A 55 year old man complained of a painless mass at the left maxillofacial region. The mass had continuously grown over 10 years. Upon physical examination a cystic mass with size of 5 cm in length with bulging smooth surface was seen on the left maxillofacial region. Computed tomography (CT) scan showed a giant cyst with bone destruction and invasion in the left maxilla, maxillary sinus and nasal cavity. Needle aspiration of the mass yielded 80 milliliter of brown fluid. The excisional biopsy was made which revealed ghost cells and dysplastic dentin that were features of dentinogenic ghost cell tumor. Finally, a dentinogenic ghost cell was diagnosed.
Cysts ; pathology ; Diagnosis, Differential ; Humans ; Male ; Maxilla ; Maxillary Sinus ; Middle Aged ; Odontogenic Tumors ; pathology

OBJECTIVETo investigate the proliferative potential of the epithelial cells in odontogenic keratocyst, radicular cyst, dentigerous cyst and ameloblastoma.

METHODSDNA contents and ploidy of basal and spinous cells in keratocyst, radicular cyst, dentigerous cyst, and the peripheral column cells and central reticular cells in ameloblastoma were analysis respectively.

RESULTSThe more and higher DNA contents and the proliferating ploidy of keratocyst and ameloblastoma than those of radicular cyst and dentigerous cyst indicate the active proliferating potential. The spinous cells showed more active proliferating growth than the basal cells of keratocyst. The higher DNA contents of radicular cyst are related to the stimulus of the inflammation. The dentigerous cysts have more di-ploidy cells without active growth potential.

CONCLUSIONSThe active cell proliferating growth in keratocyst and ameloblastoma is probably the pathological basis of their local aggressive biological behavior.

Ameloblastoma ; genetics ; pathology ; Cell Division ; genetics ; DNA ; metabolism ; Humans ; Jaw Neoplasms ; genetics ; pathology ; Odontogenic Cysts ; genetics ; pathology ; Ploidies

OBJECTIVETo report two cases of glandular odontogenic cyst and examine its cytokeratin 18,19 expression.

METHODSTwo cases of glandular odontogenic cyst were reported and studied. The cytokeratin 18, 19 expression in these two cases were also investigated using immuno-histochemical staining as well as in the situ hybridization of the cyst epithelium.

RESULTSHisto-pathological examination revealed that ciliated columnar cells, squamous cells and low-columnar cells were found in the superficial layer of the lining epithelium. Several minor salivary glands, mainly composed of seromucous cells were observed near the satellite cyst. CK18 were expressed in all layers of the lining epithelium of varying intensity. CK18 was negative in lining epithelium of the daughter cyst, but CK19 was positive. CK18-mRNA was expressed in all the layers of the lining epithelium, the salivary glands and daughter cysts.

CONCLUSIONSHistological features and CK18 expression may be indicative of the possibility of salivary glandular and odontogenic differentiation.

Adolescent ; Adult ; Epithelium ; pathology ; Female ; Humans ; Keratin-18 ; metabolism ; Keratin-19 ; metabolism ; Male ; Odontogenic Cysts ; metabolism ; pathology

An unusual odontogenic cyst, which was originally believed to be a clinical dentigerous cyst associated with an impacted mandibular third molar, was found histologically to demonstrate the characteristics of a glandular odontogenic cyst with para- and orthokeratinization. These histologic diversities were interpreted as a reflection of the pluripotentiality of the epithelial remnants of the mandibular third molars or dentigerous cyst epithelium. It is possible that it has the capacity to induce the formation of cysts in both squamous and glandular epithelium.
Tomography, X-Ray Computed ; Odontogenic Cysts/*pathology/radiography/surgery ; Mandibular Diseases/*pathology/radiography/surgery ; Mandible/radiography ; Humans ; Female ; Epithelium/pathology ; Aged

OBJECTIVETo clarify the clinicopathological spectrum and biologic behavior of unicystic ameloblastomas (UA).

METHODSRetrospective analysis of 33 UA was undertaken to relate clinicopathological variables to recurrence.

RESULTSThe clinical features of this series were in general agreement with that of the previous reports. UA tended to occur at an earlier age (mean 25.3 years), with a male predilection and predominant mandibular involvement (90.9%). Microscopically, the tumors demonstrated a generally monocystic growth pattern, with 8 being simple cystic, 10 comprising intraluminal nodules, and 15 exhibiting a conspicuous component of infiltrative tumor islands in the cyst capsule. Follow-up of 29 patients revealed 6 recurrences with an average interval of 7 years. Recurrence also related to histologic subtypes of UA, with those invading the fibrous wall having a rate of 35.7% but others 6.7%.

CONCLUSIONSDespite the fact that unicystic ameloblastoma may, in general, compare favorably with its solid or multicystic counterpart in terms of clinical behavior and response to treatment, the subsets of the maxillary lesions or tumors exhibiting mural invasion could have a high risk of recurrence.

Adolescent ; Adult ; Aged ; Ameloblastoma ; pathology ; Child ; Female ; Follow-Up Studies ; Humans ; Jaw Neoplasms ; pathology ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Odontogenic Cysts ; pathology

OBJECTIVETo investigate the clinicopathological features and behavior of a group of jaw cysts with a solely orthokeratinized lining epithelium.

METHODS20 cases of this cyst type were reported under the term of orthokeratinized odontogenic cyst (OOC) and their clinical, histological and immunocytochemical features were compared with that of odontogenic keratocyst (OKC).

RESULTSThe cysts of the present series were all solitary lesions, occurred mostly in young male patients, and showed a predilection for the posterior mandible areas. Follow-up of 15 patients revealed no recurrence following enucleation. Histological and immunocytochemical studies indicated that OOC epithelium lacked the typical features of OKC and appeared to show a lower proliferative activity.

CONCLUSIONThese findings suggest that OOC is clinicopathologically distinctive from OKC and may thus constitute its own clinical entity.

Adolescent ; Adult ; Aged ; Carcinoembryonic Antigen ; analysis ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Keratins ; analysis ; Male ; Mandibular Diseases ; metabolism ; pathology ; Middle Aged ; Mucin-1 ; analysis ; Odontogenic Cysts ; metabolism ; pathology

PURPOSE: The prevalence of supernumerary teeth has been reported to be between 0.1% and 3.8%. The aim of this study was to determine the prevalence, clinical significance, and associated pathologies of fourth molars based on a retrospective study and a literature review. MATERIALS AND METHODS: A 5-year retrospective prevalence study was conducted at the Department of Oral Diagnosis and Dentomaxillofacial Radiology of Okayama University Hospital, Okayama, Japan. The study involved extracting data from the digital records of patients from January 1, 2013 through December 31, 2017. The sampling frame included all patients who had panoramic radiographs, cone-beam computed tomography (CT), and multislice CT images during the period under review. RESULTS: A total of 26,721 cases were reviewed and 87 fourth molars were identified. The prevalence of fourth molars in the 5-year study at Okayama was calculated as 0.32%. The mean age of patients with a fourth molar was 30.43 years, and the male-to-female ratio was 1:0.98. The vast majority of cases were in the maxilla (92%) and had normal shapes (89.7%); furthermore, 82.8% of cases were unerupted. CONCLUSION: The prevalence of fourth molars in the study population was found to be 0.32%, and fourth molars occurred with approximately equal frequency in males and females. Fourth molars were more common in the maxilla and were predominantly unerupted and small.
Cone-Beam Computed Tomography ; Cross-Sectional Studies ; Diagnosis, Oral ; Female ; Humans ; Japan ; Male ; Maxilla ; Odontogenic Cysts ; Odontoma ; Pathology ; Prevalence ; Retrospective Studies ; Tooth, Supernumerary

It is not known whether the presence of an impacted tooth or the radiographic types in an odontogenic keratocyst (OKC) change the clinical biologic behavior and therapeutic approaches. This study evaluated the comparative proliferative activity and apoptosis in OKC associated with or without an impacted tooth, as well as between the unilocular and multilocular OKC varieties. Immunohistochemical expression of Ki-67 as a proliferation marker and the apoptotic reactions were assessed by the TUNEL method for 32 cases of OKC (OKC with impacted tooth, n=16; OKC without impacted tooth, n=16) and 10 cases of dentigerous cyst (DC). OKC showed a greater proliferative potential and more apoptotic reactions than DC. In particular, OKC contained proliferating and apoptotic cells situated predominantly in the suprabasal and superficial layers, respectively. However, no significant difference was found between OKC associated with or without impacted tooth, or between the unilocular and multilocular OKC varieties, in terms of proliferative activity or apoptosis. In conclusion, OKC is characterized by an increase in both cell proliferation and apoptosis, suggesting a unique proliferative and differentiation process. It is believed that incomplete removal or other contributing factors, rather than intrinsic growth or apoptosis, may be the main reasons for the aggressive biologic behavior or recurrence in multilocular OKC.
Adult ; *Apoptosis ; Cell Division ; Comparative Study ; Female ; Human ; Immunohistochemistry ; In Situ Nick-End Labeling ; Ki-67 Antigen/*analysis ; Male ; Odontogenic Cysts/*pathology ; Proliferating Cell Nuclear Antigen/analysis ; Support, Non-U.S. Gov't ; Tooth, Impacted/*pathology

Dentigerous cysts are benign odontogenic cysts that are associated with the crowns of permanent teeth. They are developmental epithelial-lined lesions which are formed from fluid accumulation in the space between the reduced enamel epithelium and the surface of crown. This may occure due to the obstructin of venous return caused by tooth impaction. The most prevalent location of dentigerous cysts are the third molar of mandible. While the single dentigerous cysts are the second most common odontogenic cysts following the radicular cysts of jaw, multiple cysts are observed in patients with some conditions such as mucopolysaccharidosis type IV, basal cell nevus syndrome, and cleidocranial dysplasia. They occur in young patients in the second or third decades of life, but it is a rare occurrence for children. A sixteen-year-old girl with painful swelling in the right mandible visited to our department. All routine laboratory test results were within normal limits. However, we were able to diagnose that she had facial asymmetry. Computed tomography showed a well-defined soft tissue mass obliterating right mandible ramus with an impacted tooth. We performed total enucleation of cyst and molar tooth. The pathology revealed a non-keratinized squamous epithelial lined cyst associated with an undamaged tooth.
Basal Cell Nevus Syndrome ; Child ; Cleidocranial Dysplasia ; Crowns ; Dental Enamel ; Dentigerous Cyst* ; Epithelium ; Facial Asymmetry ; Female ; Humans ; Jaw ; Mandible* ; Molar ; Molar, Third ; Mucopolysaccharidoses ; Odontogenic Cysts ; Pathology ; Radicular Cyst ; Tooth ; Tooth, Impacted