Intraosseous Compound-type Dermoid Cyst of the Jaw

Abstract

Dermoid cysts within the maxillofacial skeleton are extremely rare, with only 13 cases in the literature. The present report describes a new long-standing intraosseous DC and reviews the literature.A 69-year-old female presented with an expansile mandibular lesion, presenting a large radiolucency with the second and third molars impacted and displaced to the inferior mandibular border. Microscopic examination showed an intraosseous DC, lined by stratified keratinizing epithelium, with multiple aggregates of sebaceous cells and well formed sebaceous glands. Impaction of both second and third molars is an indication of initial development before the physiologic eruption time at approximately age 12. Thus, this presents an extremely longstanding intraosseous DC of at least 45 years duration. Analysis of the literature indicates that in comparison with the more common odontogenic keratocyst, intraosseous DC seems to have a very slow growth rate, and an indolent behavior.

Nasopalatine duct cyst with sebaceous differentiation: a rare case report with literature review

“…One hypothesis is that the origin might be the sequestered multipotent epithelial cells that aid in the development of the oral cavity, which may have been embedded deep in the surface and entrapped in the developing jaw during embryogenesis. Hence, its proliferation might have been induced by dental inflammation, trauma, or cystic change [ 15 , 17 , 18 ]. Another hypothesis is that cysts develop from the existing or cystic epithelium that undergoes dermal metaplasia [ 15 , 17 , 18 ].…”

“…Hence, its proliferation might have been induced by dental inflammation, trauma, or cystic change [ 15 , 17 , 18 ]. Another hypothesis is that cysts develop from the existing or cystic epithelium that undergoes dermal metaplasia [ 15 , 17 , 18 ]. Such theories can also be used to understand the sebaceous differentiation of NPDCs.…”

Sebaceous glands within odontogenic cysts

“…They are slightly more common among males. [4][5][6][7]23 Histopathologically, dermoid cysts are lined with keratinizing stratified squamous epithelium. In the fibrotic cyst wall, one or more dermal appendages such as hair follicles and sweat or sebaceous glands are seen.…”

“…Another hypothesis is that cysts develop from remains of odontogenic epithelium that change into dermal metaplasia. 7,[20][21][22]24 Allon et al 7 and Bodner et al 6 stated that the presence of SGs was an indispensable histologic element for the diagnosis of iDmC. SGs are essential for the diagnosis of DmC but any cyst with SGs may not be an iDmC.…”

“…Histopathologically, they lined with keratinized stratified squamous epithelium and one or more dermal appendages such as hair follicles, sweat glands or sebaceous glands in the wall. [4][5][6][7] Epithelium of odontogenic cysts originate from epithelial cell rests of Malassez; dental lamina (epithelial cell rests of Serres); enamel organ and reduced enamel epithelial cells; dental papilla (ectomesenchyme); and basal layer cells of the oral epithelium. Histopathologically, the lining epithelia of these cysts consist of stratified squamous epithelium, single layer cuboidal, ciliated, ciliated low columnar cells, and pseudostratified squamous epithelium.…”