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PubMed1997

Calcifying odontogenic cyst: a clinicopathologic study of 57 cases with immunohistochemical evaluation for cytokeratin.

PURPOSE: A clinicopathologic study of all cases accessioned as calcifying odontogenic cyst (COC) from 1971 to 1996 from the files of the Oral Pathology Laboratory at Temple University School of Medicine was undertaken. MATERIALS AND METHODS: Microscopic slides and clinical histories of cases diagnosed as calcifying odontogenic cyst were reviewed and analyzed. Ten cases were processed for cytokeratin immunohistochemical staining. RESULTS: Fifty-seven cases were reviewed, 28 males and 29 females. Patients' ages ranged from 7 to 83 years, with a mean age of 49.8 years. Thirty-four cases involved the mandible and 23 were from the maxilla. Seventeen were reported in peripheral locations, and 38 occurred centrally within the jaws. Two were found both centrally and peripherally. The most common clinical sign for central lesions was a radiolucency sometimes associated with a jaw expansion. The most common clinical complaint for peripheral lesions was a nodular growth on the gingiva. Although lining epithelial cells were strongly positive for cytokeratin, full-brown ghost cells and disintegrating ghost cells were nonreactive. CONCLUSION: Calcifying odontogenic cyst can occur in any age-group, intraosseously or extraosseously, and as a solid lesion. No recurrences were found after surgical removal in the current series.

Adolescent↗
PubMed1985

Peripheral calcifying odontogenic cyst (Gorlin cyst).

A case report of a rare peripheral calcifying odontogenic cyst is presented. The clinical, radiographic and histopathologic features of the lesion are discussed, along with the etiology, rate of occurrence and diagnosis.

Child↗
PubMed1985

Pigmented variant of calcifying odontogenic cyst. Report of an additional case and review of the literature.

A case of the pigmented variant of calcifying odontogenic cyst occurring in a 21-year-old Japanese male is reported, and a review of previously reported cases of the lesion is included. In addition to the characteristic histopathologic features of calcifying odontogenic cyst, dendritic cells containing melanin pigment were widely distributed in the epithelial layer and melanin pigment was also found in the epithelial cells including ghost cells in the present case. Although no conclusion could be drawn from the present examination as to the origin of melanin pigment in the calcifying odontogenic cyst, it is thought that the role of racial pigmentation is one of the important factors in occurrence of pigmented odontogenic lesions.

Adult↗
PubMed2001

A case of an ameloblastic fibro-odontoma arising from a calcifying odontogenic cyst.

This case report describes an ameloblastic fibro-odontoma arising from a calcifying odontogenic cyst (COC) in the mandible of a twenty-three-year old male. The patient was referred to the Department of Oral Surgery, Tokyo Dental College, on March 30th, 2000, complaining of a painful swelling, which had appeared three weeks earlier on his left mandibular molar region. In a pathological view, the lesion was a round cyst the size of a chicken-egg, dark red in color, and surrounded by a thick membrane. The cyst had an epithelium of varying thickness which included many ghost cells and an enamel-like structure on the inside, and a thick wall of connective tissue with an ameloblastic fibro-odontoma on the outside. Enamel organ-like epithelial islands were structured radially in the form of strands with immature dentin. Cytokeratin 19 was strongly immunoreactive in the epithelium of the lesion; osteopontin and osteocalcin reacted in the mesenchymal cells and weakly in the epithelial element of this tumor.

Adult↗
PubMed1998

[A study of histopathology and cell proliferation in calcifying odontogenic cyst].

OBJECTIVE: To investigate the histopathologic and clinical characteristics and proliferative activities of calcifying odontogenic cyst (COC). METHODS: 25 cases of COC were reviewed. The expression of proliferating cell nuclear antigen (PCNA) was studied using avidin-biotin peroxidase method and the number of nuclear organizing regions was calculated by means of the argyrophil staining technique in these cases. RESULTS: The cases were divided into 13 (52%) cysts and 12 (48%) neoplasms. Of the 12 neoplasms, 4 were odontogenic ghost cell carcinoma, with a PCNA labelling index (65.9% +/- 7.3%) significantly higher than that of benign neoplastic variant (45.8% +/- 11.5%, P < 0.05) and cystic variant (29.3% +/- 11.2%, P < 0.01). The AgNOR counts was higher in the carcinomatous than benign or cystic variant. CONCLUSION: The lesions show considerable diversity in structure and behavior. It is therefore proposed that quantiation of staining for NOR-associated proteins and the PCNA labelling index are diagnostically useful in COC.

Cell Division↗
PubMedDate not supplied

Calcifying odontogenic cyst in infancy: report of case associated with compound odontoma.

A case of calcifying odontogenic cyst associated with compound odontoma in an unerupted primary tooth in a three-year-old patient is reported. Some considerations regarding the age of the patient, differential diagnosis and treatment are discussed. Although the cyst can occur at any age, the majority of cases appear before the fourth decade of life. This malady represents less than 2 percent of all odontogenic tumors and cysts.

Child, Preschool↗
PubMed1975

Ultrastructure of the keratinizing and calcifying odontogenic cyst.

Four types of cells in the keratinizing and calcifying odontogenic cyst can be identified. The "basal cell" and "stellate reticulum-type cell" contained various amounts of tonofilaments and organelles. The "ghost cell" contained coarse bundles of tonofilaments intermingled with dilated membranous organelles. The "hornified cell" contained densely packed tonofilaments. Calcification of the ghost cell and hornified cell occurred with concomitant calcification of the adjacent collagen.

Abscess↗
PubMed1982

A pigmented calcifying odontogenic cyst.

A case of the pigmented variant of the calcifying odontogenic cyst occurring in a 15-year-old West Indian girl is reported. Melanin pigment was widely distributed and appeared in greatest amount in cells exhibiting the appearance of stellate reticulum. Ultrastructural examination demonstrated large numbers of melanosomes in these cells but relatively few in epithelial ghost cells. The latter contained thick bundles of tonofilaments. Melanocytes were identified and two forms were distinguished, depending on their content of premelanosomes and fully melanized melanosomes.

Adolescent↗
PubMed1981

Calcifying odontogenic cyst. Range, variations and neoplastic potential.

16 cases of calcifying odontogenic cysts (C.O.C.) were studied and reevaluated. It could be concluded, that the group contained two entities, a cyst and a neoplasm. The cyst occurs as three variants. 1. A simple unilocular cyst with moderate mural proliferations of epithelium and no, or sparse amounts of dentinoid (dysplastic dentin); it seems to occur during man's entire life span. 2. A unilocular cyst which produces compound or complex odontomas in its luminal part, more rarely it may instead produce an intramurally growing ameloblastic fibroma, which may call for more radical surgery. It occurs mainly in patients between 10 and 29 years of age. 3. A unilocular cyst with extensive luminal as well as mural ameloblastomalike proliferations of epithelium. The C.O.C. may be located outside or inside the bone according to the location of the source of odontogenic epithelium, from which it develops. The neoplasm shows an entirely different structure. It consists of ameloblastoma-like strands and islands of odontogenic epithelium growing infiltratively in a mature connective tissue. Varying amounts of ghost cells are seen in the epithelium and varying amounts of dentinoid is formed in contact with the odontogenic epithelium. The term "Dentinogenic ghost cell tumour" is suggested for this lesion. It is possible that it occurs predominantly in the later part of life. It occurs as an extraosseous as well as an intraosseous lesion. Recurrence has been observed following cystectomy.

Adolescent↗
PubMed2003

A case of calcifying odontogenic cyst with numerous calcifications: immunohistochemical analysis.

The purpose of this study was to investigate a case of calcifying odontogenic cyst (COC) in which numerous calcifications were observed not only in the lining epithelium, but also in the cyst wall, using cytokeratins 13 (CK13), 19 (CK19), and core binding factor a-1 (cbfa-1) as primary antibodies. Cells of Malassez's epithelial rest were stained as controls. Cells of the epithelial nests in the cyst wall were reactive for CK13, but their CK19 staining was similar to that observed in the lining epithelial cells. Calcifying nodules were reactive only for CK13. Cells of Malassez's epithelial rest were reactive for CK19 but not for CK13. Cbfa-1 positive reactivity was observed only in nuclei of spindle cells in the periodontal ligament. CK13 was positive superficial to the prickle cells. CK19 was positive in the basal cells of the oral mucosa. In the lining epithelium of the cyst, the expressions of CK13 and CK19 were similar to their immunoreactions in the oral mucosa. These results suggest that the odontogenic epithelium differentiated into squamous epithelial cells, which began as ghost cells in the COC, and that this process depended on the dystrophic calcification of differentiated odontogenic epithelial cells, not of osteogenic cells.

Adult↗
PubMed1998

Central calcifying odontogenic cyst. A review of the literature and the role of advanced imaging techniques.

The central calcifying odontogenic cyst (CCOC) is a rare lesion. This paper reports a new case, reviews the clinical, histomorphological and radiographic features reported in the literature and describes the CT and MRI features of this new case. We postulate that, as part of an evolutionary process, cystic COCs originate as unilocular lesions but may later become multilocular. The role of advanced imaging and histology in the diagnostic process are discussed.

Adult↗
PubMed1975

The calcifying odontogenic cyst. Eight new cases and a review of the literature.

Eight new cases of the calcifying odontogenic cyst have been reported. In addition, a review of the literature produced an additional sixty-five cases. This lesion can occur in any age group, but it shows a peak incidence in the second decade. It is evenly distributed between the maxilla and the manidible and occurs with equal frequency in males and females. There does not appear to be any race predilection. The calcifying odontogenic cyst may occur in association with other pathologic entities. It is postulated that it does not in every case represent a separate pathologic entity but that it may represent a secondary phenomenon which occurs within preexisting lesions.

Adult↗
PubMedDate not supplied

Calcifying odontogenic cyst associated with compound odontoma: a study on undemineralized material.

In a minority of cases of calcifying odontogenic cyst (COC) it is possible to observe the formation of dental hard tissues in the cyst wall. The use of undemineralized sections has allowed an evaluation of the mineralized tissues normally lost with the use of demineralizing agents. All the dental hard tissues presented a high degree of morpho- and histodifferentiation. The histochemical staining for calcium salts (von Kossa) showed the presence of areas of low mineralization in the portion of the lesion, where the tissue maturation was not complete. In conclusion the appearance of the dental hard tissues in this case of compound odontoma arising in the cyst wall of a COC is similar to that already described in compound odontoma not associated with COC.

Adult↗
PubMed2003

beta-Catenin is expressed aberrantly in tumors expressing shadow cells. Pilomatricoma, craniopharyngioma, and calcifying odontogenic cyst.

We studied the beta-catenin immunohistochemical profile in tumors expressing shadow cells: pilomatricoma, 10 cases; calcifying odontogenic cyst, 6 cases; and craniopharyngioma, 9 cases. There was strong membranous, cytoplasmic, and nuclear staining of the immature basaloid cells in all of these tumors. Shadow cells were negative in all tumors. It has been documented that rising levels of free beta-catenin drive the formation of complexes with T-cell factor/lymphoid enhancer factor (TCF-Lef) and up-regulate the wingless-Wnt cell-cell signals. The end result is an abnormality of beta-catenin degradation and, thus, a buildup of free beta-catenin in the cytoplasm and/or nucleus, resulting in the stimulation of cellular proliferation and/or inhibition of cell death. beta-Catenin seems to have an important role in the oncogenesis of these tumors. The similar pattern of keratinization in these tumors and the similar pattern of beta-catenin immunoreactivity in the cytoplasm and the nucleus are important findings. It seems that the activation of a common cellular pathway, namely Wnt-beta-catenin-TCF-Lef, has a role in the pathogenesis of these tumors. The latter could be related to their shared method of keratinization or shared dysfunction of the cellular adhesion complex leading to tumorigenesis.

Craniopharyngioma↗
PubMed1991

Peripheral (extraosseous) calcifying odontogenic cyst. A review of forty-five cases.

The peripheral calcifying odontogenic cyst (PCOC) is a rare lesion. The number of well-documented cases reported in the English-language literature until now is 38. The purpose of the present study is twofold: (1) to report seven new cases of PCOC and (2) to review and analyze the clinical and histomorphologic features of the previously reported cases of PCOC together with those of the present study. Most of the lesions were located in the maxillary and mandibular gingiva or alveolar mucosa anterior to the region of the first molar. Histologically, 66% of the lesions were of the cystic variant and 34% of the solid (neoplastic) variant. The terminology of the lesion and its histogenesis are discussed.

Aged↗