Glandular odontogenic cysts: Diagnosis and treatment

doi:10.1016/S1079-2104(05)80101-5

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology

Volume 79, Issue 5, May 1995, Pages 593-602

https://doi.org/10.1016/S1079-2104(05)80101-5 Get rights and content

Four cases of glandular odontogenic cyst are reported. Review of these and 13 previously reported cases indicatesthat they present as slowly growing, painless, radiolucent swellings with a predilection for the anterior part of the mandible. An incisional biopsy is essential to establish a definitive preoperative diagnosis. The unpredictable and potentially aggressive nature of these lesions is suggested by their extensive nature, penetration of cortical bone, locally invasive potential, and high incidence of recurrence after conservative treatment. In view of this behavior we suggest en bloc excision and primary reconstruction to ensure cure and reduce the operative morbidity.

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An ambiguous asymptomatic swelling in the maxillary anterior region - A case report
2016, International Journal of Surgery Case Reports
Citation Excerpt :
Ficarra et al., proposed the treatment of GOC as complete enucleation and fixation of the surrounding bone with Carnoy’s solution [14]. According to Hussain et al. it was local en bloc excision with primary reconstruction because of its aggressive nature and tendency for recurrence [15]. Bhatt et al. proposed that conservative treatment is enough for GOC [16].
Glandular odontogenic cyst is a rare and recently recognized type of developmental odontogenic cyst. Being odontogenic in origin, because of the pluripotentiality of the odontogenic epithelium it can show glandular or salivary features.
A 46 year old female patient was referred to the Oral and Maxillofacial Surgery department with chief complaint of painless swelling in the right anterior region of maxilla, radiographically associated with teeth 12, 13. Mucosa over the swelling was slightly bluish in colour and no associated palatal swelling was seen. No incidence of trauma was reported and involved teeth were not mobile.
Although we have many differential diagnoses, our working diagnosis was a periapical cyst, so conventional treatment of root canal treatment, cyst enucleation, and apicoectomy was planned.
Here we present a case which was initially misdiagnosed and mismanaged but on subsequent histopathologic examination revealed the final diagnosis.
Glandular odontogenic cyst arising in the posterior region of the mandible
2014, Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology
Glandular odontogenic cyst (GOC) is a rare, benign, cystic lesion of the jaws, which occurs mostly in the mandible, especially in the anterior region. The histogenesis of GOC remains uncertain and the World Health Organization classified the lesion as a developmental odontogenic epithelial cyst in 1992. In this article, we describe a rare case of GOC arising in the posterior region of the mandible in a 64-year-old male and also present the clinical, radiological and histopathological features of GOC. Radiological examination revealed a solitary well-defined unilocular radiolucent lesion in the left mandibular posterior region. The lesion was clinically diagnosed as radicular cyst associated with the left first molar. The cystic lesion was enucleated from the jaw bone in one piece and tooth extraction was performed under general anesthesia. The surgical specimen was investigated histopathologically and was diagnosed as GOC. Due to the high recurrence rate of GOC, complete removal of the cystic lesion and careful clinical and radiological follow-up are important. In the present case, a panoramic radiograph was taken after 19 months of follow-up, which revealed complete healing of the involved site with no evidence of recurrence.
Maxillary reconstruction with bone transport distraction and implants after partial maxillectomy
2013, Journal of Oral and Maxillofacial Surgery
Citation Excerpt :
Recurrence, which ranges from 29% to 55%,4 is thought to be due to the thin capsule, presence of microcysts that can make complete removal a challenging task19 and invasion through medullar spaces.15,26 Therefore, recurrence is related not only to the biology of the lesion, but also to the type of treatment chosen.11,15,18 This observation played a key role in the shift noted during the mid- to late-2000s toward the more radical methods that are in vogue today.4,9,12,16,18,19
Maxillary and mandibular bone defects can result from injury, congenital defect, or accident, or as a consequence of surgical procedures when treating pathology or defects affecting jaw bones. The glandular odontogenic cyst is an infrequent type of odontogenic cyst that can leave a bony defect after being treated by aggressive surgical means. First described in 1987 by Padayachee and Van Wyk, it is a potentially aggressive entity, having a predisposition to recur when treated conservatively, with only 111 cases having been reported hitherto. Most reports emphasize its clinical, radiographic, and histologic features, including a few considerations on rehabilitation for these patients. The aim of this article is to present the case of a 24-year-old male patient who, in 2001, was diagnosed with a glandular odontogenic cyst and to focus on the surgical approach and rehabilitation scheme. We performed an anterior partial maxillectomy. The osseous defect was treated using bone transport distraction. Dental and occlusal rehabilitation was achieved with titanium implants over transported bone and an implant-supported overdenture. A 9-year follow-up shows no evidence of recurrence of the pathology, adequate shape and amount of bone, functional occlusal and dental rehabilitation, and patient's satisfaction.
Treatment of mandibular glandular odontogenic cyst with immediate reconstruction: Case report and 5-year follow-up
2010, British Journal of Oral and Maxillofacial Surgery
Citation Excerpt :
Its size may vary.4 Radiographically it is a bony, unilocular, or more commonly multilocular, radiolucent lesion with well-defined limits.2,6–10 A 37-year-old white man was referred with a swelling on the labial aspect of his right mandibular body.
Anterior Mandibular Swelling
2010, Journal of Oral and Maxillofacial Surgery
Citation Excerpt :
Recurrence rates appear to correlate with the treatment modality used, ranging from 29% to 55%, and conservative methods such enucleation and curettage have been found to be commonly associated with recurrent disease.9,21 Hussain et al25 suggested local en bloc excision with primary reconstruction in view of the high recurrence rate associated with conservative treatment of these cysts and their invasive potential. For the choice of the best treatment, Kaplan et al18 in a review of 56 cases suggested that some characteristics of this lesion have to be considered and evaluated so that one can choose the more suitable surgical technique, diminishing the propensity for recurrence.
Odontogenic cysts and tumors
2009, Diagnostic Surgical Pathology of the Head and Neck: Expert Consult - Online and Print

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^a: Department of Oral and Maxillofacial Surgery, Dental Hospitaland School.

View full text

Glandular odontogenic cysts: Diagnosis and treatment

J Oral Maxillofac Surg

Int J Oral Maxillofac Surg

J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol

Two cystic lesions with features of both the botryoid odontogenic cyst and the central mucoepidermoid tumour: sialo-odontogenic cyst

J Oral Pathol

The glandular odontogenic cyst: an apparent entity

J Oral Pathol

The histomorphological specimen of the gingival cyst in the adult

Oral Surg Oral Med Oral Pathol