Abstract
Pigmented odontogenic keratocyst (OKC) is rare and its etiology remains uncertain. A 14-year-old black boy was referred for diagnosis of a painless lesion in the anterior mandibular region, with unknown evolution. Radiographically, there was a well-circumscribed, unilocular, and radiolucent image. The hypotheses of diagnosis were OKC and central giant cell lesion. An excisional biopsy was performed. A histopathological examination revealed a cystic lesion, lined by stratified and squamous epithelium, with corrugated parakeratin. Basal layer cuboid and columnar cells were palisade-arranged. A brownish, sparse, intracytoplasmic pigmentation was observed in the basal cell layer, which was positive with Fontana-Masson staining. The immunohistochemistry reactions revealed positive dendritic cells for S-100 protein, HMB45, and Melan-A. The final diagnosis was pigmented OKC. The patient is under periodic follow-up, and no clinical and imaging signs of recurrence were observed after 18 months. Thus, melanin does not represent an additional risk for recurrence in OKC.
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