Botryoid Odontogenic Cyst Research Articles

Glandular Odontogenic Cyst: An Arduous Diagnostic Entity

Glandular odontogenic cyst GOC is a rare cyst that is predominantly noticed in the anterior region of the mandible with a prevalence of 0.012- 1.3 of all jaw cysts more commonly in male population with a mean age of 49.5 years. Clinically in most cases it presents as an asymptomatic swelling and radiographically it may appear as unilocular or multilocular radiolucency which is non-specific. Histopathological diagnosis is of utmost importance and it is challenging as it can resemble other jaw cysts like botryoid odontogenic cyst lateral periodontal cyst and malignant neoplasms like mucoepidermoid carcinoma. In this article we present a series of six cases reported to our institution with swelling of the face of varying extent and different radiological presentations which were diagnosed as GOC.

GOC in Maxillary Anterior Jaw: An Infrequent Case Report

Padayachee and Van Wyk in 1987 first documented the case of Glandular odontogenic cyst (GOC) and regarded this as ‘sialo-odontogenic cyst’ they published two cases that mimicked botryoid odontogenic cyst and the central mucoepidermoid tumor of jaws. Glandular odontogenic cyst (GOC) is counted as infrequent developmental odontogenic cyst of jaw that has the incidence of 0.012 to 1.3% only GOC is very rare with only 111 cases have been documented in the English literate till date. This case report in unique as this patient presented with the painless swelling in maxillary anterior region.

IMMUNOEXPRESSION OF STEM CELL MARKERS IN DEVELOPMENTAL ODONTOGENIC CYSTS

<h3>Objectives</h3> Developmental odontogenic cysts (DOCs) originate from remnants of the odontogenesis, rich in multipotent stem cells (SC). The aim was to evaluate the immunoexpression of multipotent SC markers in DOCs and to compare aggressive and indolent cysts. <h3>Study Design</h3> Immunohistochemistry using the immunoperoxidase technique was performed on 42 DOCs using monoclonal antibodies for CD44 and CD90. The sample consisted of 20 odontogenic keratocysts (OKs), 7 dentigerous cysts (DCs), 7 glandular odontogenic cysts (GOCs), 4 calcifying odontogenic cysts (COC), 2 adult gingival cysts, 1 lateral periodontal cyst, 1 botryoid odontogenic cyst, and 1 orthokeratinized odontogenic cyst. <h3>Results</h3> DOCs revealed immunopositivity in epithelium and capsule for CD44 and CD90. CD44 immunoexpression in epithelium and capsule was superior in OK, followed by DC and GOC (<i>P</i> = .000). For CD90, only the capsule showed greater expression in OK, followed by calcifying odontogenic cyst and DC (<i>P</i> = .000). Aggressive cysts (OK and GOC), when compared to indolent cysts, showed superior positivity for CD44 in the epithelium (<i>P</i> = .007) and for CD90 in the capsule (<i>P</i> = .006). <h3>Conclusions</h3> Multipotent SC can participate in the histogenesis and pathogenesis of DOCs. This study also suggests that multipotent SC can be associated with the distinct biological behaviors of these lesions.

Histological differentiation between glandular odontogenic cyst and dentigerous cyst exhibiting mucous metaplasia

<h3>Introduction</h3> Microscopic features of GOC have been described in detail in literature, sometimes diagnostic confusion arises due to overlap of its histomorphological characteristics with other odontogenic cysts. Most common GOC mimics include dentigerous cyst with mucous metaplasia (DCM), botryoid odontogenic cysts, radicular cysts and surgical ciliated cysts. This study aims to evaluate clinical, radiographic, and histological disparity between glandular odontogenic cyst and dentigerous cyst with mucous metaplasia. <h3>Methods</h3> 15 cases of glandular odontogenic cyst (GOC) and 11 cases of dentigerous cyst with mucous metaplasia (DCM) from pathology records were reviewed considering clinical and histopathological data. Statistical analysis was applied on microscopic parameters to evaluate if any feature was helpful in differentiating them. <h3>Results</h3> GOC had male predilection while no such association was evident in DCM. The mean age was 47.7 years and 41.5 years for GOC and DCM respectively. Posterior mandible was the commonly affected site for GOC, but DCM was almost equally distributed between mandible and maxilla. The presence of intraepithelial microcyst, apocrine snouting and papillary projections appeared to be most helpful in distinguishing GOC from DCM (p=0.001). Our study found that the presence of eight or more parameters were highly predictive of GOC whereas five or fewer parameters were more predictive of DCM. <h3>Conclusion</h3> Even though GOC is aggressive with a high recurrence rate, the expected morbidity in cases of DCM is higher due to transformation into ameloblastoma or mucoepidermoid carcinoma. Hence careful evaluation of microscopic parameters along with clinical history and radiology can help in differentiating these two pathologies.

Biomarkers involved in the proliferation of the odontogenic keratocyst, glandular odontogenic cyst and botryoid odontogenic cyst.

Odontogenic cysts are a heterogeneous group of lesions with varied clinical behavior. To analyze the expression of the epidermal growth factor receptor (EGFR), Cyclin D1, and transcription factor SOX2 in the odontogenic epithelium evaluating the cell cycle control and cystic expansion. This was a cross-sectional study including 40 cases, 20 odontogenic keratocysts (OKC), 10 botryoid odontogenic cysts (BOC), and 10 glandular odontogenic cysts (GOC). All cases of OKC, BOC, and GOC were positive for EGFR in all layers of the cyst lining. The highest expression of nuclear Cyclin D1 was observed in the suprabasal layer of OKCs and in the basal and suprabasal layers of GOC and BOC (p < 0.001). In addition, SOX2 was only expressed in the suprabasal layer of OKCs. The high expression of EGFR in the cyst membrane suggests that EGF stimulates epithelial proliferation in BOCs, and the high expression of SOX2 in OKCs may be related to the presence of stem cells in the lesion. Cyclin D1 is related to cell cycle disruption in G1-S contributing to stimulates epithelial proliferation of OKCs and GOCs and BOCs.

Cisto periodontal lateral e cisto odontogênico botrióide

Cystic jaw bone lesions have been largely studied and discussed since the beginning of their recognition. Although many of them have already been well-defined, some of them go on generating divergent opinions, such as the lateral periodontal cyst (LP C) and the botryoid odontogenic cyst (BOC). The objective of this article is to report two cases of unusual characteristics, one of them is about a lateral periodontal cyst and the other one is about a botryoid odontogenic cyst, presenting considerations as to their clinical, radiographic and histological aspects.

A bunch of grapes with a bag of marbles: The concurrence of the botryoid odontogenic cyst with a compound odontoma

AbstractThe botryoid odontogenic cyst is considered a rare multilocular variant of the lateral periodontal cyst. The clinical, radiological and histopathological features of a case with a coinciding compound odontoma, affecting the anterior mandible, are presented. A 33‐year‐old South African male presented with an asymptomatic, progressive, firm swelling of the right anterior mandible. Radiographic examination revealed a multilocular, radiolucent lesion with a corticated border causing buccal expansion and erosion of the buccal plate. In addition, well‐defined denticles were present impeding the eruption of the right mandibular canine. Removal of the lesion resulted in the loss of four teeth. Histopathological results provided a final diagnosis of a botryoid odontogenic cyst and a concurrent compound odontoma.Statement of Clinical SignificanceThe botryoid odontogenic cyst is a rare entity and, thus, the information provided in this report contributes to the growing repository of literature surrounding these cysts. Furthermore, the concurrence of a compound odontoma contributes to its rarity.

Conservative management of botryoid odontogenic cysts using Carnoy's solution

Introduction: Only 96 cases of botryoid odontogenic cysts (BOCs) have been reported worldwide since it was first described in 1973. The optimum treatment modality has not yet been established. Between 2017 and 2018, three patients presented to our oral surgery department with BOCs and were managed by enucleation and application of Carnoy's solution.

Glandular Odontogenic Cyst

A cyst is a Pathological cavity which consists of solid, semi-solid or gaseous contents which are not createdby the accumulation of pus and which may or may not be lined by epithelium. The cysts of the jaw aredivided into two categories namely epithelial and non-epithelial. The epithelial cysts are further classifiedinto developmental and inflammatory. Based on their origin the developmental cysts are further classified intoodontogenic and non-odontogenic cysts. Hence the odontogenic cysts are described as jaw cysts originatingfrom the odontogenic epithelium. A glandular odontogenic cyst (GOC) is a developmental cyst. A glandularodontogenic cyst (GOC) is a sparse entity of odontogenic origination. A glandular odontogenic cyst is knownfor its hostile behaviour, unforeseeable nature, indeterminate clinical features and high recurring potentiality.The aggressive behaviour may be attributed to the cell kinetics of the lining epithelium or the conservativetreatment approach. Apart from the aforementioned peculiarities, GOC is also notorious for impersonatingclinicopathological lesions such as Botryoid odontogenic cyst, which is also a regionally aggressivepolycystic form of a lateral periodontal cyst and central mucoepidermoid tumour further complicating thediagnosis. These features further establish Glandular odontogenic cyst as an independent biological entity.This article focuses on discussing the various aspects of the rare entity that is a glandular odontogenic cystin terms of histopathological features, radiological features, diagnostic criteria, clinical features, cytologicalinvestigations, differential diagnosis and treatment approach.

RECURRENT BOTRYOID ODONTOGENIC CYST OF THE MANDIBLE: A CASE REPORT WITH 7-YEAR FOLLOW-UP

Botryoid odontogenic cyst is a rare noninflammatory odontogenic cyst. Herein, we report a case of recurrent botryoid odontogenic cyst. In 2010, a 44-year-old woman presented with a well-defined radiolucency extending from left first premolar to right canine in the mandible without intraoral alterations. Following incisional biopsy, histopathologic examination was suggestive of a botryoid odontogenic cyst. After endodontic treatment and apicoectomy of the involved teeth, the cyst was treated with decompression and enucleation. Microscopic examination showed a highly inflamed odontogenic cyst. For 7 years, the patient presented no alterations. In 2018, she presented a small well-defined, round-shaped radiolucency in the region under left central and lateral incisors. Microscopic examination revealed multiple cystic spaces lined by nonkeratinized stratified squamous epithelium with few cell layers and areas of plaque-like thickening. The cyst wall was composed of dense fibrous tissue with minimal inflammation. Diagnosis of botryoid odontogenic cyst was issued, and the patient is under follow-up. Botryoid odontogenic cyst is a rare noninflammatory odontogenic cyst. Herein, we report a case of recurrent botryoid odontogenic cyst. In 2010, a 44-year-old woman presented with a well-defined radiolucency extending from left first premolar to right canine in the mandible without intraoral alterations. Following incisional biopsy, histopathologic examination was suggestive of a botryoid odontogenic cyst. After endodontic treatment and apicoectomy of the involved teeth, the cyst was treated with decompression and enucleation. Microscopic examination showed a highly inflamed odontogenic cyst. For 7 years, the patient presented no alterations. In 2018, she presented a small well-defined, round-shaped radiolucency in the region under left central and lateral incisors. Microscopic examination revealed multiple cystic spaces lined by nonkeratinized stratified squamous epithelium with few cell layers and areas of plaque-like thickening. The cyst wall was composed of dense fibrous tissue with minimal inflammation. Diagnosis of botryoid odontogenic cyst was issued, and the patient is under follow-up.

DEMOGRAPHIC AND CLINICAL PROFILE OF DEVELOPMENTAL ODONTOGENIC CYSTS IN A BRAZILIAN POPULATION

Odontogenic cysts (OCs) are the most frequent lesions of gnathic bones and present with unique clinical findings and diverse biological behavior. Objective: To describe the demographic and clinical characteristics of developmental OCs diagnosed in a pathologic anatomy service. Study design: Through retrospective and descriptive analyses, data referring to age, sex, size, location, and radiographic characteristics were obtained from the biopsy request forms in the period 2002-2018. Results: A total of 135 cases of developmental OC were identified, of which 48% (n = 65) were odontogenic keratocyst (OKC), 36% (n = 49) dentigerous cyst (DC), 9% (n = 12) calcifying odontogenic cyst (COC), 3% (n = 4) gingival cyst of adult, and 1.48% (n = 2) glandular odontogenic cyst (GOC). Lateral periodontal cyst (LPC), botryoid odontogenic cyst (BOC), and orthokeratinized odontogenic cyst (OOC), were 1% (n = 1) each. Mean age of the patients was 30.6 years, with no predilection for sex. OKC, COC, and GOC showed the largest sizes, with averages of 2.92 cm, 2.67 cm, and 4.0 cm, respectively. The posterior mandible was affected more often (59%; n = 80). Radiographically, 41.5% exhibited a unilocular radiolucent appearance. Conclusion: DC and OKC were more frequent in this study. Developmental OCs predominated in the posterior mandible and the most aggressive lesions were large in sizes. Odontogenic cysts (OCs) are the most frequent lesions of gnathic bones and present with unique clinical findings and diverse biological behavior. Objective: To describe the demographic and clinical characteristics of developmental OCs diagnosed in a pathologic anatomy service. Study design: Through retrospective and descriptive analyses, data referring to age, sex, size, location, and radiographic characteristics were obtained from the biopsy request forms in the period 2002-2018. Results: A total of 135 cases of developmental OC were identified, of which 48% (n = 65) were odontogenic keratocyst (OKC), 36% (n = 49) dentigerous cyst (DC), 9% (n = 12) calcifying odontogenic cyst (COC), 3% (n = 4) gingival cyst of adult, and 1.48% (n = 2) glandular odontogenic cyst (GOC). Lateral periodontal cyst (LPC), botryoid odontogenic cyst (BOC), and orthokeratinized odontogenic cyst (OOC), were 1% (n = 1) each. Mean age of the patients was 30.6 years, with no predilection for sex. OKC, COC, and GOC showed the largest sizes, with averages of 2.92 cm, 2.67 cm, and 4.0 cm, respectively. The posterior mandible was affected more often (59%; n = 80). Radiographically, 41.5% exhibited a unilocular radiolucent appearance. Conclusion: DC and OKC were more frequent in this study. Developmental OCs predominated in the posterior mandible and the most aggressive lesions were large in sizes.

Immunohistochemical profile of the anti-apoptosis, apoptosis and proliferation markers Bcl-2, caspase-3, p53, and Ki-67 in botryoid odontogenic cysts compared to lateral periodontal cysts and gingival cysts of the adult

ABSTRACT We investigated the differences in growth and rates of recurrence of the botryoid odontogenic cyst (BOC) and the less aggressive lateral periodontal cyst (LPC) and gingival cyst of the adult (GCA). We compared the immunohistochemical expression of selected biomarkers of apoptosis and proliferation and of regulators of their activity. Sections from archival paraffin blocks of 15 BOCs, six GCAs, six LPCs, and three odontogenic keratocysts (OKCs) were processed for immunohistochemical localization of Bcl-2, caspase-3, p53 and Ki-67. Labeled and unlabeled epithelial cells were counted and differences in the mean labeling index (LI) were evaluated statistically. The only significant differences in LI were for the anti-apoptotic marker, Bcl-2; the hierarchy was BOC > OKC > LPC > GCA. In two BOCs, 97% of the cells, and in all OKCs, all of the basal cells were labeled with Bcl-2. Otherwise, cells labeled with Bcl-2, p53 and caspase-3 were scattered among the basal and intermediate epithelial cell layers. Ki-67 labeled almost exclusively basal cells in the BOCs, LPCs and GCAs, and both basal and intermediate layer cells in the OKCs. Our findings suggest that while there was no significant difference in replicative potential of the GCAs, LPCs and BOCs, factors that influence apoptosis may be partially responsible for the more aggressive behavior of BOCs and OKCs.

A Clinicopathological Approach to Odontogenic Cysts: the Role of Cytokeratin 17 and bcl2 Immunohistochemistry in Identifying Odontogenic Keratocysts

Odontogenic keratocysts (OKCs) are developmental cysts of the jaws that require proper diagnosis due to their potential for local aggressive growth and recurrences. OKCs have a typical parakeratotic epithelium demonstrating transepithelial cytokeratin 17 (CK17) and basal bcl2 staining on immunohistochemistry (IHC), which distinguishes them from other common jaw cysts. Secondary to inflammation, the epithelial lining may be altered and loses the typical IHC phenotype. The aim of the present study was to analyse a series of consecutive jaw cysts for their expression of CK17 and bcl2 and assess how these IHC stains may help in their diagnosis. All cysts were retrospectively assessed for available clinical, radiological and pathological findings and diagnoses were revised whenever needed. 85 cysts from 72 patients were collected from two departments. The series had 21 OKCs, the remaining non-OKCs included radicular/residual, dentigerous, paradental, lateral periodontal, botryoid odontogenic cysts. OKCs with typical epithelium showed the typical IHC phenotype, which was generally lost in inflammation-associated altered epithelium. Contrarily to earlier descriptions, a wide variety of CK17 positivity was seen in the majority of non-OKCs, including focal transepithelial staining. Basal bcl2 staining was also seen in 16 non-OKCs. These stainings were never as strong in intensity as seen in OKCs. One case was histopathologically identified as OKC due to focally maintained IHC profile. CK17 and bcl2 IHC may help in the diagnosis of OKCs, but must be interpreted with caution and is not a yes or no tool in the diagnostic puzzle.

Botryoid Odontogenic Cyst

A 70-year-old man consulted for a mass of unspecified duration in the anterior area of the mandible. Radiologic information was not provided. An incision biopsy was performed by the dentistry service. The specimen received at the laboratory was labeled “cystic lining” and consisted of two light-gray to dark brown, irregularly shaped tissue fragments measuring 0.3 cm and 0.4 cm in diameters. Histological sections show biloculated cyst wall segments composed of fibrocollagenous tissue lined by an epithelial lining of varying thickness. (Figure 1) The latter consists of a thin layer of non-keratinizing epithelium with plaque-like thickenings that are composed of cells with a whorled pattern and variably clear cytoplasm. (Figures 2 &amp; 3) Based on these microscopic features we signed the case out as a botryoid odontogenic cyst.&#x0D; Botryoid odontogenic cyst (BOC) is a developmental, non-inflammatory odontogenic cyst derived from residual odontogenic epithelium such as the dental lamina.1,2 It occurs between the roots of erupted teeth and is typically multilocular. It represents less than 1% of odontogenic cysts. Most cases occur in the sixth and seventh decades of life and a slight preponderance of males has been observed.1 Other studies report an equal distribution between sexes.2 It most often occurs in the mandible anterior to the molars, particularly the incisive/canine and premolar regions.1,2 Most BOCs are asymptomatic and discovered incidentally on radiographs although occasionally bone expansion is observed.1 Radiologically, BOCs often present with a multilocular radiological appearance.2 This multilocular feature has been likened to a “bunch of grapes” (botryoid: from the Greek botrys – bunch of grapes, and oeides – in the shape of).3&#x0D; Microscopically, the cyst locules are lined by a one-to-two cell thick non-keratinizing epithelium with plaque-like thickenings of cells in a whorled arrangement and connective tissue septa.1,3 Cytoplasmic clearing may be observed because of glycogen.1&#x0D; The differential diagnosis includes a lateral periodontal cyst (LPC) and a gingival cyst (GC). Although their histological features are largely identical, a LPC is unilocular while a GC occurs in the alveolar ridge of infants.1-3 A BOC is often considered a multilocular variant of lateral periodontal cyst.2,3 Making this distinction however is more than just of morphologic interest but is important as BOCs are reported to give rise to recurrences unlike LPCs and GCs.2,3 An ameloblastoma may be considered because of the multilocular appearance although the microscopic features are sufficiently distinct to rule out this entity. An adenomatoid odontogenic tumor (AOT) may be considered because of the nodular thickenings with a whorled pattern. However, AOT is a solid tumor characterized in addition by the presence of rosette- or duct-like spaces with dentinoid matrix.&#x0D; The recommended treatment is by enucleation.1 Successful conservative management with Carnoy’s solution has also been described.4 Peripheral ostectomy has also been recommended – a more aggressive approach being proposed as appropriate to extirpate any residual lesion.3 Recurrence has been stated to be between 15 to 30% which is largely ascribed to the multilocular characteristic of BOCs and consequent difficulty of complete removal, or of larger lesions.1-3 Thus, appropriate follow-up of cases or adjunctive therapy after enucleation might be warranted.2,3 To the author’s awareness, this is the first locally reported case of BOC after a search of local health research databases.

A Case of Botryoid Odontogenic Cyst in the Right Maxillary Molar Region

A Case of Botryoid Odontogenic Cyst in the Right Maxillary Molar Region

BOTRYOID ODONTOGENIC CYST IN THE MAXILLA

A 53-year-old woman presented an asymptomatic lesion in the anterior maxilla, causing a discrete bone expansion and covered by healthy oral mucosa. Cone beam computed tomography showed coalescent and well-defined hypodense areas at the periapical region of teeth 11, 12, and 13, measuring 12 mm, with buccal cortical bone discontinuity. The diagnosis hypothesis of an odontogenic cyst was confirmed by microscopic examination after incisional biopsy. The lesion was enucleated and tooth 12 was removed. The surgical specimen analysis revealed multiple cystic spaces lined by a thin, nonkeratinized epithelium with plaquelike thickenings. Some clear cells were noticed. The cystic wall was of a fibrous connective tissue. The final diagnosis was of botryoid odontogenic cyst. After 9 months of follow-up, there are no clinical or radiographic signs of recurrence. SUPPORT: FAPEMIG. A 53-year-old woman presented an asymptomatic lesion in the anterior maxilla, causing a discrete bone expansion and covered by healthy oral mucosa. Cone beam computed tomography showed coalescent and well-defined hypodense areas at the periapical region of teeth 11, 12, and 13, measuring 12 mm, with buccal cortical bone discontinuity. The diagnosis hypothesis of an odontogenic cyst was confirmed by microscopic examination after incisional biopsy. The lesion was enucleated and tooth 12 was removed. The surgical specimen analysis revealed multiple cystic spaces lined by a thin, nonkeratinized epithelium with plaquelike thickenings. Some clear cells were noticed. The cystic wall was of a fibrous connective tissue. The final diagnosis was of botryoid odontogenic cyst. After 9 months of follow-up, there are no clinical or radiographic signs of recurrence. SUPPORT: FAPEMIG.

Botryoid Odontogenic Cyst with Extensive Clear Cells

Benay Yildirim and Emre Baris* Author Affiliations Department of Oral Pathology, Turkey Received: July 13, 2019 | Published: July 19, 2019 Corresponding author:Emre Baris, Department of Oral Pathology, Turkey DOI: 10.26717/BJSTR.2019.19.003360 Also View In:

Botryoid odontogenic cyst: Report of case found in routine imaginological examinations and an update of the literature

Botryoid odontogenic cyst: Report of case found in routine imaginological examinations and an update of the literature

Botryoid Odontogenic Cyst: a Case Report

A 57-year-old Asian, female patient with asymptomatic hyperthyroidism developed a multilocular, radiolucent lesion, of 4 years' evolution, in the anterior region of the mandible; the lesion was well delimited and associated with the roots of vital teeth #31, #32, and #33. Excisional biopsy was performed, and a hypothetical diagnosis of periapical granuloma was made. The histologic sections revealed fragments of the odontogenic cyst, covered by thin layers of squamous epithelium, with focal areas of acanthosis and the presence of thicker epithelial areas composed of clear cells. Hyalinization of the connective tissue close to the epithelial layer was observed. The final diagnosis was botryoid odontogenic cyst, a rare cyst. As this cyst is multilocular, complete removal is difficult, rendering a high possibility of recurrence, and thus, a correct diagnosis is important.

PC196: Botryoid odontogenic cyst in mandible

PC196: Botryoid odontogenic cyst in mandible