Radiological challenges in distinguishing keratocystic odontogenic tumor from ameloblastoma: an extraordinary occurrence in the same patient

Abstract

ObjectivesThe aims of this study are to describe the radiological appearance of two common odontogenic lesions (keratocystic odontogenic tumor and ameloblastoma) arising in the same patient simultaneously with their radiological differences and histological correlates, and to describe challenges in radiological diagnosis. DesignSingle case report. SettingTertiary referral center. ParticipantsForty-one year-old African-American male patient. Main outcome measureLesion appearance on computed tomography (CT) scan and pathological correlates. ResultsA 41year-old African-American male presented with asymptomatic right maxillary swelling. A CT scan of the maxillofacial skeleton showed and expansile and cystic lesion of the right hemimaxilla with trabecular osseous expansion, and a left cystic lesion in the left hemimaxilla expanding into the pterygopalatine fossa. Biopsy confirmed the suspected diagnoses of right ameloblastoma and left keratocystic odontogenic tumor. ConclusionAlthough they are among the most common odontogenic tumors, the presence of concurrent ameloblastoma and KOT is an exceedingly rare occurrence in the same patient. The appearance on CT scan may help in distinguishing ameloblastoma from KOT by looking at bone expansion and high density areas, although the gold standard diagnostic test remains open biopsy.