Botryoid odontogenic cyst: case report with etiopathogenic, diagnostic and therapeutic considerations

Gonçalves, Rhoner; Júnior, Ophir Ribeiro; Borba, Alexandre Meireles; Ribeiro, Annelise Nazareth Cunha; Sugaya, Norberto Nobuo; Júnior, Jayro Guimarães

doi:10.1590/1981-86372015000300015618

Cited by 3 publications

(12 citation statements)

References 9 publications

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“…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 The differential diagnosis includes a lateral periodontal cyst (LPC) and a gingival cyst (GC).…”

Section: (Hematoxylin -Eosin 40x)mentioning

confidence: 99%

“…Although their histological features are largely identical, a LPC is unilocular while a GC occurs in the alveolar ridge of infants. [1][2][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.…”

Section: (Hematoxylin -Eosin 40x)mentioning

confidence: 99%

“…[1][2][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.…”

Section: (Hematoxylin -Eosin 40x)mentioning

confidence: 99%

“…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.…”

Section: (Hematoxylin -Eosin 40x)mentioning

confidence: 99%

“…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 Creative Commons (CC BY-NC-ND 4.0) Attribution -NonCommercial -NoDerivatives 4.0 International…”

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Botryoid Odontogenic Cyst

Carnate

2020

Philipp J Otolaryngol Head Neck Surg

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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 & 3) Based on these microscopic features we signed the case out as a botryoid odontogenic cyst. 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 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 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. 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.

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Section: (Hematoxylin -Eosin 40x)mentioning

confidence: 99%

Section: (Hematoxylin -Eosin 40x)mentioning

confidence: 99%

Section: (Hematoxylin -Eosin 40x)mentioning

confidence: 99%

Section: (Hematoxylin -Eosin 40x)mentioning

confidence: 99%

mentioning

confidence: 99%

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Botryoid Odontogenic Cyst

Carnate

2020

Philipp J Otolaryngol Head Neck Surg

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Mandibular Botryoid Cyst with Large Extension, Treated by Decompression and Marsupialization: A Case report

Salman,

Santana,

Souza

2023

MCCRJ

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The maxillo-mandibular complex is subject to rare pathologies, such as odontogenic and non-odontogenic cysts and tumors. The presentation can be clinically symptomatic, with localized edema, facial asymmetry, paresthesia, dental mobility, gingival discoloration and pathological fracture of alveolar bone. It can also be asymptomatic, occasionally discovered during routine radiographic examination. The lateral periodontal cyst (LPC) is a rare odontogenic cyst that usually appears on the lateral surface of vital tooth roots and can have a more aggressive presentation known as botryoid odontogenic cyst (BOC). BOC is a rare odontogenic pathology, which can be extensive causing bone destruction and tooth loss. Large cases can be treated surgically, with decompression and marsupialization, presenting good clinical progress, reduction in symptoms with bone growth potential, which associated with conventional surgical enucleation, in a pathology of smaller dimensions, has better prognosis. This study presents a case of an extensive symptomatic BOC in the mandible, discovered by routine radiographic examination, and treated by marsupialization and decompression, and discusses this pathology and the importance of proper management to avoid tissue and dental damage. The cases must be followed up for years due to the high possibility of recurrence.

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Botryoid odontogenic cyst

Cunha¹,

Silva²,

Silva³

et al. 2019

J Oral Diag

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Botryoid odontogenic cyst (BOC) is a rare variant of the lateral periodontal cyst (LPC).As the biological behavior of BOC is variable and the literature is limited to that of individual case reports, there is no accepted consensus on the best management strategy. A 43-year-old Caucasian male was referred to a private dental clinic for routine radiographic examination. Extraoral and intraoral evaluations revealed no alterations. Panoramic radiography, periapical radiography, and cone beam computed tomography revealed a well-circumscribed osteolytic lesion of 2.0 cm in diameter, extending from the region of teeth 33 to 35. The provisional diagnostic was odontogenic keratocyst or lateral periodontal cyst. Histological analysis of the incisional biopsy revealed multiple cystic cavities lined by a thin nonkeratinized epithelium, exhibiting focal plaque-like thickenings, surrounded by a dense fibrous capsule. The diagnosis was BOC. The purpose of this study was to critically analyze the clinical and radiologic features of BOC based on case reports and case series published in the literature from 1973 to 2018 and to add a new one from our files.

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Botryoid odontogenic cyst: case report with etiopathogenic, diagnostic and therapeutic considerations

Cited by 3 publications

References 9 publications

Botryoid Odontogenic Cyst

Botryoid Odontogenic Cyst

Mandibular Botryoid Cyst with Large Extension, Treated by Decompression and Marsupialization: A Case report

Botryoid odontogenic cyst

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