Odontogenic Keratocyst with Vascular Component - A Case Report

Abstract

Odontogenic keratocyst(OKC) is a developmental cyst of odontogenic origin. The unique features of the cyst's histopathology make it distinct from other cysts of the jaws. Generally, it presents with no symptoms with the unilocular or multilocular radiographic feature. A 33-year-old male patient with a painless swelling in the lower right posterior region of the jaws was reported to the outpatient department of our college. There was slight facial asymmetry and swelling on the buccal side. The right submandibular lymph nodes were palpable, and OPG showed a well-defined radiolucency. The FNAC showed numerous keratin flecks with RBC, and the inflammatory background was reported as OKC. The gross specimen was blackish brown, with histopathology features quite atypical since numerous endothelial-lined blood vessels of various sizes filled with RBCs were in the connective tissue capsule. Along with the classic elements of OKC, such as stratified squamous parakeratinised epithelial lining with grooves, there was also a rete ridge formation in the epithelial lining, and it was reported as an Odontogenic Keratocyst. The presence of blood vessels can activate the epithelial cells, thus giving rise to rete ridge formations. There are also possibilities for the presence of other vascular malformations. Regardless of recurrences in OKCs, factors that indicate the virulence of the cyst should be considered in the treatment. The multipotentiality of these odontogenic remnants and their reactive response in the surrounding tissues can be varied. Here we discuss a unique case report of OKC in a 33-yearold male patient with many vascular channels in the ramus-molar region of the mandible with an unusual histopathological presentation for OKC.