Odontogenic keratocyst: Difference between revisions

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{{Infobox medical condition
| name = Odontogenic keratocyst
| image = [[File:Keratocystic_odontogenic_tumour_-_2_-_very_high_mag.jpg|left|thumb|alt=Odontogenic keratocyst under microscope]]
| caption = Histological image of an odontogenic keratocyst
| field = [[Oral and maxillofacial pathology]]
| synonyms = Keratocystic odontogenic tumor
| symptoms = Swelling, pain, drainage, asymptomatic
| complications = [[Infection]], [[jaw fracture]], [[tooth displacement]]
| onset = Typically in the second and third decades of life
| duration = Chronic
| causes = Arises from [[dental lamina]]
| risks = [[Nevoid basal cell carcinoma syndrome]]
| diagnosis = [[Radiograph]], [[biopsy]]
| differential = [[Ameloblastoma]], [[dentigerous cyst]], [[radicular cyst]]
| treatment = Surgical removal, [[marsupialization]], [[enucleation]]
| medication = None specific, [[antibiotics]] for infection
| prognosis = Good with treatment, but high recurrence rate
| frequency = 3-11% of all [[jaw cysts]]
}}
[[File:Relative_incidence_of_odontogenic_cysts.jpg|thumb|Relative incidence of odontogenic cysts]]
[[File:Classic_keratocystic_odontogenic_tumour.jpg|left|thumb|Classic keratocystic odontogenic tumour]]
[[File:Keratocystic_odontogenic_tumour_-_2_-_intermed_mag.jpg|left|thumb|Odontogenic keratocyst under intermediate magnification]]
[[File:Keratocystic_odontogenic_tumour_-_intermed_mag.jpg|thumb|Odontogenic keratocyst under intermediate magnification]]
[[File:Keratocystic_odontogenic_tumour_-_2_-_high_mag.jpg|left|thumb|Odontogenic keratocyst under high magnification]]
[[File:Massive_keratocystic_odontogenic_tumour.jpg|left|thumb|Massive keratocystic odontogenic tumour]]
'''Odontogenic keratocyst''' (OKC), also known as '''keratocystic odontogenic tumor''' (KCOT), is a rare and benign but locally aggressive developmental cystic neoplasm that arises from the dental lamina. It is characterized by its unique histopathological appearance and has a high recurrence rate.
'''Odontogenic keratocyst''' (OKC), also known as '''keratocystic odontogenic tumor''' (KCOT), is a rare and benign but locally aggressive developmental cystic neoplasm that arises from the dental lamina. It is characterized by its unique histopathological appearance and has a high recurrence rate.
==Etiology==
==Etiology==
The exact cause of OKC is unknown. However, it is believed to be associated with the PTCH1 gene mutation. This mutation is also associated with [[Nevoid basal cell carcinoma syndrome|nevoid basal cell carcinoma syndrome]] (NBCCS), a condition that increases the risk of developing multiple OKCs.
The exact cause of OKC is unknown. However, it is believed to be associated with the PTCH1 gene mutation. This mutation is also associated with [[Nevoid basal cell carcinoma syndrome|nevoid basal cell carcinoma syndrome]] (NBCCS), a condition that increases the risk of developing multiple OKCs.
==Clinical Features==
==Clinical Features==
OKCs can occur at any age but are most commonly diagnosed in the second and third decades of life. They have a slight male predilection and are more common in the mandible than the maxilla. Patients with OKC often present with swelling, pain, and occasionally pus discharge. However, many OKCs are asymptomatic and are discovered incidentally during routine dental radiographs.
OKCs can occur at any age but are most commonly diagnosed in the second and third decades of life. They have a slight male predilection and are more common in the mandible than the maxilla. Patients with OKC often present with swelling, pain, and occasionally pus discharge. However, many OKCs are asymptomatic and are discovered incidentally during routine dental radiographs.
==Diagnosis==
==Diagnosis==
The diagnosis of OKC is based on a combination of clinical, radiographic, and histopathological findings. Radiographically, OKCs often appear as unilocular or multilocular radiolucent lesions with well-defined borders. Histologically, they are characterized by a thin, uniform epithelial lining with a corrugated parakeratin surface and a prominent basal cell layer.
The diagnosis of OKC is based on a combination of clinical, radiographic, and histopathological findings. Radiographically, OKCs often appear as unilocular or multilocular radiolucent lesions with well-defined borders. Histologically, they are characterized by a thin, uniform epithelial lining with a corrugated parakeratin surface and a prominent basal cell layer.
==Treatment==
==Treatment==
The treatment of OKC is controversial due to its high recurrence rate. Treatment options include conservative methods such as enucleation and curettage, and more aggressive methods such as resection. Recent studies have suggested the use of adjunctive therapies such as Carnoy's solution and cryotherapy to reduce the recurrence rate.
The treatment of OKC is controversial due to its high recurrence rate. Treatment options include conservative methods such as enucleation and curettage, and more aggressive methods such as resection. Recent studies have suggested the use of adjunctive therapies such as Carnoy's solution and cryotherapy to reduce the recurrence rate.
==Prognosis==
==Prognosis==
The prognosis of OKC is generally good with appropriate treatment. However, the high recurrence rate and association with NBCCS warrant long-term follow-up.
The prognosis of OKC is generally good with appropriate treatment. However, the high recurrence rate and association with NBCCS warrant long-term follow-up.
[[Category:Oral Pathology]]
[[Category:Oral Pathology]]
[[Category:Cysts]]
[[Category:Cysts]]
[[Category:Odontogenic Tumors]]
[[Category:Odontogenic Tumors]]
{{stub}}
{{stub}}
<gallery>
File:Keratocystic_odontogenic_tumour_-_2_-_very_high_mag.jpg|Odontogenic keratocyst under very high magnification
File:Relative_incidence_of_odontogenic_cysts.jpg|Relative incidence of odontogenic cysts
File:Classic_keratocystic_odontogenic_tumour.jpg|Classic keratocystic odontogenic tumour
File:Keratocystic_odontogenic_tumour_-_2_-_intermed_mag.jpg|Odontogenic keratocyst under intermediate magnification
File:Keratocystic_odontogenic_tumour_-_intermed_mag.jpg|Odontogenic keratocyst under intermediate magnification
File:Keratocystic_odontogenic_tumour_-_2_-_high_mag.jpg|Odontogenic keratocyst under high magnification
File:Massive_keratocystic_odontogenic_tumour.jpg|Massive keratocystic odontogenic tumour
</gallery>

Latest revision as of 04:32, 14 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Odontogenic keratocyst
Odontogenic keratocyst under microscope
Synonyms Keratocystic odontogenic tumor
Pronounce N/A
Specialty N/A
Symptoms Swelling, pain, drainage, asymptomatic
Complications Infection, jaw fracture, tooth displacement
Onset Typically in the second and third decades of life
Duration Chronic
Types N/A
Causes Arises from dental lamina
Risks Nevoid basal cell carcinoma syndrome
Diagnosis Radiograph, biopsy
Differential diagnosis Ameloblastoma, dentigerous cyst, radicular cyst
Prevention N/A
Treatment Surgical removal, marsupialization, enucleation
Medication None specific, antibiotics for infection
Prognosis Good with treatment, but high recurrence rate
Frequency 3-11% of all jaw cysts
Deaths N/A


Relative incidence of odontogenic cysts
Classic keratocystic odontogenic tumour
Odontogenic keratocyst under intermediate magnification
Odontogenic keratocyst under intermediate magnification
Odontogenic keratocyst under high magnification
Massive keratocystic odontogenic tumour

Odontogenic keratocyst (OKC), also known as keratocystic odontogenic tumor (KCOT), is a rare and benign but locally aggressive developmental cystic neoplasm that arises from the dental lamina. It is characterized by its unique histopathological appearance and has a high recurrence rate.

Etiology[edit]

The exact cause of OKC is unknown. However, it is believed to be associated with the PTCH1 gene mutation. This mutation is also associated with nevoid basal cell carcinoma syndrome (NBCCS), a condition that increases the risk of developing multiple OKCs.

Clinical Features[edit]

OKCs can occur at any age but are most commonly diagnosed in the second and third decades of life. They have a slight male predilection and are more common in the mandible than the maxilla. Patients with OKC often present with swelling, pain, and occasionally pus discharge. However, many OKCs are asymptomatic and are discovered incidentally during routine dental radiographs.

Diagnosis[edit]

The diagnosis of OKC is based on a combination of clinical, radiographic, and histopathological findings. Radiographically, OKCs often appear as unilocular or multilocular radiolucent lesions with well-defined borders. Histologically, they are characterized by a thin, uniform epithelial lining with a corrugated parakeratin surface and a prominent basal cell layer.

Treatment[edit]

The treatment of OKC is controversial due to its high recurrence rate. Treatment options include conservative methods such as enucleation and curettage, and more aggressive methods such as resection. Recent studies have suggested the use of adjunctive therapies such as Carnoy's solution and cryotherapy to reduce the recurrence rate.

Prognosis[edit]

The prognosis of OKC is generally good with appropriate treatment. However, the high recurrence rate and association with NBCCS warrant long-term follow-up.

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