"Because of its intrinsic characteristics consistent with neoplasms, the odontogenic keratocyst has joined the group of benign odontogenic tumors in 2005 and renamed keratocystic odontogenic tumor (KOT). The main characteristics of this pathology include: aggressive behavior, autonomous growth, high recurrence rate and, sometimes, silent clinical manifestation of lesions to large size. These peculiarities, combined with their frequency, delay diagnosis, prognosis and limited treatment difficult. This study aims to present a case of atypical KOT emphasizing its solvability without surgical intervention or invasive procedures, and comparing its clinical, radiological and histopathological characteristics and therapeutic alternatives to those described in the literature. The most common treatment for KOT is enucleation followed by curettage, but its friable nature, associated with a fibrous connective tissue with thin, hinders its complete removal. In large lesions, it has been chosen by marsupialization followed by enucleation. The advantages of this technique are the thickness of the capsule, the reduction in lesion size and, therefore, easy and complete removal lower recurrence rate. Due to the characteristics of this injury, it deserves special attention, since successful treatment depends on accurate diagnosis, an appropriate surgical procedure and an appropriate and periodic radiographic preservation, in order to prevent the appearance of new lesions in the area.
The KOT has some peculiarities such as the friable nature of the capsule and the epithelium, high proliferative activity, aggressive behavior and high recurrence rates. Therefore, it deserves special attention, once early and precise diagnosis is the basis for the success of any therapy. As for the treatment, marsupialization must be performed in case of large cystic lesions, in order to reduce tumor volume and recurrence rates. However, patient adherence to periodic radiographic follow-up is essential to therapeutic success.
Last date updated on September, 2020