Recurrent Keratocystic Odontogenic Tumor Research Articles

Primary Intraosseous Carcinoma Arising on Top of Recurrent Kerato-Cystic Odontogenic Tumor in a Young Male Patient

Primary Intraosseous Carcinoma Arising on Top of Recurrent Kerato-Cystic Odontogenic Tumor in a Young Male Patient

Keratocystic odontogenic tumor: A biopsy service's experience with 104 solitary, multiple and recurrent lesions.

BackgroundKeratocystic odontogenic tumor (KCOT) is a clinically significant cystic lesion of odontogenic origin. This study aimed to retrospectively review and describe the clinicopathologic features of KCOT and to objectively compare the clinical and histological features of solitary, multiple and recurrent KCOT in a Saudi Arabian population.Material and MethodsBiopsy request forms, pathology records and archival materials (all histological slides) of 104 cases of KCOT from 75 patients were retrieved. Demographic and clinical details as well as histological evaluation were analyzed and compared between the 3 groups using chi-squared or Mann-Whitney tests of association as appropriate.ResultsSignificant differences were noted in the age of presentation, location and association with impaction between multiple and solitary cases. Histologically, there was a difference in the mitotic count, presence of satellite cysts and proliferating odontogenic epithelium between solitary and multiple lesions. There was no difference between the KCOT that later recurred and solitary lesion which did not recur even when matched clinically for age, sex and location. There were differences when solitary KCOT that later recurred or recurrent KCOT were compared with multiple lesions. Multiple lesions still had more significant proliferative activity parameters than solitary recurrence-related KCOT.ConclusionsKCOTs in Saudi Arabians are not different from those reported from other parts of the world. Clinical and histological analyses showed multiple KCOT is different from its solitary recurrent or non-recurrent counterparts and has a higher proliferative activity than both. Clinicohistologic features alone cannot wholly explain the behavior of KCOT. Key words:Descriptive study, keratocystic odontogenic tumor, odontogenic keratocyst, solitary, multiple, recurrent.

Keratocystic odontogenic tumors related to Gorlin–Goltz syndrome: A clinicopathological study

BackgroundAssess clinicopathological features of patients with keratocystic odontogenic tumor (KCOT) associated with Gorlin–Goltz syndrome in our institution from 2004 to 2015. MethodAfter histopathological analyses of KCOT related to Gorlin–Goltz syndrome, 7 patients were assessed. These patients presented a total of 15 primary and 2 recurrent KCOT. ResultsAll patients presented a multiple KCOT, and 13 lesions were located in mandible (77%) and 4 (23%) in maxilla. Most of the tumors presented a unilocular pattern (71%) and had tooth association (88%). Four patients (57%) were in the age group of 10–19 years and three patients (43%) were in the age group of 20–29 years. There were four male and three female patients. ConclusionKCOT is a frequent manifestation of Gorlin–Goltz syndrome and can be its first sign, mainly in young patients. The four patients presented with two lesions (57%) and three lesions in three patients (43%).

Differential expression of TLR3 and TLR4 in keratocystic odontogenic tumor (KCOT): A comparative immunohistochemical study in primary, recurrent, and nevoid basal cell carcinoma syndrome (NBCCS)–associated lesions

BackgroundToll-like receptors (TLRs) play an essential role in the activation of innate immunity and they can promote cancer cell survival and tumor progression. It has been claimed that TLRs can somehow predict the clinical behavior in oral squamous cell carcinoma (OSCCs). AimTo elucidate the molecular basis underlying keratocystic odontogenic tumor (KOCTs) aggressive behavior and recurrence we carried out this immunohistochemical study on TLR3 and TLR4 expression in sporadic primary KCOTs (sp-KCOTs), sporadic recurrent KCOTs (sp-KCOTs), and NBCCS-associated KCOTs (NBCCS-KCOTs). Method40 cases of KOCTs removed from 23 men and 17 women were the sample. Paraffin-embedded blocks were processed for immunohistochemistry. Sections were incubated with TLR3 and TLR4 antibodies and immunoreactivity evaluated on a semi-quantitative score. ResultsBoth TLR3 and TLR4 were expressed in KCOTs epithelium, although with a different extent. TLR3 was not expressed in sp-KCOTs and sr-KCOTs, but it showed a faint staining in NBCCS-KCOTs. On the other hand, both cytoplasmic and nuclear staining for TLR4 was detected in all the 3 types of lesions; however being significantly more expressed in sr-KCOT and NBCCS-KCOTs (p < 0.0001).Our results, demonstrated an association between TLR4, but not TLR3 expression to recurrence behavior of KCOTs. In fact, TLR4 was up-regulated in sr-KCOTs and NBCCS-KCOTs but not in sp-KCOTs. ConclusionsAccording these findings it seems conceivable to assume that the up-regulation of TLR4 in some KCOTs can be correlated somehow to their tendency recurrence.

Keratocystic Odontogenic Tumor (KCOT/OKC)-Clinical Guidelines for Resection.

There is no clinical consensus for the treatment of Keratocystic Odontogenic Tumor (KCOT). KCOTs are regarded as benign aggressive tumors and resection is usually considered as a last option. We review the clinical indications for resection based on a case series. This is a retrospective study of patients with KCOT treated in a single unit over 17years. Eighty patients were identified, of which 12 (15%) underwent resection. The remaining 68 patients were managed by enucleation and curettage, enucleation with peripheral ostectomy, or decompression with secondary enucleation. Data extracted includes gender, age, race, location, previous treatment for the lesion, surgery and outcome/follow up. Twelve patients treated by resection were identified. The location in the ten benign resected KCOTs was either the mandibular ramus or the posterior maxilla. All mandibular KCOTs exhibited perforation of the lingual plate and involvement of the pterygoid musculature. Seven of the ten cases were recurrent KCOTs and three had no prior treatment. Two had malignant changes in the KCOT and were also resected. The primary reason for resection of KCOT was involvement of the pterygoid muscles. The presence of malignant change was a separate indication for resection.

Response to the critique of “Keratocystic odontogenic tumor: systematic review with analysis of 72 additional cases from Mumbai, India”

Response to the critique of “Keratocystic odontogenic tumor: systematic review with analysis of 72 additional cases from Mumbai, India”

Ki-67 and p53 expression in solitary sporadic, syndrome associated and recurrent keratocystic odontogenic tumor.

Background:Ki-67 and p53 are markers expressed in actively proliferating cells, particularly in neoplasms.Objectives:(1) To study the proliferative potential of epithelia in Solitary Sporadic, Syndrome-associated and Recurrent Keratocystic odontogenic tumors (KCOTs) using Ki67 and p53 labeling indices (LI). (2) To derive a relationship if any between the expression of these proteins and the biologic behavior of Solitary Sporadic and Syndrome associated KCOTs.Study Design:Thirteen paraffin embedded blocks of KCOTs (Solitary Sporadic, n = 03; Recurrent, n = 03; Syndrome associated, n = 07) were stained immunohistochemically for Ki-67 and p53 and labeling indices were calculated.Statistical Analysis:Z test with predetermined alpha set at 0.05 was used for the comparison of Ki-67 positivity between the three groups and p53 positivity between the three groups.Results:Ki-67 labeling indices were: 30% in solitary sporadic; 26% in recurrent; and 32% in syndrome associated KCOTs. p53 labeling indices were: 19% in solitary sporadic; 23% in recurrent; and 21% in syndrome-associated KCOTs. There was no difference seen in the rate of proliferation in the epithelial linings between the three groups. However, in our cases where Ki-67 positivity was seen there was expression of p53. Though not statistically significant a trend was seen, reflecting the loss of balance between the proliferative potential and apoptotic activity.Conclusion:On the basis of proliferative index alone it is not possible to comment on biological behavior of KCOTs associated with syndrome versus those of solitary and recurrent. There is probably a mesenchymal role which needs to be researched.

Single tooth prosthetic rehabilitation of a patient with recurrent keratocystic odontogenic tumor

Background Keratocystic odontogenic tumor (KCOT) is one of the most common odontogenic neoplasms. There are many kinds of treatment modalities which can be a conservative method, such as enucleation or an aggressive method, such as enucleation followed by cryosurgery and radical surgical tactics with bone resection. In the literature a relatively high recurrence rate reported for KCOT with a range of 5-70 % depending on the method of treatment.

Keratocystic odontogenic tumor related to nevoid basal cell carcinoma syndrome: clinicopathological study

Aim: To assess clinicopathological features of patients with keratocystic odontogenic tumor (KCOT) associated with nevoid basal cell carcinoma syndrome (NBCCS) in a single Brazilian institution. Methods: After histopathological analyses of KCOT related to NBCCS, the medical charts of 14 patients were assessed. These patients presented a total of 31 primary and 8 recurrent KCOT. Results: Out of 14 patients, 8 presented a single KCOT, 4 showed synchronous tumors, 1 had 3 metachronous lesions and another patient had 2 synchronous lesions at initial evaluation and then developed other 3 metachronous lesions. Besides the 31 primary KCOTs, 18 lesions were located in mandible and 13 in maxilla. Most tumors presented unilocular pattern and association with a tooth. Conclusions: KCOT is a frequent manifestation of NBCCS and can be its first sign, mainly in young patients. In contrast to a previously published series, most patients presented a single lesion.

Can clinical and radiological features predict recurrence in solitary keratocystic odontogenic tumors?

The solitary keratocystic odontogenic tumor (KCOT) is a neoplasm, which recurs in 28% of cases. The purpose of this study is to determine whether clinicoradiographic features can predict recurrence. From 2000 to 2009, 106 solitary KCOTs were retrieved from the Oral Biology Service of British Columbia. Among 58 KCOTs including all recurrent KCOTs (rKCOT) and nonrecurrent KCOTs (nrKCOT) (followed up for at least 5 years), only 29 had radiographs (rKCOT, 18; nrKCOT, 11). Patients with recurrences were significantly older than those without. Interestingly, those cases, which were considered KCOTs before surgery, were significantly more likely not to recur within 5 years of follow-up. Most radiological features did not differ between nrKCOT and rKCOT on the basis of panoramic radiography only.

Recurrent keratocystic odontogenic tumor in the masseter muscle overlying the boney perforations: a case report

Keratocystic odontogenic tumor (KCOT) is a benign intraosseous neoplasm of odontogenic origin with high recurrence rates and tendency to invade adjacent tissue. Most recurrences occur in the first 5 years after surgery and are usually located at the site of the primary tumor in the jaws. We report a rare case of KCOT which recurred in the masseter muscle 14 years after segmental mandibulectomy and autogenous frozen lesional mandible reimplantation. The patient had undergone enucleation of KCOT in the right mandible 20 years before segmental mandibulectomy. This case could further demonstrate the aggressive behavior of KCOT.

Complete TMJ replacement using custom titanium-HTR prosthetics following a partial mandibulectomy, a case presentation with 5-year follow-up

This case presentation refers to a 56 year old male patient, which is diagnosed with a recurrent keratocystic odontogenic tumor that completely compromises the left ascending ramous, condylar complex and retro molar portion of the mandible, requiring excision of the lesion. After the excision intervention, under a secondary surgical procedure, a complete TMJ replacement surgery utilizing custom made titanium-HTR prosthesis is executed under general anesthesia. This presentation refers to the experience utilizing this procedure and a 5 year follow-up to determine the long term viability and functionality of such prosthesis.

下顎骨区域切除後の移植腸骨部に再発を認めた 角化囊胞性歯原性腫瘍の1 例

下顎骨区域切除後の移植腸骨部に再発を認めた 角化囊胞性歯原性腫瘍の1 例

Recurrent keratocystic odontogenic tumor in the mandible: A case report and literature review

Keratocystic odontogenic tumor is characterized by benign intraosseous neoplasm of odontogenic origin with high recurrence rates. Conservative or aggressive management has been suggested a method of treatment. Conservative approaches have some advantages in that they avoid adverse effects on the development of involved teeth and the jaw when the patient is young, although aggressive methods, including surgical resection, can be recommended considering the nature of the neoplasm. Here we report a case of a 7-year-old patient with a recurrent keratocystic odontogenic tumor treated by marsupialization for normal development of the involved teeth.