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calcifying odontogenic cyst

Wednesday 8 September 2004

Gorlin cyst, calcifying odontogenic cyst (COC) , keratinizing and calcifying odontogenic cyst


Definition: Calcifying odontogenic cyst may vary from a simple central bony, thin epithelial lined cyst to a complex focally solid tumor-like mass.

See also : Calcifying cystic odontogenic tumor (CCOT) is preferred 2005 WHO terminology > calcifying odontogenic tumor


- Calcifying odontogenic cyst (COC / CCOT)

Variants may be a neoplasm with cystic degeneration. They may occur in any tooth bearing site but most often in the posterior mandible. There is no gender predilection and the lesion has been diagnosed in patients under 10 and over 80. Clinically they may present as a firm but asymptomatic expansion of the buccal cortical plate. Radiographically they may be unilocular or multilocular.

Varying amounts of radio-opaque material can be seen, depending on the amount of mineralization. Calcifying odontogenic cysts histologically may be cystic, multicystic or solid.

They can show a stratified squamous epithelium with a well defined basal layer consisting of cuboidal or columnar cells.

Ghost cells similar to those found in pilomatricoma are seen.

In addition mineralization resembling dentin or cementum may be seen.

These lesions are treated with conservative surgical excision and the recurrence rates are very low.


- somatic mutations of CTNNB1 coding for the cadherin-associated protein beta-catenin (14578169)

Differential diagnosis

- central jaw lesion with basal palisading of epithelium

  • COC
  • COC in combination with second tumor
  • ameloblastoma
  • keratocystic odontogenic tumor
    -dentinogenic ghost cell tumor/carcinoma
    - odontogenic cyst or tumor, NOS

- ghost cells identified, unknown anatomic location:

  • COC
  • dentinogenic ghost cell tumor
  • ghost cell odontogenic carcinoma: infiltrative and exhibits mitotic activity, nuclear atypia, and/or necrosis.
  • odontom
  • ameloblastic fibro-odontoma
    -* pilomatrixoma
  • matrical carcinoma
  • craniopharyngioma

See also

-  odontogenic cysts
- odontogenic tumors