Hyperkeratosis and atypical proliferation appearing in the lining epithelium of a radicular cyst. Report of a case

doi:10.1016/S1010-5182(05)80484-6

Journal of Cranio-Maxillofacial Surgery

Volume 21, Issue 5, July 1993, Pages 210-213

https://doi.org/10.1016/S1010-5182(05)80484-6 Get rights and content

Summary

It is widely accepted that radicular cysts (apical periodontal cysts) are commonly lined with stratified squamous epithelium without keratin formation. However, we identified a case of maxillary radicular cyst with remarkable keratinization and atypical proliferation of the lining epithelium among the 207 radicular cyst cases seen at our department. Histopathological and clinical findings of these cysts were reviewed.

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Cited by (3)

Orthokeratinized odontogenic cysts presenting as a periapical lesion: Report of a case and literature review
2014, Journal of Endodontics
Citation Excerpt :
This is particularly significant because oral pathologists have used this method to differentiate KCOT from OOC and keratinized RCs. In addition to this fact, it has been postulated that cystic lesions showing either orthokeratin or an epithelium similar to that seen in parakeratotic oral mucosa, as well as other pathologic conditions with scanty parakeratin areas, should not be diagnosed as KCOTs or even as OOCs (19–24). Although there are many articles reporting the immunohistochemistry cytokeratin profile expression for RC and KCOT, this information is not useful for OOC and keratinized RC.
Inflammatory cysts, granulomas, abscesses, and fibrous scars represent most periapical radiolucencies. However, other less common lesions, such as orthokeratinized odontogenic cysts (OOCs), can be found at this region, and they deserve to be discussed because the prognosis for an OOC is different from that expected for the ordinary inflammatory periapical diseases.
An interesting case of OOC associated with a nonvital tooth in a 40-year-old woman is described. After a previous clinical diagnosis of a radicular cyst, the tooth was extracted, and the lesion was enucleated and submitted to microscopy examination.
Because of the detection of an orthokeratinized epithelium lining, a diagnosis of OOC was concluded. After 2 years of periodic follow-up, no signs of recurrence were detected.
The presence of keratin in radicular lesions must be carefully evaluated to eliminate the diagnosis of lesions with more aggressive behavior, such as an OOC or even a keratocystic odontogenic tumor. Hence, histopathologic examination is mandatory to confirm the type of lesion and to differentiate other pathologic conditions, therefore establishing patients' prognoses precisely.
Cysts of orofacial region
2020, Shafer's Textbook of Oral Pathology: Ninth Edition
An unsuspected ameloblastoma in the subpontic region of the mandible with consideration of pathogenesis from the radiographic course
2010, European Journal of Medical Research

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Hyperkeratosis and atypical proliferation appearing in the lining epithelium of a radicular cyst. Report of a case

Summary

J. Oral Maxillofac. Surg.

Oral Surg. Oral Med. Oral Pathol.

Int. J. Oral Maxillofac. Surg.

J. Oral Maxillofac. Surg.