scholarly journals p63 Expression in Solitary and Syndromic Odontogenic Keratocysts: An Immunohistochemical Study

Proceedings ◽  
2019 ◽  
Vol 35 (1) ◽  
pp. 29
Author(s):  
Luconi ◽  
Togni ◽  
Giannatempo ◽  
Caponio ◽  
Mascitti ◽  
...  

In the last years, the classification of odontogenic cysts and tumors has been highly debated, especially regarding odontogenic keratocyst (OKC). [...]

2017 ◽  
Vol 18 (12) ◽  
pp. 1173-1176 ◽  
Author(s):  
Prashant Rao ◽  
Aparna Paliwal ◽  
Shekhar Grover ◽  
Sandeep Gupta ◽  
Nidhi Choudaha

ABSTRACT Introduction Odontogenic cysts are commonly encountered lesions among head and neck pathologies. Odontogenic keratocyst (OKC) has unique features of recurrence and local aggressiveness. Podoplanin (PDP) is a lymphatic endothelial marker and is shown to be expressed in a variety of tissues. Hence, we planned to assess the significance of PDP in OKC and dentigerous cyst (DC). Materials and methods The present study included assessment of immunoexpression of PDP in OKC and DC. Twenty specimens each of OKC and DC were included in the present study and were stained with D2-40 antibody. All the sections were analyzed and were categorized as negative staining, weakly positive staining, and strongly positive staining. All the results were analyzed by Statistical Package for the Social Sciences (SPSS) software. Results We detected PDP-positive staining in the cell membrane and cytoplasm of the cells of basal cell layer and suprabasal cell layers. In DC cases, we observed positive staining only in cases associated with inflammation. Conclusion Podoplanin does play a significant role in enhancing the local invasive and neoplastic properties of OKC. Clinical significance Podoplanin expression in OKC is potentially associated with moderate invasive nature of the neighboring structures. How to cite this article Gupta S, Paliwal A, Choudaha N, Gupta A, Rao P, Grover S. Assessment of Proliferative Potential of Odontogenic Keratocyst and Dentigerous Cyst using Podoplanin: An Immunohistochemical Study. J Contemp Dent Pract 2017;18(12):1173-1176.


Author(s):  
Jose Carnate

A 37-year-old woman consulted for a slow-growing mass of one-year duration on the left side of the mandible with associated tooth mobility. Clinical examination showed buccal expansion along the left hemi-mandible from the mid-body to the molar-ramus region with associated mobility and displacement of the pre-molar and molar teeth. Radiographs showed a well-defined unilocular radiolucency with root resorption of the overlying teeth. Decompression and unroofing of the cystic lesion was performed. Received in the surgical pathology laboratory were several gray-white rubbery to focally gritty tissue fragments with an aggregate diameter of 1 cm. Histopathologic examination shows a fibrocollagenous cyst wall lined by a fairly thin and flat stratified squamous epithelium without rete ridges. (Figure 1) The epithelium is parakeratinized with a wavy, corrugated surface while the basal layer is cuboidal and quite distinct with hyperchromatic nuclei. (Figure 2) Based on these features, we signed the case out as odontogenic keratocyst (OKC). Odontogenic keratocysts are the third most common cysts of the gnathic bones, comprising up to 11% of all odontogenic cysts, and most frequently occurring in the second to third decades of life.1,2 The vast majority of cases occur in the mandible particularly in the posterior segments of the body and the ramus. They typically present as fairly large unilocular radiolucencies with displacement of adjacent or overlying teeth.1 If associated with an impacted tooth the radiograph may mimic that of a dentigerous cyst.2 Microscopically, the parakeratinized epithelium without rete ridges, and with a corrugated luminal surface and a prominent cuboidal basal layer are distinctive features that enable recognition and diagnosis.1,2,3 Occasionally, smaller “satellite” or “daughter” cysts may be seen within the underlying supporting stroma, sometimes budding off from the basal layer. Most are unilocular although multilocular examples are encountered occasionally.1 Secondary inflammation may render these diagnostic features unrecognizable and non-specific.2 Morphologic differential diagnoses include other odontogenic cysts and unicystic ameloblastoma. The corrugated and parakeratinized epithelial surface is sufficiently consistent to allow recognition of an OKC over other odontogenic cysts, while the absence of a stellate reticulum and reverse nuclear polarization will not favor the latter diagnosis.2,3 Odontogenic keratocysts are developmental in origin arising from remnants of the dental lamina. Mutations in the PTCH1 gene have been identified in cases associated with the naevoid basal cell carcinoma syndrome as well as in non-syndromic or sporadic cases.1,3 These genetic alterations were once the basis for proposing a neoplastic nature for OKCs and thus the nomenclature “keratocystic odontogenic tumor” was for a time adopted as the preferred name for the lesion.3,4 Presently, it is felt there is not yet enough evidence to support a neoplastic origin and hence the latest WHO classification reverts back to OKC as the appropriate term.1 Sekhar et al. gives a good review of the evolution of the nomenclature for this lesion.3 Treatments range from conservative enucleation to surgical resection via peripheral osteotomy.5 Reported recurrences vary in the literature ranging from less than 2% of resected cases up to 28% for conservatively managed cases.1,5 These are either ascribed to incomplete removal or to the previously mentioned satellite cysts - the latter being a feature associated with OKCs that are in the setting of the naevoid basal cell carcinoma syndrome.1,2,3 Thus, long term follow-up is recommended.5 Malignant transformation, though reported, is distinctly rare.2


2019 ◽  
Vol 9 (1) ◽  
pp. 8-15
Author(s):  
Mohammad Asifur Rahman ◽  
Tarin Rahman ◽  
Ismat Ara Haider

Odontogenic Keratocyst is an aggressive odontogenic cyst with a high recurrence rate. After radicular and follicular cysts, odontogenic keratocysts are the third most common cyst of the jaws and approximately 12-14% of all odontogenic cysts. It has been retermed to Keratocystic odontogenic tumour (KCOT) as it better reflects its neoplastic nature but recently it has been re classified and retermed into the cystic category. Various surgical methods have been proposed but comparatively, conservative treatment options such as Dredging methods might be the treatment of choice due to preservation of anatomical structure. Objective: The aim of this study was to analyse the clinical, radiological and histopathological characteristics of Odontogenic Keratocyst and provide a proper management system affected by this type of lesions. Materials and methods: The prospective study was performed in Dhaka Dental College and Hospital from a period of January 2014 to January 2018. A total number of 75 patients were selected for this study based on clinical, radiological and histopathological confirmation of odontogenic keratocysts. The treatment options were enucleation, enucleation with curettage, enucleation with peripheral ostectomy, Dredging method and surgical resection. After treatment patients were followed up 1months, 3 months and 6 months in every year at least for 5 years. Results: Among 75 patient of odontogenic keratocyst; the mean age was 27.69±13.35 and age range was 11 to 66 years. Male were 53(71%) and 22 (29%) were female patients. 53 (70.67%) cases were found in the mandible, 15(20%) cases in the maxilla and in 7(9.33%) cases were involved in both maxilla and mandible; mandibular posterior region was the most specific region involved 37(69.81%).The most common clinical features revealed pain and swelling. Radiologically, 70.66% unilocular, 96% well defined and 94.66% radiolucent area were prominent. Bone expansion 37.38%, root resorption 30.00% and 36% were associated with an impacted tooth. Regarding treatment options enucleation with curatage 12%, enucleation, curettage & peripheral ostectomy 29.33%, Dredging 52% and surgical resection 6.6% was done. Recurrence occurred in 18 patients with recurrence rate of 24%. Conclusion: Odontogenic keratocyst is an aggressive cyst, male predominant, posterior mandible is the commonest site and well defined unilocular radiolucency are commonest radiological feature. Radical treatment options such as resection reduced the recurrences of the tumour but higher morbidity and jaw deformity. Comparatively, conservative treatment options such as Dredging methods might be the treatment of choice due to preservation of anatomical structure. A long term follow up is paramount importance for the research and understanding the clinical pattern, behavior, treatment and recurrence of the lesion. Update Dent. Coll. j: 2019; 9 (1): 8-15


2014 ◽  
Vol 5 (2) ◽  
pp. 172 ◽  
Author(s):  
VenkateshV Kamath ◽  
Krishnanand Satelur ◽  
Komali Yerlagudda ◽  
Nagaraja Anand ◽  
Praveen Anigol

2020 ◽  
Vol 9 (6) ◽  
pp. 531-534
Author(s):  
Diogo Henrique Marques ◽  
Maylson Alves Nogueira Barros ◽  
Vitor Bruno Teslenco ◽  
Cláudio Marcio Santana Junior ◽  
Lucas Marques Meurer ◽  
...  

Introdução: Os ceratocistos odontogênicos (CCA) são considerados raros cistos de desenvolvimento, derivados dos remanescentes da lâmina dentária, com atividade intraóssea benigna, porém localmente invasivo e agressivo. O tratamento para o ceratocisto odongênico é variado, podendo-se encontrar modalidades tais como:enucleação, isolada ou associada a curetagem, com osteotomia periférica, aplicação da solução de Carnoy ou crioterapia, descompressão, marsupialização e ressecções. Objetivo: O presente trabalho tem como objetivo relatar um caso de ceratocisto odontogênico, onde foi escolhida abordagem conservadora por curetagem e osteotomia periférica. Relato de caso: Paciente de 68 anos, leucoderma, referiu ao exame clínico dor espontânea em região retromolar esquerda e parestesia em lábio inferior. A paciente foi submetida a biopsia por aspiração e excisional, após confirmação histopatológica foi proposto uma enucleação associada a osteotomia periférica sob anestesia geral. A paciente permanece em acompanhamento clínico e radiográfico, sem sinais de recidiva da lesão. Conclusão: Embora apresentem um comportamento agressivo, os ceratocistos odontogêncios podem ser tratados com segurança, de forma conservadora, por meio de enucleação seguida de osteotomia periférica com mínimo de morbidade. Descritores: Osteotomia; Curetagem; Cistos Odontogênicos. Referências Borghesi A, Nardi C, Giannitto C, Tironi A, Maroldi R, Di Bartolomeo F, Preda L. Odontogenic keratocyst: imaging features of a benign lesion with an aggressive behaviour. Insights Imaging. 2018 Oct;9(5):883-897. Park JH, Kwak EJ, You KS, Jung YS, Jung HD. Volume change pattern of decompression of mandibular odontogenic keratocyst. Maxillofac Plast Reconstr Surg. 2019 Jan 7;41(1):2.  Karaca C, Dere KA, Er N, Aktas A, Tosun E, Koseoglu OT, Usubutun A. Recurrence rate of odontogenic keratocyst treated by enucleation and peripheral ostectomy: Retrospective case series with up to 12 years of follow-up. Med Oral Patol Oral Cir Bucal. 2018 Jul 1;23(4):e443-e448.  Guerra LAP, Silva PS, Dos Santos RLO, Silva AMF, Albuquerque DP. Tratamento conservador de múltiplos tumores odontogênicos ceratocístico em paciente não sindrômico. Rev cir traumatol. buco-maxilo-fac. 2013; 13(2):43-50. Sundaragiri KS, Saxena S, Sankhla B, Bhargava A. Non syndromic synchronous multiple odontogenic keratocysts in a western Indian population: A series of four cases. J Clin Exp Dent. 2018;10(8):e831-6. Freitas AD, Veloso DA, Santos ALF, Freitas VA. Maxillary odontogenic keratocyst: a clinical case report. RGO Rev Gaúch Odontol. 2015; 63(4):484-88. Madhireddy MR, Prakash AJ, Mahanthi V, Chalapathi KV. Large Follicular Odontogenic Keratocyst affecting Maxillary Sinus mimicking Dentigerous Cyst in an 8-year-old Boy: A Case Report and Review. Int J Clin Pediatr Dent. 2018 Jul-Aug;11(4):349-351.  Moura BS, Cavalcante MA, Hespanhol W. Tumor odontogênico ceratocistico. Rev Col Bras Cir., 2016;43(6):466-71. Valori FP, Costa E, Buscatti MY, Oliveira JX, Costa C. Tumor odontogênico queratocístico: características intrínsecas e elucidação da nova nomenclatura do queratocisto odontogênico. J Health Sci Inst. 2010;28(1):80-3. Slusarenko da Silva Y, Stoelinga PJW, Naclério-Homem MDG. The presentation of odontogenic keratocysts in the jaws with an emphasis on the tooth-bearing area: a systematic review and meta-analysis. Oral Maxillofac Surg. 2019;23(2):133-47.


2002 ◽  
Vol 81 (11) ◽  
pp. 757-760 ◽  
Author(s):  
D.C. Barreto ◽  
A.E. Bale ◽  
L. De Marco ◽  
R.S. Gomez

The human patched gene ( PTCH) functions in both embryologic development and tumor suppression. PTCH mutations have been found in odontogenic keratocysts. However, the expression and localization of the protein product of the gene have not been determined in odontogenic tumors and cysts. We investigated 68 odontogenic lesions by immunohistochemistry, and compared their PTCH expression with that in basal cell carcinomas. All odontogenic lesions, including two keratocysts with truncating mutations, were positive for PTCH. Different types of lesions had different amounts of staining. Lack of staining was noted in the majority of basal cell carcinomas. Taken together, these data suggest that odontogenic keratocysts arise with heterozygous mutations of the PTCH gene.


1998 ◽  
Vol 16 (4) ◽  
pp. 185-192 ◽  
Author(s):  
Hiroshi Takahashi ◽  
Shuichi Fujita ◽  
Shigeru Yamabe ◽  
Takeshi Moriishi ◽  
Haruo Okabe ◽  
...  

Proliferating cell nuclear antigen (PCNA) is a nuclear protein synthesized in the late G1 and S phase of the cell cycle, and immunohistochemical detection of the protein represents a useful marker for the proliferating fraction of cells in tissue specimens. PCNA expression was studied in odontogenic keratocysts (n= 15) and ameloblastomas (n= 46) using an avidin–biotin–peroxidase complex method on routinely processed paraffin sections. The percentage of PCNA-positive cells determined by point counting was significantly lower in the ameloblastomas (mean 9.4%, standard deviation (SD) 11.0) than in odontogenic keratocysts (mean 29.9%, SD 24.0). In ameloblastomas, the mean percentage of PCNA-positive cells was lowest in the acanthomatous pattern and highest in plexiform pattern. The mean percentage of PCNA-positive cells in plexiform pattern was non-significantly higher than that in follicular pattern. The mean percentage of PCNA-positive cells in plexiform and follicular patterns was significantly higher than that in cyctic and acanthomatous patterns. The frequency of PCNA-positive cells was significantly higher in the peripheral cells of follicular and plexiform patterns than in the central cells of both patterns (p< 0.01). Therefore, peripheral cells were regarded as reserve cell of central cells. The mean percentage of PCNA-positive cells in the epithelial lining of odontogenic keratocyst was not significantly different from those in the peripheral cells of follicular and plexiform patterns of ameloblastoma. In contrast, the odontogenic keratocyst exhibited a mean percentage of PCNA-positive cells which was statistically higher than that in other histological elements of ameloblastomas. The present study suggests that odontogenic keratocyst is regarded as benign odontogenic tumour.


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