A case of orthokeratinizing odontogenic cyst in the mandible

Transcription

1 114 J Meikai Dent Med 44 1, , A case of orthokeratinizing odontogenic cyst in the mandible Nobuaki TAMURA 1, Hiroshi TAKESHIMA 1, Kentaro KIKUCHI 2, Hideyuki GOTO 1, Ryuhei AOKI 1, Koutaro FUJITA 1, Shoko KAWAGUCHI 1, Yoko OYAMA 1, Takuya SONOKAWA 1, Hiroyuki TOYOTA 1, Yoshimichi URA 1, Hiroyasu MATSUYAMA 1, Toru TAKUSAGAWA 1, Tsuneyasu TATSUTA 1, Kaoru KUSAMA 2 and Jun SHIMADA 1 1 Division of Oral and Maxillofacial Surgery, Department of Diagnostic & Therapeutic Sciences, Meikai University School of Dentistry 2 Division of Pathology, Department of Diagnostic & Therapeutic Sciences, Meikai University School of Dentistry Abstract : We report a case of orthokeratinizing odontogenic cyst arising from the mandible. A 46-year-old male was referred to our department because of a pointed out the boundary clear unilocular transmission image of the right mandible body at the time of X-ray examination in the near dental clinic. Under a clinical diagnosis of cyst, the residual cyst was removed under general anesthesia. The pathological diagnosis was a orthokeratinizing odontogenic cyst. There has been no evidence of recurrence after the operation. Key words : orthokeratinizing odontogenic cyst, mandible 2005 WHO orthokeratinizing odontogenic cyst : OOC keratocystic odontogenic tumor : KCOT 1 OOC 1

2 Fig 1 X Fig 2 CT Fig Fig 3 Computed tomography CT scans showing a cystic lesion with thinning of the mandibular cortical bone. A : axial, B : coronal Intraoral photograph at the time of the first visit exami- Fig 1 nation. Fig 2 Orthopantomograph at the first examination revealing a unilocular radiolucent lesion in the right mandibular arrow Fig 4 Intraoperative finding and Gross appearance of the excised specimen. A : Intraoperative finding B : Gross appearance of the excised specimen

3 Fig 4 Fig 5A Fig 5B Fig 5C Fig 5 Histopathological examination HE A : Semi-macro B: X40 C : X 200 Cystic cavity lined with orthokeratinized epithelium. OOC 9 12 keratinizing cystic lesions KCOT OOC OOC , 4 OOC KCOT OKC OKC WHO KCOT 1 AFIP Armed Forces Institute of Pathology OOC 8 3, 9 OOC Clowley OOC X OCC KCOT OOC

4 1 117 OOC OOC 12 CK 17 OOC KCOT CK19 OOC KCOT 13, 14KCOT OOC CK 19 15, 16 Epidermoid cyst : EC Radicular cyst : RC CK EC CK5, 7, 10, 14 CK4, 8, 13, 16, 18, 19 Gao 17 RC CK Gao 18 CK13 CK18 Lu 19 CK18 20 CK17 RC CK 10/13 CK18 21, 22 OOC 0 4 2, 4, 6, 7, KCOT Leon Barnes, John W. Eveson, Peter Reichart and David Sidransky : Pathology And Genetics of Head and Neck Tumours WHO Classification of Tumours pp , IARC Press, Lyon, 2005 Crowley TE, Kaugars GE and Gunsolley JC : Odontogenic keratocysts : a clinical and histologic comparison of the parakeratin and orthokeratin variants. J Oral Maxillofac Surg. 50, 22 26, 1992 Dong Q, Pan S, Sun LS and Li TJ : Orthokeratinized odontogenic cyst : a clinicopathologic study of 61 cases. Arch Pathol Lab Med. 134, , , , , 220, 2012 Wright JM : The odontogenic keratocyst : orthokeratinized variant. Oral Surg Oral Med Oral Pathol 51, , 1981 Li TJ, Kitano M, Chen XM, Itoh T, Kawashima K, Sugihara K, Nozoe E and Mimura T : Orthokeratinized odontogenic cyst : a clinicopathological and immunocytochemical study of 15 cases. Histopathology 32, , 1998 RA Robinson and SD Vincent : Atlas of Tumor Pathology, 4th Series, Fascicle 16 Tumors and Cysts of the Jaws Armed Forces Institute of Pathology, Washington, D. C. pp30 32, 2012 Brannon RB : The odontogenic keratocyst. A clinicopathologic study of 312 cases. Part I. Clinical features. Oral Surg Oral Med Oral Pathol 42, 54 72, 1976 Crowley TE, Kaugars GE and Gunsolley JC. Odontogenic keratocysts : a clinical and histologic comparison of the parakeratin and orthokeratin variants. J Oral Maxillofac Surg. 50, 22 26, , , 2012 Onuki M, Saito A, Hosokawa S, Ohnuki T, Hayakawa H, Seta S, Muramatsu T and Furusawa M : A case of orthokeratinized odontogenic cyst suspected to be a radicular cyst. Bull Tokyo Dent Coll. 50, 31 35, , , 2011 Patricia GA 20, 22 36, 2010

5 , 73 84, , , 2011 Gao Z, Mackenzie IC, Cruchley AT, Williams DM, Leigh I, and Lane EB : Cytokeratin expression of the odontogenic epitheria in dental follicles and developmental cysts. J Oral Pathol Med 18, 63 67, 1989 Gao Z, Mackenzie IC, Williams DM, Cruchley AT, Leigh I, and Lane EB : Patterns of keratin-expression in rests of malassez and periapical lesions. J Oral Pathol Med 17, , 1988 Lu DP, Tatemoto Y, Kimura T, and Osaki T : Expression of cytokeratins CKs 8, 13 and 18 and their mrna in epithelial linings of radicular cysts ; implication for the same CK profiles as nasal columnar epithelium in squamous epithelial lining. Oral Dis 8, 30 36, , , 2005 Craig GT, Holland CS, and Hindle MO : Dermoid cyst of the mandible. Br J Oral Surg 18, , 1980 Komiyama K, Miki Y, Oda Y, Tachibana T, Okaue M, Tanaka H, and Moro I : Uncommon dermoid cyst presented in the mandible possibly originating from embryonic epithelial remnants. J Oral Pathol Med 31, ,