Calcifying Odontogenic Cyst

Etiology • An odontogenic cyst with characteristic microscopic pattern • May be noted in association with other odontogenic tumors • Origin is residual odontogenic epithelium in the jaws; stimulus
unknown
Clinical Presentation • Usually a unilocular, well-defined radiolucency, chiefly of maxilla • Scattered opacities seen in up to 50% of cases • May be associated with the crown of an unerupted tooth • An extraosseous form may occur (usually anterior to first molar) • May be more solid than cystic (odontogenic ghost cell tumor)
Radiographic Findings • Well-defined radiolucency or lucency with opaque foci (dystrophic calcification of keratin produced by lining epithelium) • Tooth displacement or root resorption may be seen.

Diagnosis • Stratified squamous lining with prominent basal layer • Budding or extension of epithelium into the cyst wall may be
noted. • Characteristic ghost cell keratinization required for diagnosis • Ghost cells may undergo dystrophic calcification. • Foreign body reaction may occur when ghost cells come in
contact with connective tissue. • The solid or tumorous form shares microscopic features with
ameloblastoma.
Differential Diagnosis: Radiographic • Calcifying epithelial odontogenic tumor • Ossifying fibroma • Ameloblastic fibro-odontoma Treatment • Enucleation/excision • If noted in association with another odontogenic tumor, con-
sideration must be given to the behavior of the accompanying lesion.
Prognosis • Some recurrence potential, especially in association with solid
lesions • Overall prognosis is very good • Excellent prognosis for peripheral (gingival) lesions