Cystic Odontoma in a Patient with Hodgkin’s Lymphoma

Abstract

Cystic odontoma is a rare entity, which is characterized by the association of a cyst with complex/compound odontoma. The aim of this study was to report the case of a 5-year-old male patient diagnosed previously with Hodgkin's lymphoma and treated successfully with chemotherapy and radiotherapy, who developed a mandibular odontogenic lesion. Physical examination revealed a swelling on the right side of the mandible. Radiographically, a well-defined radiolucent area surrounded by radiopaque material was observed. An incisional biopsy was performed and microscopic analysis showed a cystic lesion consisting of an atrophic epithelium comprising 2-3 cell layers and the absence of inflammation in the cystic capsule. The cyst was decompressed and the lesion was removed after 3 months of follow-up. Microscopic analysis of the surgical specimen showed a cystic hyperplastic epithelium surrounded by an intense chronic inflammatory cell infiltrate, which was in close contact with mineralized tissue resembling dentin and cementum. The final diagnosis was cystic odontoma. Since chemotherapy can affect the growth and development of infant teeth, a relationship between chemotherapy-associated adverse events and cystic odontoma is suggested in the present case.

A giant mandibular dentigerous cyst associated with a compound odontoma: A case report

“…Complications associated with dentigerous cysts includes; Pathological bone fracture, loss of permanent teeth, bone deformities and the development of malignancies such as ameloblastoma, squamous cell carcinoma and intraosseous mucoepidermoid carcinoma. 1,2,5,7,8 In this case, the patient had to lose all the teeth in the region due to asymptomatically enlaged cyst and was not noticed for a long time. In our opinion, it can be considered a great chance for the patient not to have a trauma to the region in the presence of this cyst, which can cause jaw fracture very easily.…”

“…Odontomas are considered developmental malformations (hamartoma) more than benign neoplasms. 1,3,5,10 It is thought that odontoma is caused by budding of extraodontogenic epithelial cells from dental lamina. This cell cluster forms a large mass of dental tissue that can settle in an abnormal configuration but consists of normal enamel, dentin, cementum and pulp 1 .…”

“…The morphologically irregular structure consists of dentin, cement and enamel structures. 1,3,5,9 Radiographically compound odontoma is seen as a cluster of dental-like structures surrounded by a radiolucent area with variable dimensions and shapes. Complex odontoma can be seen radiographically as irregularly bordered uniform radiopacity surrounded by a radiolucent area in the form of amorphous calcification dental tissue masses and can be confused with osteoma or some highly calcified bone lesions.…”

“…It is noticed when routine radiographic examinations are being explored or investigated the reason for a not erupted tooth. 1,3,5,9,13 Cystic involvement of compound odontoma is very rare. The majority of reported cystic odontoma cases to date are the cases of complex odontoma.…”

“…4 The treatment for dentigerous cysts is surgical excision with removal of related teeth in similar manner, and in some cases it may be necessary to marsupialize the lesion for reduction of bone defect size prior to surgical intervention. 2,5,6 In this case report, a huge dentigerous cyst, which occupying 2/3 of the mandibular corpus, accompanied by a compound odontoma, was diagnosed in a 56-year-old male patient by implementing cone beam computed tomography (CBCT) and treated, histologically examined and followed-up for 2 years.…”