RESUMO
Objetivo: Describir un caso de quiste odontogénico in- flamatorio cuya presentación imagenológica no es la habitual. Caso clínico: Acude a la clínica profesional de Pato- logía Oral de la Universidad Andrés Bello una paciente de género femenino de 13 años, sin antecedentes mórbidos, con un hallazgo radiográfico de lesión mixta ubicada entre los premolares inferiores derechos. Es derivada al posgrado de cirugía oral y maxilofacial para que le realicen una biopsia excisional de la lesión con una hipótesis diagnóstica de tumor odontogénico adenomatoide. Una vez realizado el estudio histopatológico, se define la lesión como quiste odontogénico inflamatorio, que por las características clínicas-radiográficas podría corresponder con un quiste residual de un diente tem- poral. Debido a la variabilidad en la presentación clínica e ima- genológica de las lesiones quísticas maxilofaciales, el estudio anatomopatológico es imprescindible para un correcto diag- nóstico y tratamiento (AU)
Aim: To present a case of inflammatory odontogenic cyst with unusual imaging presentation. Clinical case: A 13-year-old female patient, with no history of morbidity, with a radiographic finding of a mixed lesion located between the lower right premolars. The patient visited the professional Oral Pathology clinic of the Andrés Bello University and was referred to postgraduate oral and maxillofacial surgery for an excisional biopsy of the lesion, with a diagnostic hypothesis of adenomatoid odontogenic tu- mor. After the histopathological study, the lesion was defined as an inflammatory odontogenic cyst, which, based on clini- cal-radiographic characteristics, could be a residual cyst of a primary tooth. Due to the variability in the clinical and imaging pres- entation of maxillofacial cystic lesions, anatomopathological study is essential for correct diagnosis and treatment (AU)
Assuntos
Humanos , Feminino , Adolescente , Cistos Odontogênicos , Cisto Odontogênico Calcificante/cirurgia , Faculdades de Odontologia , Biópsia/métodos , Diagnóstico por Imagem/métodos , Diagnóstico Clínico , Chile , Técnicas Histológicas , Cisto Odontogênico Calcificante/diagnóstico por imagem , Procedimentos Cirúrgicos Bucais/métodosRESUMO
The calcifying odontogenic cyst is as a benign, rare developmental odontogenic cyst with a wide range of histologic characteristics. It may present along with other odontogenic pathologies such as odontoma, ameloblastoma, adenomatoid odontogenic tumor, ameloblastic fibroma, and ameloblastic fibro-odontoma. Clinically, it can be an either intra- or extraosseous painless swelling that can produce cortical expansion. It affects mostly the anterior area of the mandible. Radiographically, it appears as a well-circumscribed unilocular radiolucency containing flecks of indistinct radiopacities. In about one third of cases, an impacted tooth is associated. In this paper, we employ a patient with an enormous calcifying odontogenic cyst to review both the pathology and active decompression and distraction sugosteogenesis, a novel technique employed to treat odontogenic entities. This dual approach usually results in an accelerated bone healing (sugosteogenesis), partial removal of the cystic epithelium, thickening of the wall, and migration of chronic inflammatory cells which triggered epithelial modulation, ultimately causing a realignment in the biologic behavior of the lesion.
Assuntos
Ameloblastoma , Cisto Odontogênico Calcificante , Tumores Odontogênicos , Odontoma , Ameloblastoma/diagnóstico por imagem , Ameloblastoma/cirurgia , Descompressão , Humanos , Cisto Odontogênico Calcificante/diagnóstico por imagem , Cisto Odontogênico Calcificante/cirurgiaRESUMO
BACKGROUND: The aim of this study was to integrate the available data published on calcifying odontogenic cyst (COC), dentinogenic ghost cell tumor (DGCT), and ghost cell odontogenic carcinomas (GCOCs) into a comprehensive analysis of their clinicoradiological features, treatment, and recurrence. MATERIALS AND METHODS: An electronic search with no publication date restriction was undertaken in October 2017 in the following databases: PubMed, Medline Ovid, Web of Science, and Scopus. Eligibility criteria included publications containing enough clinical, radiological, and histopathological information to confirm a definite diagnosis of these lesions. Data were evaluated descriptively. RESULTS: The literature review indicated a total of 234 publications reporting 367 COCs, 55 DGCTs and 44 GCOCs. These lesions have a predilection for Asian males. COCs mainly affect the mandible and patients in the second decade of life, DGCTs mostly affect the mandible and patients in the fourth decade of life, and GCOCs mostly affect the maxilla and patients in the fifth decade of life. CONCLUSION: Conservative surgery was the most common therapy for COCs and DGCTs, while radical surgery was most common for GCOCs. This study provides important and interesting data that could help clinicians and surgeons as well as oral and maxillofacial pathologists with the diagnosis and management of these lesions.
Assuntos
Cisto Odontogênico Calcificante , Tumores Odontogênicos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Bases de Dados Bibliográficas , Feminino , Humanos , Masculino , Neoplasias Mandibulares/diagnóstico por imagem , Neoplasias Mandibulares/epidemiologia , Neoplasias Mandibulares/cirurgia , Neoplasias Maxilares/diagnóstico por imagem , Neoplasias Maxilares/epidemiologia , Neoplasias Maxilares/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Cisto Odontogênico Calcificante/diagnóstico por imagem , Cisto Odontogênico Calcificante/epidemiologia , Cisto Odontogênico Calcificante/cirurgia , Tumores Odontogênicos/diagnóstico por imagem , Tumores Odontogênicos/epidemiologia , Tumores Odontogênicos/cirurgia , Procedimentos Cirúrgicos Bucais , Adulto JovemRESUMO
O cisto odontogênico calcificante (COC) é considerado como condição patológica benigna de ocorrência rara em maxila e mandíbula, caracterizado por revestimento cístico de células epiteliais odontogênicas, contendo células fantasmas com propensão a regiões de calcificação. Neste artigo, descreveu-se a configuração clínica e histopatológica do COC por meio de relato de caso submetido a tratamento cirúrgico e acompanhamento pós-operatório. Paciente de 11 anos apresentou aumento de volume em região maxilar à esquerda, próxima ao sulco nasolabial e sem sintomatologia dolorosa. Os exames radiográficos indicaram lesão radiolúcida, bem circunscrita e expansiva em maxila, que foi submetida a enucleação associada a ostectomia marginal das paredes corticais ósseas. O histopatológico revelou revestimento cístico com epitélio odontogênico ameloblástico, ninhos espalhados de células fantasmas e regiões eosinofílicas de material compatível com dentinóide. Evidenciou-se, assim, perfil clínico de COC, que pode ser confundido com outras lesões císticas ou tumorais, sendo essencial o diagnóstico por meio de análise histopatológica. A abordagem cirúrgica proporcionou adequado diagnóstico e tratamento. Após acompanhamento clínico e radiográfico, não houve recorrência do COC.
Calcifying odontogenic Cyst (COC) has been considering as benign pathological ill and rare occurrence in maxilla and mandible, there been showed odontogenic epithelial cystic lining demonstrating ghost cells with a propensity to calcify. In this article, we described the clinical and histopathological features from case reported who had undergone surgical approach and postoperative follow-up. A 11 year-old-girl had presented volumetric increased in left maxilla area near nasolabial fold. The radiography images had indicated radiolucent lesion, well-circumscribed and wide on cortical maxillary bone, which was undergone enucleation associated with marginal osteotomy on the bone cortical walls. The histopathological features showed cystic lining with odontogenic epithelium containing ghost cells and some areas with eosinophilic matrix material compatible dentinoid. Thus, it was evidenced a clinical features of COC which could be confused with other cystic or tumoral lesions, there being essential on diagnosis and treatment. After clinical and radiographic follow-up during 07 years, there was no recurrence of the COC.
Assuntos
Cisto Odontogênico Calcificante , Odontogênese , Osteotomia , Patologia Bucal , Cirurgia Bucal , Cisto Odontogênico Calcificante/diagnóstico por imagemRESUMO
The aim of this study was to describe the clinicopathologic features of 177 keratocystic odontogenic tumors (KCOTs) diagnosed in a Brazilian population. A total of 177 KCOTs were reviewed and affected 158 patients with ages ranging from 5 to 79 years (mean age = 32 years) with a slight female predominance. Mandible was the most common affected site (69.3%), and a unilocular radiolucency was the most common radiographic image. Microscopically, all cases showed at least focal areas of classic KCOT, but several histological aspects were also observed, including diffuse and focal epithelial lining hyperplasia (48.6%), epithelial budding (12.4%), reactive cytological alterations (11.3%), dystrophic calcification (7.9%), daughter cysts (7.8%), odontogenic epithelial remnants (4.5%), focal areas of orthokeratinization (2.8%), and ameloblastomatous epithelium (1.7%). These variations may make KCOT diagnosis challenging in some cases, so careful full-sample analysis and knowledge of these uncommon histological features associated with KCOT are essential for correct diagnosis.
Assuntos
Neoplasias Mandibulares/diagnóstico , Neoplasias Maxilares/diagnóstico , Cisto Odontogênico Calcificante/diagnóstico , Adolescente , Adulto , Idoso , Brasil , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Neoplasias Mandibulares/diagnóstico por imagem , Neoplasias Mandibulares/cirurgia , Neoplasias Maxilares/diagnóstico por imagem , Neoplasias Maxilares/cirurgia , Pessoa de Meia-Idade , Cisto Odontogênico Calcificante/diagnóstico por imagem , Cisto Odontogênico Calcificante/cirurgia , RadiografiaRESUMO
The calcifying cystic odontogenic tumor normally presents as a painless, slow-growing mass, involving both maxilla and mandible, primarily the anterior segment (incisor/canine area). It generally affects young adults in the third to fourth decades, with no gender predilection. Computerized tomography images revealed important characteristics that were not detected by panoramic radiography, such as fenestration, calcification and tooth-like structures. The typical microscopic feature of this lesion is the presence of variable amounts of aberrant epithelial cells, without nuclei, which are named "ghost cells". In addition, dysplastic dentine can be found and occasionally the cyst can be associated with an area of dental hard tissue formation resembling an odontoma. The treatment for calcifying cystic odontogenic tumor involves simple enucleation and curettage. The purpose of this article is to present two different manifestation of calcifying cystic odontogenic tumor in which computerized tomography, associated to clinical features, served as an important tool for diagnosis, adequate surgical planning and follow-up of patients.
Assuntos
Neoplasias Maxilomandibulares/diagnóstico por imagem , Cisto Odontogênico Calcificante/diagnóstico por imagem , Adolescente , Adulto , Feminino , Humanos , Neoplasias Maxilomandibulares/cirurgia , Masculino , Cisto Odontogênico Calcificante/cirurgia , Tomografia Computadorizada por Raios XRESUMO
The calcifying epithelial odontogenic tumor (CEOT) is a rare benign odontogenic neoplasm that accounts for approximately 1% of all odontogenic tumors. Its origin is controversial as well as its true malignant potential. A case of an advanced CEOT associated with an impacted right second molar in the mandible of a young black female patient is presented. Computed tomography imaging, radiographic and pathological findings, surgical patterns, gross anatomy of the lesion and the performed treatment are discussed.
Assuntos
Neoplasias Mandibulares , Cisto Odontogênico Calcificante , Dente Impactado , Adolescente , Feminino , Humanos , Neoplasias Mandibulares/diagnóstico por imagem , Neoplasias Mandibulares/patologia , Neoplasias Mandibulares/cirurgia , Cisto Odontogênico Calcificante/diagnóstico por imagem , Cisto Odontogênico Calcificante/patologia , Cisto Odontogênico Calcificante/cirurgia , Radiografia , Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgiaRESUMO
The present report describes a case of odontoma-producing intraosseous calcifying odontogenic cyst in a 36-year-old Black male in the right mandibular bicuspid region. The lesion involved an unerupted permanent canine, which was displaced to the mandible base and a calcified mass that was later recognized as an odontoma. The lesion was surgically removed.