the pigment is always melanin. Most of the patients are Asians and Blacks, thereby implicating racial pigmentation as an important factor. <h3>Conclusion</h3> We report a melanin pigmented dentigerous cyst associated with impacted teeth 16 and 16A in a 27 year old black male. Our dentigerous cyst demonstrated macroscopic and microscopic visible melanin pigmentation. Melanin pigmented dentigerous cysts are quite rare with only three other cases reported to date in the English language literature to which we add this first case involving the maxilla.