PARAKERATINIZED ODONTOGENIC KERATOCYST: A CASE REPORT WITH 8 YEARS FOLLOW-UP

OKC (odontogenic keratocyst) of parakeratinized variant is a benign developmental cyst in jaw, aggressive in nature, and is considered a mystery for surgeons in terms of its management. Though they are benign in nature they have a unique tendency to recur after conservative treatment. Therefore most appropriate management still remains controversial. Treatment modalities advocated ranges from conservative approach of enucleation to most radical form of resection. Here is a case of Parakeratinized odontogenic keratocyst in which treatment was done by enucleation with peripheral ostectomy along with chemical cauterization through CarnoyÂ’s solution. The patient was kept under follow up without any signs of recurrence for past 8 years.

Fourth branchial pouch anomaly presenting as a neonatal neck lump

A 1-week-old female infant presented with a transilluminating neck lump that increased in size with crying. The presumptive diagnosis was lymphatic malformation, but imaging raised the possibility of an abscess or necrotic tumour. A biopsy revealed a likely developmental cyst with local inflammatory change. Microlaryngoscopy revealed a fourth branchial pouch sinus, which was cauterised. The sinus and neck lump resolved without need for further treatment.

Squamous carcinoma arising in a branchial cleft cyst: have you ever treated one? Will you?

The existence of primary branchiogenic carcinoma – that is, carcinoma arising in a pre-existing branchial cleft cyst (a benign developmental cyst) – has in recent decades been the subject of increasing scepticism. Recognition of the propensity of a variety of head and neck sites – including in particular the tonsil – to give rise to cervical metastases while the primary tumours themselves remain undetected has given rise to the idea that virtually all cystic carcinomas of the neck represent metastatic deposits, whether or not their primary sites are found. A diagnosis of primary branchiogenic carcinoma should be viewed with extreme scepticism, and every effort should be made (e.g. imaging, panendoscopy, elective tonsillectomy) to exclude the existence of a primary site elsewhere, before considering a diagnosis of primary branchiogenic carcinoma.

Giant enterocystoma within an infant's tongue

A rare developmental cyst within the tongue and submandibular triangle ofa male infant containing heterotopic gastric and intestinal epithelium (enterocystoma) is described and its derivation discussed. This cyst was ofsuch a size as to cause feeding difficulties and partial airway obstruction during sleep. Following C.T. scanning, total obstruction necessitated an emergency tracheostomy. Successful enucleation via a median labiomandibulotomy was performed without further complication and two years later there is no sign of recurrence.