Diagnostic and treatment features of keratocystic odontogenic tumors

Abstract

Keratocystic odontogenic tumors (KCOT) comprise a unique pathological entity characterized by aggressive/destructive behavior and propensity to recurrence. This study describes the diagnostic and treatment features of a KCOT lesion. A 22-year old man was referred for surgical treatment of pericoronitis on tooth no. 37. Panoramic radiography revealed a unilocular, large radiolucent area extending from tooth no. 36 to the left mandibular ramus. Aspiration and incisional biopsy were performed, and the tissue sample was sent for microscopic evaluation. Microscopically, a cystic lesion was observed, lined by keratinized squamous epithelium and filled with keratin lamellae, confirming the diagnosis of KCOT. Surgery was performed in an outpatient setting and involved osteotomy, detachment of the cystic lesion, and removal of teeth no. 36, 37, and 38. The patient was clinically and radiographically followed for 12 months, and no evidence of recurrence was observed. KCOTs should be considered in the differential diagnosis of lesions affecting the posterior region of the mandible. Accurate clinical, radiographic, and microscopic examinations are essential to establish the definitive diagnosis and choose the most effective therapy.