Manikkath Aparna1, Mukund Gupta2, Nanditha Sujir3, Abhay Kamath4, Monica Solomon5, Keerthilatha Pai6, Raghu Radhakrishnan7. 1. Postgraduate Student, Department of Oral and Maxillofacial Pathology Manipal College of Dental Sciences, Manipal, Karnataka, India. 2. Postgraduate Student, Department of Oral and Maxillofacial Surgery Manipal College of Dental Sciences, Manipal, Karnataka, India. 3. Postgraduate Student, Department of Oral Medicine and Radiology Manipal College of Dental Sciences, Manipal, Karnataka, India. 4. Professor and Head, Department of Oral and Maxillofacial Surgery Manipal College of Dental Sciences, Manipal, Karnataka, India. 5. Professor, Department of Oral and Maxillofacial Pathology, Manipal College of Dental Sciences, Manipal, Karnataka, India. 6. Professor and Head, Department of Oral Medicine and Radiology Manipal College of Dental Sciences, Manipal, Karnataka, India. 7. Professor and Head, Department of Oral and Maxillofacial Pathology Manipal College of Dental Sciences, Manipal, Karnataka, India, e-mail: raghu.radhakrishnan@gmail.com.
Abstract
AIM: To report a case of a non-neoplastic variant of calcifying odontogenic cyst (COC) with the lining epithelium showing ameloblastomatous proliferation and capsule exhibiting features of a cholesterol granuloma. The importance of delineating this histologic variant from unicystic ameloblastoma and the formation of cholesterol granuloma in this variant is discussed. BACKGROUND: Calcifying odontogenic cyst is a developmental jaw cyst, which presents itself as both the neoplastic and the non-neoplastic forms. The ameloblastomatous variant of COC is often mistaken for unicystic ameloblastoma and treated aggressively. CASE REPORT: A 68-year-old female who presented with a cystic enlargement of the posterior mandible on the right side was suggestive of unicystic ameloblastoma based on radiography and initial biopsy report. Microscopic examination of the excision specimen, however, was fitting in favor of calcifying odontogenic cyst with ameloblastomatous proliferation. CONCLUSION: Identifying the non-neoplastic ameloblastomatous variant of COC from a cystic ameloblastoma is crucial as the treatment of the two lesions vary considerably. CLINICAL SIGNIFICANCE: This case emphasizes the need for thorough examination of the entire surgical specimen before arriving at an appropriate diagnosis.
AIM: To report a case of a non-neoplastic variant of calcifying odontogenic cyst (COC) with the lining epithelium showing ameloblastomatous proliferation and capsule exhibiting features of a cholesterol granuloma. The importance of delineating this histologic variant from unicystic ameloblastoma and the formation of cholesterol granuloma in this variant is discussed. BACKGROUND: Calcifying odontogenic cyst is a developmental jaw cyst, which presents itself as both the neoplastic and the non-neoplastic forms. The ameloblastomatous variant of COC is often mistaken for unicystic ameloblastoma and treated aggressively. CASE REPORT: A 68-year-old female who presented with a cystic enlargement of the posterior mandible on the right side was suggestive of unicystic ameloblastoma based on radiography and initial biopsy report. Microscopic examination of the excision specimen, however, was fitting in favor of calcifying odontogenic cyst with ameloblastomatous proliferation. CONCLUSION: Identifying the non-neoplastic ameloblastomatous variant of COC from a cystic ameloblastoma is crucial as the treatment of the two lesions vary considerably. CLINICAL SIGNIFICANCE: This case emphasizes the need for thorough examination of the entire surgical specimen before arriving at an appropriate diagnosis.
Authors: Dardo Menditti; Luigi Laino; Marina DI Domenico; Giuseppe Troiano; Mario Guglielmotti; Sara Sava; Antonio Mezzogiorno; Alfonso Baldi Journal: In Vivo Date: 2018 Sep-Oct Impact factor: 2.155