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Intraosseous and extraosseous calcifying odontogenic cyst (Gorlin cyst).

This retrospective study of 15 central and five peripheral calcifying odontogenic cysts (COCs) was undertaken to compare the characteristics of these two lesions. The data reveal that the central COCs were more common than peripheral lesions by a 3:1 ratio and that they were usually diagnosed in the second decade of life, whereas the peripheral ones were usually noted after the age of 50. Seven of the 15 central COCs (47%) were associated with odontomas, and three (20%) with dentigerous cysts. Conservative enucleation or excision was the treatment of choice.

Adolescent↗

Calcifying odontogenic cysts: co-expression of intermediate filament proteins, and immunohistochemical distribution of keratins, involucrin, and filaggrin.

The epithelia lining the cyst of five cases of calcifying odontogenic cyst (COC) were evaluated immunohistochemically with the use of monoclonal antibodies (MoAb's) against keratin (PKK1, KL1, K4.62, K8.12) and vimentin, and polyclonal antisera agonist involucrin and filaggrin. Epithelial lining of COC was classified into 1) thin squamous-cell epithelium, 2) ameloblastoma-like, and 3) thin or 4) thick calcifying odontogenic epithelium. Foci consisting of ghost cells or calcified cells were categorized as calcifying epithelial odontogenic tumor (CEOT). Thin squamous-cell epithelium reacted with PKK1, KL1, K4.62, K8.12, and anti-vimentin MoAb's, thus demonstrating the co-expression of keratin and vimentin. Ameloblastoma-like cells showed positive staining with PKK1, KL1, and sometimes with anti-vimentin. Thick calcifying odontogenic epithelial lining showed stratification of cell layers, and the most strikingly reactive zone was the upper intermediate layer, which showed the presence of keratin, involucrin, and a small amount of filaggrin. Cells of this layer might be the most differentiated type of cells in COC. Undifferentiated odontogenic cells of COC masses were characterized by co-expression of keratin and vimentin, and by the absence of involucrin and filaggrin. All ghost cells were devoid of any immunostaining except for filaggrin, which was rarely positive, but eosinophilic or basophilic cells surrounding the ghost cells showed intense staining for all keratin proteins except vimentin.

Adolescent↗

Odontoma-producing intraosseous calcifying odontogenic cyst: case report.

The present report describes a case of odontoma-producing intraosseous calcifying odontogenic cyst in a 36-year-old Black male in the right mandibular bicuspid region. The lesion involved an unerupted permanent canine, which was displaced to the mandible base and a calcified mass that was later recognized as an odontoma. The lesion was surgically removed.

Adult↗

[Calcifying odontogenic cyst: apropos of 5 cases].

With reference to 5 personal cases involving the mandible 3 times and the lower gum twice, the authors recall the principal characteristics of calcified odontogenic cysts: very little clinical manifestation frequently limited to simple tumefaction, well bounded radiological image with low density, cyst with an epithelial border comprized of calcification and ghost cells. Calcified odontogenic cysts which have a definite morphological likeness to Malherbe's epithelioma, also have the same benigh course as the latter.

Adolescent↗

Simultaneous occurrence of a calcifying odontogenic cyst and its malignant transformation.

The authors report a 48-year-old woman with a lesion in the maxilla, where a typical calcifying odontogenic cyst and a malignant tumor occurred simultaneously. She was diagnosed as having a malignant calcifying odontogenic cyst (tumor). The patient died of intracranial extension 20 months after diagnosis. Metastases were not detected.

Cell Transformation, Neoplastic↗

The central (intraosseous) calcifying odontogenic cyst: an analysis of 215 cases.

This study reviews and analyzes the clinical, radiographic, and histomorphologic features of the 215 cases of central calcifying odontogenic cyst (CCOC) reported in the literature. Based on the present information, a clinicopathologic classification of calcifying odontogenic cyst is proposed. The CCOC is also compared with its peripheral counterpart and the differences discussed.

Adolescent↗

An ultrastructural study of the calcifications in calcifying odontogenic cysts and odontomas.

The calcifications associated with the epithelium of the calcifying odontogenic cyst and odontoma were studied ultrastructurally and found to be of three types: (1) spherical calcifications which form on ghost cells and which therefore are dystrophic, (2) spherical calcifications which appear to be dysplastic enamel, and (3) irregularly shaped, diffuse calcifications which form on a collagenous matrix and appear to by dysplastic dentin or cementum.

Calcinosis↗

Calcifying odontogenic cyst with ameloblastic fibro-odontome: one lesion or two?

The calcifying odontogenic cyst is unusual in that it is frequently found in conjunction with the histologic features of a variety of other odontogenic conditions. Two cases are reported, one of which contained areas histologically similar to the ameloblastic fibro-odontome and also showed condensations of cells in the stroma beneath epithelial strands proliferating from the cyst lining. In both cases the "ghost cells" stained strongly for disulphide groups but only occasional areas were positive for sulphydryl groups. No amyloid or "amyloid-like" material was detected. As no part of the current name is specific to this lesion it is suggested that the nomenclature should be changed--perhaps to "ghost cell dyst".

Adult↗

Histological variation of the lining epithelium of the calcifying odontogenic cyst. A light microscopic study.

The lining epithelium of thirty cases of calcifying odontogenic cysts (COC) was studied light microscopically. Results show two distinct types: 1. the classical highly-differentiated lining epithelium characterised by a basal layer of columnar cells with nuclear polarisation supporting suprabasally several layers of stellate reticulum-like cells and containing variable amount of ghost cells present in all the cases and a necessary criteria for the diagnosis of COC; 2. the undifferentiated lining epithelium which is of 2-3 cells to 5-8 cells thick, non-, para- or orthokeratinised and resembled reduced enamel epithelium. This is seen in some cases in some parts of the cystic lining. Variations within the highly-differentiated epithelium include spindle-cell change, epithelial pearl formation and ghost cell dominant type. In the present series, ten cases were associated with odontome formation, three with melanin pigment and one with clear cells. The study supports the concept that COC are lesions of odontogenic origin that may arise as primary lesions from the remains of the dental epithelium or secondarily from the lining epithelium of pre-existing lesions.

Adolescent↗

The calcifying odontogenic cyst: report of case.

A 14-year-old black girl with a calcifying odontogenic cyst that resembled a cystic compound odontoma radiographically was examined and treated. The clinical, radiographic, and histologic picture presented by the lesion and its treatment were discussed.

Adolescent↗

Calcifying odontogenic cyst: radiologic findings in 11 cases.

OBJECTIVE: This retrospective study examines the relationship between histopathologically diagnosed cases of in calcifying odontogenic cysts (COCs) on the adjacent dentition. STUDY DESIGN: The records including diagnostic radiograph images of 11 patients treated for COCs from 1991 to 2004 were analyzed and correlations made between radiologic and histopathologic features. Special attention was applied to the associations between COCs and adjacent teeth. RESULTS: Radiologic and histopathologic features of the 11 lesions were variable, with some lesions being more solid and others more cystic. Calcifications varied from small flecks to solid calcified areas of frank odontoma. In 7 cases, the COC was associated with an impacted tooth and 5 of these cases involved COC-enveloping teeth. All cases excepting one in an edentulous jaw segment showed positional changes of adjacent teeth, including impaction. CONCLUSIONS: The radiographical features of COCs are varied but there is a high frequency of changes in adjacent teeth, including dental impaction. The presence of impaction or displacement of teeth for COCs occurring in the posterior segments of the jaw, and absence of this finding for anteriorly placed lesions may be indicative of the timing of COC development.

Adolescent↗

[Expression of nuclear factor-kappaB, Ki-67 and matrix metalloproteinase-9 in calcifying odontogenic cyst].

OBJECTIVE: To evaluate the expression of nuclear factor-kappaB (NF-kappaB), Ki-67 and matrix metalloproteinase-9 (MMP-9) in calcifying odontogenic cyst (COC), in order to investigate the proliferation and invasion of COC. METHODS: Twenty-six cases of COC were classified into calcifying cystic odontogenic tumor (CCOT), dentinogenic ghost cell tumor (DGCT) and ghost cell odontogenic carcinoma (GCOC) based on the WHO classification of odontogenic tumors in 2005. The specimens of COC and 10 classic ameloblastoma (AB) were examined immunohistochemically to determine the expression of NF-kappaB p65, Ki-67 and MMP-9. RESULTS: NF-kappaB was mainly detected in the cytoplasm of most tumor cells, but was only detected in the nucleus of few tumor cells (rate of nuclear staining < 1%). The expression of Ki-67 was significantly higher in GCOC than in CCOT (P < 0.001), DGCT (P < 0.05) and AB (P < 0.005). MMP-9 was detected both in tumor cells and stromal cells. GCOC showed significantly higher percentage of MMP-9 positive cases in stromal cells than CCOT, DGCT and AB (P < 0.05). CONCLUSIONS: NF-kappaB may minimally affect the progression and invasion of COC. GCOC shows significantly higher proliferative activity and aggressiveness than CCOT and DGCT. MMP-9 in stroma may play a key role in the invasion of GCOC.

Humans↗