SERCAN KÜÇÜKKURT, HÜSEYİN CAN TÜKEL, EMRE BARIŞ

A giant mandibular dentigerous cyst associated with a compound odontoma: A case report

Odontoma is a non-aggressive ectomesenchymal tumor of unknown origin that are more considered developmental malformations (hamartomas) than benign neoplasms. Dentigerous cyst is an epithelium-lined sac enclosing the crown of an unerupted tooth. Occasionally, the dentigerous cyst is associated with odontoma. Dentigerous cysts that have not been noticed for a long time can reach huge sizes due to effect of their asymptomatic structure. A 53-year-old male referred to our department with swelling on his right mandibular region. Clinical and radiographic examination revealed an extensive radiolucency extending from left second premolar to right angle of mandibula. Previously marsupialization of the cyst was tried from two different location. However, as a result of the failure of the process the patient was referred to our department. Enucleation of the cyst with odontoma was done under local anesthesia with sedation. Also associated teeth were extracted which have periodontal problems and mobility. At the 2 years of follow up, there was a complete healing in cyst region and no recurrence. Histopathological examination revealed a dentigerous cyst associated with an odontoma that is because there was no any other unerupted tooth. The association of a huge dentigerous cyst with a compound odontoma makes this case rare and interesting.

Mandibulada kompound odontoma ile ilişkili dev bir dentigeröz kist: Bir olgu sunumu

Odontoma, benign neoplazmadan daha çok gelişimsel malformasyon (hamartom) olarak kabul edilen agresif olmayan ektomezenkimal bir tümör çeşididir. Dentigeröz kistler, sürmemiş bir diş kronuna eşlik eden iyi huylu odontojen kaynaklı kistlerdir. Dentigeröz kistlerin nadiren de odontoma ile ilişkili olduğu bilinmektedir. Dentigeröz kistler uzun süre fark edilmezlerse, asemptomatik yapılarının etkisiyle büyük boyutlara ulaşabilirler. 53 yaşındaki bir erkek hasta sağ mandibular bölgede şişlik ile kliniğimize başvurdu. Klinik ve radyografik incelemelerde, sol ikinci premolar dişten mandibulanın sağ angulus bölgesine uzanan geniş bir radyolusent alan saptandı. Daha önce kistin tedavisi amacıyla iki farklı noktadan marsupyalizasyon işleminin denendiği ancak işlemin radyolusent sahada herhangi bir küçülme ya da iyileşmeye sebep olmadığına karar verilmesinin ardından hasta tarafımıza yönlendirildiği öğrenildi. Odontoma ile kistin enükleasyonu lokal anestezi ile derin sedasyon yardımıyla yapıldı. Ayrıca bölgedeki periodontal sorunlar ve mobilite gösteren dişler hastanın ilgili dişlere önerilen tedavi seçeneklerini reddetmesi üzerine çekildi. 2 yıllık takipte, kist bölgesindeki tam bir iyileşme gözlendi, nüks belirtisine rastlanmadı. Histopatolojik tanı, bölgede sürmemiş başka bir dişin de var olmamasına dayanarak odontoma ile ilişkili dentigeröz kist olarak konuldu. Bu vakada nadir görülen, kompound odontoma ile ilişkili dev boyutta dentigeröz kist olgusu rapor edilmektedir.

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Astekar M, Manjunatha BS, Kaur P, Singh J. Histopathological insight of complex odontoma associated with a dentigerous cyst. BMJ Case Rep 2014; 2014.

Wanjari SP, Tekade SA, Parwani RN, Managutti SA. Dentigerous cyst associated with multiple complex composite odontomas. Contemp Clin Dent 2011; 2: 215-217.

Soluk Tekkesin M, Pehlivan S, Olgac V, Aksakalli N, Alatli C. Clinical and histopathological investigation of odontomas: review of the literature and presentation of 160 cases. J Oral Maxillofac Surg 2012; 70: 1358-1361.

Serra-Serra G, Berini-Aytes L, Gay-Escoda C. Erupted odontomas: a report of three cases and review of the literature. Med Oral Patol Oral Cir Bucal 2009; 14: E299-303.

Costa V, Caris AR, Leon JE, Ramos CJ, Jardini V, Kaminagakura E. Cystic Odontoma in a Patient with Hodgkin's Lymphoma. Case Rep Dent 2015; 2015: 292819.

Kalaskar RR, Kalaskar AR, Pol CA, Ghige SK. Cystic compound odontome in the anterior maxilla: A rare case report. Indian J Oral Sci 2012; 3: 168-171.

Ikeshima A, Tamura Y. Differential diagnosis between dentigerous cyst and benign tumor with an embedded tooth. J Oral Sci 2002; 44: 13-17.

Moosvi Z, Tayaar SA, Kumar GS. Neoplastic potential of odontogenic cysts. Contemp Clin Dent 2011; 2: 106-109.

Arunkumar KV, Vijaykumar, Garg N. Surgical management of an erupted complex odontoma occupying maxillary sinus. Ann Maxillofac Surg 2012; 2: 86-89.

Yildirim-Oz G, Tosun G, Kiziloglu D, Durmus E, Sener Y. An unusual association of odontomas with primary teeth. Eur J Dent 2007; 1: 45-49.

Hitchin AD. The aetiology of the calcified composite odontomes. Br Dent J 1971; 130: 475-482.

Ragalli CC, Ferreria JL, Blasco F. Large erupting complex odontoma. Int J Oral Maxillofac Surg 2000; 29: 373-374.

Perumal CJ, Mohamed A, Singh A, Noffke CE. Sequestrating giant complex odontoma: a case report and review of the literature. J Maxillofac Oral Surg 2013; 12: 480-484.

Phillips MD, Closmann JJ, Baus MR, Torske KR, Williams SB. Hybrid odontogenic tumor with features of ameloblastic fibro-odontoma, calcifying odontogenic cyst, and adenomatoid odontogenic tumor: a case report and review of the literature. J Oral Maxillofac Surg 2010; 68: 470-474.

Philipsen HP, Reichart PA, Praetorius F. Mixed odontogenic tumours and odontomas. Considerations on interrelationship. Review of the literature and presentation of 134 new cases of odontomas. Oral Oncol 1997; 33: 86- 99.

Araki M, Kameoka S, Matsumoto N, Komiyama K. Usefulness of cone beam computed tomography for odontogenic myxoma. Dentomaxillofac Radiol 2007; 36: 423- 427.

Quereshy FA, Savell TA, Palomo JM. Applications of cone beam computed tomography in the practice of oral and maxillofacial surgery. J Oral Maxillofac Surg 2008; 66: 791-796.

Marques YM, Botelho TD, Xavier FC, Rangel AL, Rege IC, Mantesso A. Importance of cone beam computed tomography for diagnosis of calcifying cystic odontogenic tumour associated to odontoma. Report of a case. Med Oral Patol Oral Cir Bucal 2010; 15: e490-493.