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Calcifying Odontogenic Cyst (gorlin cyst) - Coggle Diagram
Calcifying Odontogenic Cyst (gorlin cyst)
family of odontogenic
ghost cell lesions
DDs
Dentinogenic ghost cell tumor (DGCT)
Ghost cell odontogenic carcinoma (GCOC)
Calcifying odontogenic cyst (COC)
Simple cyst
Peripheral (Extraosseous) rare 10% --> anti mandible
mostly appear pink to red, smooth, circumscribed ele
vated masses on the gingivae or alveolar mucosa. They
measure an average diameter of 11 mm
mostly intraosseous
Cyst associated
with odontoma
Definition
WHO: Calcifying odontogenic cyst (COC) is a developmental odontogenic cyst characterized
histologically by ghost cells, which often calcify.
Epidemiology
1% of
odontogenic cysts
age: peak 2nd to 3rd decades
sex: equal
sites:
mandible 50% equal distribution
maxilla 50 % ; more anterior
Single most common site (37%) is the maxillary inci
sor/canine region
Clinical Presentation
Occasional cases
presented with unerupted teeth
rarely tooth displacement
painful swelling
common: tooth mobility
80% painless swelling buccolingual expansion
The swelling is often bony hard and is usually on the buccal or labial aspect of the jaws. Occasional
lesions may perforate the cortical plate and extend into the
soft tissues.
recurrences rare
Radiological Features
Most are unilocular. Up to 18% may be multilocular
60% contain areas of calcification
25% are associated with an odontoma
Average size is 30 mm. Only about 25% are greater
than 40 mm
Well- defined radiolucency with corticated margin
root resorption
tooth displacement
Radiological Differential Diagnosis
with calcificastion
adenomatoid odontogenic tumour
calcifying epithelial odontogenic tumour
dentinogenic ghost cell tumor
conventional odontoma.
without calcification
include any of the cystic jaw lesions,
Histopathology
Ghost Cells (Pathognomonic)
: Focal accumulations of large, pale, eosinophilic cells with lost nuclei. They appear in the lining or lumen, may
calcify
, and can extrude into the connective tissue wall.
Connective Tissue Wall: May contain extruded ghost cells (eliciting a giant cell reaction)
Lining
: A
unicystic lesion
lined by odontogenic epithelium. The lining often resembles unicystic ameloblastoma (
columnar basal cells with reversed polarity and stellate reticulum-like superficial layer),
though areas of flattened stratified squamous epithelium are common.
About 50% contain
dentinoid
in the cyst wall adjacent to the epithelium
Treatment
; surgical enucleation