CALCIFYING EPITHELIAL ODONTOGENIC CYST

INTRODUCTION

The calcifying epithelial odontogenic cyst described by Gorlin is a relatively uncommon cystic lesion of the jawbones. There are numerous terminologies suggested for this lesion such as Gorlin -Gold cyst, calcifying ghost cell odontogenic tumor,cystic calcifying odontogenic tumor.It can be mainly

of two types-1.cystic lesion, solid neoplastic lesion along with a malignant counterpart.

ETIOLOGY

May develop from

Reduced enamel epithelium Remanants of odontogenic epithelium, gingiva or bone

CLINICAL FEATURES

Age - second and third decade

Sex -males=females

Site-1.mandibular premolar region

2.anterior maxilla and mandible

Features:

Presents as a bony hard swelling of the jaws measuring upto 2 to 3 centimeters in diameter Expansion and distortion of the cortical plates is usually common and may also cause

perforation. Pain is rare and can also develop in association with an odontome. Extraosseous lesion presents as a sessile or pedunculated gingival swelling.

Radiographic features:

May present as radiolucencies or radiolucencies with foci of opacification, particularly associated with odontomas.

May be associated with an unerupted tooth Extra osseous lesion causes an indentation of the underlying bone.

Histopathology:

It mainly presents as a cystic cavity, lined by an odontogenic keratinised epithelium of about six to eight cell layer thickness

The basal cells of the lining epithelium are columnar cells or cuboidal in nature. The luminal surface shows the presence of ghost cells that are larger than normal cells often

vacuolated and remnants of nuclear chromatin are more prominent. The ghost cells often undergo calcifications. The connective tissue capsule contains many satellite microcysts and there may be presence

of multiple,multinucleated giant cells.

Differential diagnosis:

Calcifying epithelial odontogenic tumor.Adenomatoid odontogenic tumorDentigerous cystAmeloblastoma

Treatment:

Surgical enucleation