Clinicopathological analysis of odontogenic keratocysts with dysplasia

IF 1.9 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Oral Surgery Oral Medicine Oral Pathology Oral Radiology Pub Date : 2025-07-21 DOI:10.1016/j.oooo.2025.04.036

Julia Yu Fong Chang , Yi-Ping Wang , Pei-Hsuan Lu

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Abstract

Introduction

Odontogenic keratocyst (OKC) with dysplasia is one of the precursor lesions of primary intraosseous carcinoma (PIOC). The aim of this study is to perform clinicopathological analysis of OKC with dysplasia. Be cautious with the clinicopathologic features of OKC with dysplasia and close follow-up might be helpful for early detection and improvement of the prognosis of PIOC.

Materials and Methods

This retrospective study included 6 cases. Patients’ age, gender, lesion location, symptoms, radiographic and microscopic findings were reviewed and analyzed.

Results

This study included 4 male and 2 female patients of mean age 51 (range 16-81) years. Lesions were slightly more common on the maxilla than the mandible, esp. posterior maxilla. The most common chief complaint was pain and swelling. Two-third of the cases showed an unilocular radiolucency with cortical bone perforation and were associated with impacted tooth. Root resorption was seen in 3 cases while tooth displacement was present in one case. In addition to the classic OKC histopathologic features, budding of the epithelium, basal cell hyperplasia and crowding, increased number and upward located mitotic figures, high columnar palisaded basal cells with frequent reverse polarity, and occasional basal vacuolation were also noted. Heavy inflammation was also frequently present in focal areas.

Conclusions

The dysplastic changes in OKC were infrequently concomitant occurred within classic OKC. Therefore, be familiar with the clinicopathologic features of high-risk cases, and careful examination are required for accurate diagnosis.

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牙源性角化囊肿伴发育不良的临床病理分析

牙源性角化囊肿伴发育不良是原发性骨内癌（PIOC）的前兆病变之一。本研究的目的是对伴有发育不良的OKC进行临床病理分析。注意OKC伴不典型增生的临床病理特点，密切随访，可能有助于及早发现和改善PIOC的预后。材料与方法对6例患者进行回顾性研究。对患者的年龄、性别、病变部位、症状、影像学和显微镜检查结果进行了回顾和分析。结果本组患者男4例，女2例，平均年龄51岁（16 ~ 81岁）。上颌病变略多于下颌骨，尤其是后上颌。最常见的主诉是疼痛和肿胀。三分之二的病例显示单眼透光并伴有皮质骨穿孔，并伴有埋伏牙。3例出现牙根吸收，1例出现牙移位。除了典型的OKC组织病理学特征外，还注意到上皮出芽，基底细胞增生和拥挤，有丝分裂象数量增加和位置向上，高柱状栅栏状基底细胞频繁出现反极性，偶尔出现基底空泡化。严重的炎症也经常出现在病灶区域。结论典型OKC伴发性发育不良的发生率较低。因此，熟悉高危病例的临床病理特征，仔细检查才能准确诊断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral Surgery Oral Medicine Oral Pathology Oral Radiology DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.80

自引率

6.90%

发文量

1217

审稿时长

2-4 weeks

期刊介绍： Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology is required reading for anyone in the fields of oral surgery, oral medicine, oral pathology, oral radiology or advanced general practice dentistry. It is the only major dental journal that provides a practical and complete overview of the medical and surgical techniques of dental practice in four areas. Topics covered include such current issues as dental implants, treatment of HIV-infected patients, and evaluation and treatment of TMJ disorders. The official publication for nine societies, the Journal is recommended for initial purchase in the Brandon Hill study, Selected List of Books and Journals for the Small Medical Library.