The Keratocystic Odontogenic Tumor Revisited

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1.Carlson ER, Oreadi D, McCoy JM: Nevoid basal cell carcinoma syndrome and the keratocystic odontogenic tumor. J Oral Maxillofac Surg 73:S77, 2015. http://dx.doi.org/doi:10.1016/j.joms.2015.04.037A review of the principal signs and symptoms of the Nevoid Basal Cell Carcinoma Syndrome with guidelines on screening and treatment protocols for patients with the syndrome.2.Booms P, Harth M, Sader R, Ghanaati S: Vismodegib hedgehog-signaling inhibition and treatment of basal cell carcinomas as well as keratocystic odontogenic tumors in Gorlin syndrome. Ann Maxillofac Surg 5:14, 2015. http://dx.doi.org/doi:10.4103/2231-0746.161049The hedgehog signaling pathway inhibitor drug vismodegib has FDA approval to treat otherwise inoperable basal cell carcinomas. It does this by inhibiting the PTCH1 signaling pathway. When used in patients with basal cell nevus syndrome, it has been noted to also shrink the keratocystic odontogenic tumors offering a possible future medical management for these lesions.3.Ally MS, Tang JY, Joseph T, et al: The use of vismodegib to shrink keratocystic odontogenic tumors in patients with basal cell nevus syndrome. JAMA Dermatol 150:542, 2014. http://dx.doi.org/doi:10.1001/jamadermatol.2013.7444Another article to show that vismodegib, when taken orally can inhibit and cause shrinkage of the keratocystic odontogenic tumors in Gorlin's syndrome as well as treating the basal cell carcinomas. It does, however, cost around $300 per tablet.4.Dashow JE, McHugh JB, Braun TM, et al: Significantly decreased recurrence rates in keratocystic odontogenic tumor with simple enucleation and curettage using Carnoy's Versus Modified Carnoy's Solution. J Oral Maxillofac Surg 73: 2132, 2015. http://dx.doi.org/doi:10.1016/j.joms.2015.05.005An article from two different programs showing that the original formulation of Carnoy's solution is more effective in treating keratocystic odontogenic tumors than the modified Carnoy's solution which lacks chloroform.5.Khot K, Deshmukh SB, Alex S; Comparative analysis of the immunohistochemical expression of vascular endothelial growth factor and matrix metalloproteinase-9 in keratocystic odontogenic tumor, dentigerous cyst and radicular cyst. J Cancer Res Ther 11:635, 2015. http://dx.doi.org/doi:10.4103/0973-1482.144591An article to show that the biochemical and histochemical makeup of keratocystic odontogenic tumors differs from that of simple dentigerous cysts, and not only can be helpful in the diagnosis but may also explain differences in behavior.6.Al-Moraissi EA, Pogrel MA, Ellis E 3rd: Does the excision of overlying oral mucosa reduce the recurrence rate in the treatment of the keratocystic odontogenic tumor? A systematic review and meta-analysis [published online ahead of print April 7, 2016]. J Oral Maxillofac Surg. http://dx.doi.org/10.1016/j.joms.2016.03.043A review article that looks at the controversial issue of where it is necessary to remove the overlying mucosa from a keratocystic odontogenic tumor to decrease the risk of recurrence. This review shows that it may be of some value.7.Barry JY, Le CH, Baumann J, et al: Endoscopic resection of maxillary sinus keratocystic odontogenic tumors [published online ahead of print March 12, 2016]. Laryngoscope. http://dx.doi.org/10.1002/lary.25920A novel technique of removal of keratocystic odontogenic tumors via the maxillary sinus by the use of functional endoscopic sinus surgery with an endoscope and instruments to essentially de-roof and open up the cystic tumor into the maxillary sinus. Long-term results are not available.8.Asutay F, Atalay Y, Turamanlar O: Three-dimensional volumetric assessment of the effect of decompression on large mandibular odontogenic cystic lesions. J Oral Maxillofac Surg 74:1159, 2016. http://dx.doi.org/10.1016/j.joms.2015.12.010An article showing by objective measurement the three-dimensional cone-beam CT scanning of keratocystic odontogenic tumors of the mandible. It accurately documents the decrease in size with decompression.9.Pogrel MA: The keratocystic odontogenic tumour (KCOT)–an odyssey. Int J Oral Maxillofac Surg 44:1565, 2015. http://dx.doi.org/10.1016/j.ijom.2015.03.008This article shows the progress in one unit over 30 years in the management of keratocystic odontogenic tumors going from enucleation to enucleation plus cryosurgery to decompression and through to enucleation with peripheral ostectomy. The results obtained from these different treatment plans are compared and discussed.10.Bai MR, Shen T, Chen YU, Geng N: Primary intraosseous squamous cell carcinoma in pre-existing keratocystic odontogenic tumor: A case report and literature review. Mol Clin Oncol 4:187, 2016. http://dx.doi.org/doi:10.3892/mco.2015.678An article to show the possibility of malignant change in keratocystic odontogenic tumors. This is extremely rare and only appears to be reported in tumors of longstanding or after multiple recurrences.11.Sharif FN, Oliver R, Sweet C, Sharif MO: Interventions for the treatment of keratocystic odontogenic tumours. Cochrane Database Syst Rev 5:CD008464, 2015. http://dx.doi.org/10.1002/14651858.CD008464.pub. J Oral Maxillofac Surg 73: 2132, 2015. http://dx.doi.org/10.1016/j.joms.2015.05.005A review of research papers on the management of Keratocystic Odontogenic Tumors (KCOT). It transpires that there was no high level evidence of the effectiveness of managing KCOTs by comparing the effectiveness of different treatments. No eligible studies for inclusion were identified.