Diagnosis Of Glandular Odontogenic Cyst Research Articles

GLANDULAR ODONTOGENIC CYST IN THE ANTERIOR MANDIBLE: AN UNUSUAL CASE

Glandular odontogenic cyst (GOC) is an unusual entity, locally aggressive and with a high recurrence rate. A 60-year-old male patient was referred with the diagnosis of GOC from an incisional biopsy. Computed tomography revealed a hypodense unilocular lesion with cortical bone resorption involving the mandibular anterior region. After ostectomy, microscopic examination showed fragments of cystic capsule partially covered by epithelium of variable thickness, composed of cuboidal and columnar cells with papillary projections forming spherical nodules occasionally with the presence of cilia. Apocrine metaplasia was also seen, as well as clear cells in the epithelium basal layer. Additionally, intraepithelial microcysts and glandular spaces were observed. The diagnosis of GOC was made. After 4 months of follow-up, no recurrence was reported. Glandular odontogenic cyst (GOC) is an unusual entity, locally aggressive and with a high recurrence rate. A 60-year-old male patient was referred with the diagnosis of GOC from an incisional biopsy. Computed tomography revealed a hypodense unilocular lesion with cortical bone resorption involving the mandibular anterior region. After ostectomy, microscopic examination showed fragments of cystic capsule partially covered by epithelium of variable thickness, composed of cuboidal and columnar cells with papillary projections forming spherical nodules occasionally with the presence of cilia. Apocrine metaplasia was also seen, as well as clear cells in the epithelium basal layer. Additionally, intraepithelial microcysts and glandular spaces were observed. The diagnosis of GOC was made. After 4 months of follow-up, no recurrence was reported.

GLANDULAR ODONTOGENIC CYST IN ANTERIOR MANDIBLE: A CASE REPORT

A 35-year-old male patient was referred to the oral clinic complaining of a sensitivity in the right lower canine, without gingival edema or any other sign. On radiographic examination, a well-defined multilocular, radiolucent lesion associated with the roots of the lower incisor and canine was noted. The initial clinical diagnostic hypotheses were ameloblastoma or keratocyst. After complete removal of the lesion by curettage, microscopic examination revealed a thin and friable cystic capsule and lining composed of nonkeratinized stratified squamous epithelium as well as superficial cuboidal eosinophilic cells and intra-epithelial microcystic structures. The final diagnosis of glandular odontogenic cyst was made. Surgical treatment of the lesion was successful and the patient is being followed up. Since surgical treatment, the patient has been followed up with no evidence of recurrence.

GLANDULAR ODONTOGENIC CYST OR LOW-GRADE MUCOEPIDERMOID CARCINOMA? A CASE CHARACTERIZED WITH OVERLAPPING HISTOMORPHOLOGICAL FINDINGS

Background Glandular odontogenic cyst (GOC) is a rare odontogenic epithelial cyst of the jaw, with glandular differentiation. It occurs in adults and mostly in the anterior mandible. Case A 38-year-old female patient underwent curettage because of a well-circumscribed 15 × 10 mm cystic lesion, associated with the molar tooth root, in the mandible. Histopathologic examination revealed a neoplastic cystic lesion containing distorted small glands that seemed smaller in size around the cyst lined by mucinous columnar epithelium. In rare areas, immature metaplastic squamous epithelial islands in relation to the wall of the cyst was striking. There were often goblet cells within the cyst lining. No significant nuclear atypia was detected in the epithelium. Very rarely, typical mitoses were observed. Free mucin ponds were commonly observed in the cyst lumen, stroma. PanCK stain highlighted much smaller glands in areas around the cyst, as well as small clusters of epithelial cells in abortive, distorted character and even without gland structure. No significant staining was detected with P53 and Ki67. The case was considered to be compatible with GOC due to lack of nuclear atypia, low mitotic and Ki67 index, and no evidence of destructive invasion. However, because low-grade mucoepidermoid carcinoma could not be excluded, follow-up was recommended. Conclusions GOC has histomorphological findings overlapping with those of low-grade mucoepidermoid carcinoma. The absence of nuclear atypia, mitotic activity, and invasion findings is important in the diagnosis of GOC, but LGMECs that have weak criteria for malignancy may cause serious problems in differentiation from GOCs in some cases.

GLANDULAR ODONTOGENIC CYST: A CASE REPORT WITH EMPHASIS IN DIAGNOSIS AND TREATMENT

A 40-year-old female patient attended the oral and maxillofacial surgery service with complaint of an increase in volume in the anterior region of the mandible. With a time of evolution of 6 months, the region of the lesion presented blue coloration, hardened consistency, and painful symptomatology, measuring approximately 4 cm. Displacement of dental elements (31, 32, and 33) was evidenced. Radiographically, a multilocular radiolucent osteolytic lesion was observed. Diagnostic hypotheses were given for odontogenic keratocysts and botryoid cyst. The incisional biopsy was performed, obtaining the histopathologic diagnosis of glandular odontogenic cyst. The patient was submitted to excisional biopsy, confirming the previous histopathologic diagnosis. Due to the aggressiveness and the high recurrence rate inherent to this lesion, segmental resection of the lesion was performed, followed by block graft reconstruction. This case highlights the importance of an effective diagnosis to provide adequate treatment and absence of relapses. A 40-year-old female patient attended the oral and maxillofacial surgery service with complaint of an increase in volume in the anterior region of the mandible. With a time of evolution of 6 months, the region of the lesion presented blue coloration, hardened consistency, and painful symptomatology, measuring approximately 4 cm. Displacement of dental elements (31, 32, and 33) was evidenced. Radiographically, a multilocular radiolucent osteolytic lesion was observed. Diagnostic hypotheses were given for odontogenic keratocysts and botryoid cyst. The incisional biopsy was performed, obtaining the histopathologic diagnosis of glandular odontogenic cyst. The patient was submitted to excisional biopsy, confirming the previous histopathologic diagnosis. Due to the aggressiveness and the high recurrence rate inherent to this lesion, segmental resection of the lesion was performed, followed by block graft reconstruction. This case highlights the importance of an effective diagnosis to provide adequate treatment and absence of relapses.

SURGICAL TREATMENT OF GLANDULAR ODONTOGENIC CYST IN POSTERIOR REGION OF MANDIBLE

A 49-year-old male patient complained "I can’t chew on the swollen side" (according to patient information). The anamnesis revealed a slightly painful lesion with 5 years of evolution. The physical examination showed swelling, with both cortices expanding, approximately 3 cm, in a retromolar area on the right side of the mandible, covered by normal-looking mucosa. Imaging examination showed an intraosseous lesion with hypodense area associated to tooth 46 in retromolar region. Incisional biopsy followed by histopathological examination closed the diagnosis of glandular odontogenic cyst. The lesion was treated by enucleation followed by peripheral ostectomy. The 12-month follow-up showed no signs of recurrence at clinical examination, such as imaging tests. Although the glandular odontogenic cyst is a rare entity, it needs to be diagnosed and treated, since it may present an aggressive character to the gnathic bones. A 49-year-old male patient complained "I can’t chew on the swollen side" (according to patient information). The anamnesis revealed a slightly painful lesion with 5 years of evolution. The physical examination showed swelling, with both cortices expanding, approximately 3 cm, in a retromolar area on the right side of the mandible, covered by normal-looking mucosa. Imaging examination showed an intraosseous lesion with hypodense area associated to tooth 46 in retromolar region. Incisional biopsy followed by histopathological examination closed the diagnosis of glandular odontogenic cyst. The lesion was treated by enucleation followed by peripheral ostectomy. The 12-month follow-up showed no signs of recurrence at clinical examination, such as imaging tests. Although the glandular odontogenic cyst is a rare entity, it needs to be diagnosed and treated, since it may present an aggressive character to the gnathic bones.

GLANDULAR ODONTOGENIC CYST: A REPORT OF A CASE

Glandular odontogenic cyst (GOC) is a rare developmental cyst, comprising less than 1.0% of the jaws cysts. We report a case of a 45-year-old Caucasian male, presenting with a slight painless swelling in the posterior region of the mandible. Cone beam computed tomography revealed a well-defined hypodense lesion, approximately 3.2 × 2.2 cm, involving the tooth 48. An incisional biopsy was performed, and microscopic examinations revealed multiple pathologic cavities lined by odontogenic epithelium of variable thickness, presenting small duct-like structures and occasional goblet cells, surrounded by a fibrous capsule. The diagnosis was GOC. Cystic marsupialization was carried out, and clear regression of the lesion is observed after 9 months’ follow-up. Because of the aggressive biologic behavior, a correct diagnosis of GOC is essential to ensure the proper management of the lesion. As the diagnosis of GOC may be challenging, we provide a discussion of the histopathologic criteria of differential diagnosis.

HOW CONSERVATIVE CAN WE BE IN THE TREATMENT OF GLANDULAR ODONTOGENIC CYSTS? A CASE REPORT

The glandular odontogenic cyst (GOC) is a rare maxillary cyst with an aggressive, potentially recurrent behavior. Because of such behavior, treating GOC conservatively remains a controversy for many oral and maxillofacial surgeons and oral pathologists. This study reports on a case in which GOC decompression was used with fairly good results in a male patient. After detailed clinical and radiographic examination, we performed an incisional biopsy with simultaneous placement of a decompression device. On receiving the histologic diagnosis of GOC, we decided to keep the decompression for 8 months, which resulted in significant volumetric reduction of the lesion verified through sequential radiographic examination and allowed for curettage of the residual pathologic tissue in a second surgical opportunity. Thus, our opinion is that decompression associated with curettage is a feasible conservative treatment for GOC. Still, longer follow-up is recommended to detect and intervene at the earliest signs of recurrence.

GLANDULAR ODONTOGENIC CYST: A SERIES OF 17 NEW CASES

Objective Our aim is to report a series of 17 new cases of glandular odontogenic cyst (GOC) diagnosed in a Brazilian laboratory of oral pathology in the last 7 years. Study Design All clinical and radiographic features were retrieved from patients’ charts and the diagnosis of GOC was confirmed after microscopic evaluation following the current World Health Organization (WHO) criteria. Results There were 13 women and 4 men, with a mean age of 46 years. Eleven cases involved the mandible and 6 cases involved the maxilla, particularly the anterior region (10 cases), as extensive well-defined unilocular radiolucencies with limited expansion of bone cortices. The most common histologic criteria observed were eosinophilic cuboidal cells, epithelial detachment, variable thickness, and mucous cells. Most cases were treated by surgical enucleation, with 1 case showing recurrence. Conclusions GOC is an uncommon developmental cyst with features resembling glandular differentiation that may show large size with limited bone expansion.

A Rare Case of Glandular Odontogenic Cyst With a Breif Review Of Literature

Glandular odontogenic cyst (GOC) is an extremely rare cyst of jaw bone with only 182 cases documented so far in the English literature. GOC is considered to be a locally aggressive lesion with high rate of recurrence. Anterior mandible is the most common site of involvement for GOC, involvement of the maxillary bone which is a rare occurrence. The clinical and radiographic finding of GOC are varied & often pathognomic. As clinical & radiographic findings are overlapping with those of other odontogenic cyst, a careful histopathological examination is needed to arrive at a definite diagnosis of GOC. In the present paper we reported a rare case of GOC in a 23yrs old male involving maxillary bone along with a review of literature focussing on clinical & radiological presentation and treatment outcome.

Glandular Odontogenic Cystin Maxilla : A Case Series

Glandular odontogenic cyst is rare phenomenon with 0.012% to 0.03% frequency of all jaw cysts and worldwide prevalence of 0.17%. Diagnosis of Glandular odontogenic cyst, well known for its aggressive growth potential and high rate of recurrence, is very crucial. This report presents cases of two 50-year old individuals with Glandular odontogenic cyst presenting as a radiolucent lesion of maxilla. Final diagnosis was made on the basis of histopathological features and further confirmed by immunohistochemical analysis. Keywords: histology; immunohistochemistry; odontogenic cyst.

GLANDULAR ODONTOGENIC CYST: TWENTY YEARS OF PROGRESSION IN A MISDIAGNOSED PATIENT

Glandular odontogenic cyst (GOC) is an uncommon jawbone cyst of odontogenic origin with unpredictable and potentially aggressive behavior. This study reports a case with twenty years of evolution of GOC in a patient that initially presented an asymptomatic radiolucent lesion in the anterior mandible with no clinical alteration. The involved teeth were treated endodontically and the lesion was enucleated, but the lesion growth persisted. Other enucleations were performed, but with the same results. All histopathologic analysis of the enucleations were compatible with the diagnosis of periapical cyst. The patient abandoned the treatment for years, but an incisional biopsy was performed twenty years after the first consultation. The histopathologic analysis showed a superficial layer of the epithelium with eosinophilic cuboidal and columnar ciliated cells along with papillary projections and evidence of mucous cells. The diagnosis of GOC was made and the patient was referred for appropriate treatment.

PP - GLANDULAR ODONTOGENIC CYST: A CASE REPORT

Glandular Odontogenic Cyst (GOC) is a rare developmental odontogenic lesion with an aggressive behavior and a high recurrence rate. This study presents a case report of a 70-year-old Caucasian woman, who was referred to the Oral Diseases Diagnosis Center (Federal University of Pelotas), complaining of pain in the anterior mandible when chewing, which she had felt for approximately 9 months. Intraoral examination revealed a purple extensive swelling of the anterior mandible, with rupture of the cortical bone but with no tooth displacement. Panoramic and total inferior occlusal radiographs showed a well-defined multilocular radiolucency, extending from the first inferior right molar to the second inferior left molar. Histopathological analysis of an incisional biopsy revealed a cystic capsule lined by non-keratinizing stratified squamous epithelium, revealing areas presenting a papillary aspect, with superficial columnar cells, cilia, rare groups of mucous cells, and some clear cells. The diagnosis of GOC was confirmed. Due to the large size of the lesion and the risk of pathological fracture, marsupialization was performed. A significant decrease in the lesion and bone neoformation were observed after three months of follow-up. Complete curettage of the lesion has been planned, and the patient continues in rigorous follow-up.

Molecular diagnostics in the differential diagnosis of glandular odontogenic cyst and mucoepidermoid carcinoma – case reports

AbstractGlandular odontogenic cyst (sialo‐odontogenic cyst) (GOC) is an uncommon developmental odontogenic cyst. Its clinical significance lies in its tendency to recur, and histopathological features which mimic those of mucoepidermoid carcinoma (MC). Molecular methods such as fluorescence in situ hybridisation (FISH) have the potential to identify genetic abnormalities that are specific to MC and thus avoid this diagnostic pitfall. This report describes three cystic lesions of the jaws with a differential diagnosis of GOC and MC. One occurred in the mandibular premolar area of a 49‐year‐old woman and was diagnosed as GOC. The second developed in the maxilla of a man aged 39 in association with an impacted second premolar tooth. This was initially diagnosed as dentigerous cyst, but after recurrence 6 years later, the diagnosis was revised to GOC. The third occurred in the left retromolar area of a 30‐year‐old woman 5 years after the extraction of the left mandibular third molar; a diagnosis of GOC was favoured after two incisional biopsies, but a third showed unequivocal, invasive MC which had infiltrated nerves and bone. Morphologically, the only distinguishing feature was the so‐called epithelial sphere, whorl or plaque‐like thickening, which was identified in both GOC but not in the MC. FISH confirmed the above diagnoses by demonstrating a MAML2 rearrangement in the MC, but in neither of the GOC. While histopathology may reliably distinguish between GOC and MC, the presence of the specific MAML2 rearrangement in the latter clinches the diagnosis.

Glandular Odontogenic Cyst: A Case Report

Introduction: The glandular odontogenic cyst (GOC) is a rare, locally aggressive and potentially recurrent cyst of jaws which lead in diagnostic and therapeutic challenges. Since 1992, 111 cases of GOC have been reported, with 0.2% incidence among odontogenic cysts. Case Presentation: The patient was a 33-year-old woman who came to the department of oral medicine with a complaint of facial swelling. After taking her history, and conducting clinical, radiological, and histopathologic examinations, the diagnosis of GOC was made. Conclusions: Glandular odontogenic cyst is an uncommon and relatively aggressive cyst with a high recurrence rate. Clinical and radiological evaluations are needed together with careful histopathologic evaluations for diagnosis. Oral medicine specialists should be aware of its characteristic features and make an accurate diagnosis so appropriate management can follow.

Glandular Odontogenic Cyst: Review of Literature and Report of a New Case with Cytokeratin-19 Expression

The glandular odontogenic cyst (GOC) was a rare jawbone cyst described in 1988 as a distinct entity. This lesion can involve either jaw, and the anterior region of the mandible was the most commonly affected area. Clinical and radiographic findings were not specific, and the diagnosis of GOC can be extremely difficult due to the rarity of this lesion. The cyst presented a wall constituted by fibrous connective tissue and was lined by a non-keratinized stratified squamous epithelium of variable thickness. Large areas of the lining epithelium presented cylinder cells, sometimes ciliated. A variable amount of mucina was occasionally noted. Due to the strong similarities, this cyst can be easily misdiag-nosed as a central mucoepidermoid carcinoma (CMEC). Immunohistochemistry may be an aid in diagnosis; in fact has been demonstrated that there were differences in the expression of cytokeratins (CK) in GOC and CMEC. In this study, we reported a new case of GOC in a 38 year female patient. In addition, we carried out a review of 110 previous cases reported in literature.

Glandular Odontogenic Cyst: Case Report

Glandular odontogenic cyst is a rare developmental cyst characterized by local aggressive behavior. Woman, 73, complained of a bluish swelling of the lingual portion of the anterior mandible that extended from tooth #33 to #44 and had been present for 4 years. Panoramic and periapical radiographs from the area showed an extensive multilocular radiolucent image on the anterior mandible. Incisional biopsy revealed a glandular odontogenic cyst. Treatment was en-bloc resection of the anterior mandible. Histological analysis of the surgical specimen confirmed the diagnosis of glandular odontogenic cyst. The patient was rehabilitated with a removable partial denture and has been in clinical and radiological follow-up for months with no signs of local recurrence.

Glandular Odontogenic Cyst Associated with Impacted Tooth: A Case Report

Glandular odontogenic cyst (GOC) is an uncommon developmental cyst. It accounts for 0.012% to 1.3% of all the jaw cysts; its prevalence is 0.17%. It was described by Gardner et al. in 1988 as a distinct entity. GOC has a slight predilection for mandible and affect more commonly in the middle-aged patients. Radiographic and clinical features of this cyst are not pathognomonic or specific. Only the histopathological examinations allow for certain diagnosis of the cyst. The increased recurrence rate can be due to cell kinetics in the lining epithelium, multilocularity and incomplete removal of the lining following conservative treatment. In this report, we describe a case of GOC of the mandible associated with impacted tooth. The clinical diagnosis of dentigerous cyst was made, whereas histopathological examination results in a diagnosis of glandular odontogenic cyst. Based on clinical and radiological examination the diagnosis of other lesions such as radicular cyst, dentigerous cyst, and ameloblastoma may be made but histologically GOC shows certain characteristic features.

Glandular odontogenic cyst: case report and review of diagnostic criteria

The glandular odontogenic cyst (GOC) is an uncommon jaw bone cyst of odontogenic origin with unpredictable and potentially aggressive behaviour. It also has the propensity to grow to a large size and tendency towards recurrence. GOC can be easily misdiagnosed microscopically as a central mucoepidermoid carcinoma. This paper reports a case of GOC in a 56-year-old male and reviews the main criteria for accurate diagnosis. The diagnosis of GOC can be extremely difficult due to the rarity of the cyst and lack of clear diagnostic criteria.

The use of molecular markers as an aid in the diagnosis of glandular odontogenic cyst

(1) To investigate the use of p53, Ki67, and PCNA as an aid in the diagnosis of glandular odontogenic cyst (GOC); (2) To compare the expression of these markers in GOC, low-grade mucoepidermoid carcinoma (MEPCa), and radicular cyst with mucous metaplasia (RCM) as an aid in the differential diagnosis; (3) To establish guidelines for the diagnosis of GOC. 35 patients: 10 GOC, 15 RCM, 9 MEPCa. Immunostaining of archival specimens for p53, Ki67, PCNA. Twenty-nine articles (1987-2004) with detailed histopathological descriptions of GOC, analyzed for frequency of histopathological characteristics. Mean p53 labeling index (LI) was higher in GOC (3.0+/-4.3%) and MEPCa (4.9+/-7.4%) than in RCM (0.4+/-1.2%, p=0.048). Ki67 LI was higher in GOC (4.4+/-4.7%) and RCM (3.7+/-6.7%) than in MEPCa (0.7+/-1.6%, p=0.03). There were no significant differences in the expression of PCNA. In the literature, the most consistent histopathological characteristics of GOC included epithelial spherules/"knobs"/whorls (82.8%), cuboidal eosinophilic cells (65.5%), goblet cells (65.5%), intraepithelial glandular/microcystic ducts (58.6%), variations in lining width (55.2%), ciliated cells (51.7%) and mucous pools/mucous-lined crypts (41.4%). These histopathological features were divided into major and minor signs. The diagnosis of GOC should be based on at least the focal presence of the major signs. Measurement of p53 and Ki67 may aid in the differential diagnosis of GOC.