Keratocystic odontogenic tumor: clinical characteristics, diagnosis and possible treatments

Abstract

Introduction: the keratocystic odontogenic tumor is a locally aggressive tumor lesion with high recurrence described for the first time by Philipsen in 1956 under the name odontogenic keratocyst. It is believed that it comes from the remains of the dental lamina, but is not associated with a tooth. Objective: to describe the clinical and histological behavior of the keratocystic odontogenic tumor for the appropriate diagnosis and treatment or combination of treatments with less recurrence that allow a favorable long-term prognosis or its definitive resolution. Development: clinically it has a predilection for the posterior part of the body and mandibular branch, it invades the bone marrow and expands the bone cortices late, with perforation of the lingual cortical table being common. On radiological examination, it is an osteolytic, radiolucent lesion that occupies the posterior part of the body and mandibular ramus with a thin, well-defined cortex with smooth and scalloped margins. Histologically, it is characterized by a thin lining approximately 5 to 9 cells thick, palisade cells with a cuboidal appearance, presence of parakeratin on the luminal surface, absence of papillae and formation of satellite cysts. It is a highly recurrent lesion. The presence of multiple keratocysts is associated with a syndrome called nevoid basal cell syndrome or Gorlin Goltz syndrome. Final considerations: it constitutes an aggressive odontogenic tumor with a predilection for the jaw, it affects the quality of life of patients due to its high recurrence, there are several proposed treatments: marsupialization or decompression, enucleation with peripheral osteotomy, physical-chemical treatment and freezing.