Calcifying Odontogenic Cyst

Abstract

16 cases of calcifying odontogenic cysts (C.O.C.) were studied and reevaluated. It could be concluded, that the group contained two entities, a cyst and a neoplasm. The cyst occurs as three variants. 1. A simple unilocular cyst with moderate mural proliferations of epithelium and no, or sparse amounts of dentinoid (dysplastic dentin); it seems to occur during man's entire life span. 2. A unilocular cyst which produces compound or complex odontomas in its luminal part, more rarely it may instead produce an intramurally growing ameloblastic fibroma, which may call for more radical surgery. It occurs mainly in patients between 10 and 29 years of age. 3. A unilocular cyst with extensive luminal as well as mural ameloblastomalike proliferations of epithelium. The C.O.C. may be located outside or inside the bone according to the location of the source of odontogenic epithelium, from which it develops. The neoplasm shows an entirely different structure. It consists of ameloblastoma-like strands and islands of odontogenic epithelium growing infiltratively in a mature connective tissue. Varying amounts of ghost cells are seen in the epithelium and varying amounts of dentinoid is formed in contact with the odontogenic epithelium. The term "Dentinogenic ghost cell tumour" is suggested for this lesion. It is possible that it occurs predominantly in the later part of life. It occurs as an extraosseous as well as an intraosseous lesion. Recurrence has been observed following cystectomy.

Need to reclassify keratocystic odontogenic tumor into cyst and neoplasm

“…WHO has considered neoplastic variety as dentinogenic ghost cell tumor in the classification of odontogenic tumors and cystic type is still considered as a cyst. [26] In a similar way, we also suggest that OKC's should be classified into two types depending on extent of tissue destruction, radiographic, and histopathologic features.…”

Extraosseous calcifying odontogenic cyst: a case report and a literature review

“…Praetorius et al (18) and Buchner et al (3) believe COC cystic epithelium is originated from the reduced enamel organ, from islands of odontogenic epithelium within the tooth follicle or from the remnants of odontogenic epithelium in the bone or gingival tissue. In the reported case, we believe the neoplastic epithelium arised from the odontogenic remnants of the overlying mucosa due to the lesion intimacy with the oral surface and absence of tooth or bone involvement.…”

“…They generally appear as circumscribed elevated masses, with smooth surface and firm or soft consistency. Since they have no characteristic clinical appearance they can resemble granulomas, fibrous hyperplasic or fibromas (12,18,19) .…”

“…But whether the cyst develops as central or peripheral lesion probably depends on the location of the odontogenic epithelium, which constitutes the source of the lesion. Nevertheless, the location does not seem to have any relation to either behavior or histological features of the cyst (3,18) .…”

Conservative approach to recurrent calcifying cystic odontogenic tumor occupying the maxillary sinus: a case report

“…After Gorlin et al's first description of such a lesion in 1962, it has become clear that two basic entities may be present: a cystic tumor and a solid neoplasm2. This benign cystic neoplasm is microscopically characterized by a well-defined basal layer in the epithelial lining.…”