Difference between revisions of "Keratocystic odontogenic tumour"

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Keratocystic odontogenic tumour (view source)

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{{ Infobox diagnosis
#redirect [[Odontogenic keratocyst]]
| Name      = {{PAGENAME}}
| Image      = Keratocystic_odontogenic_tumour_-_intermed_mag.jpg
| Width      =
| Caption    = Keratocystic odontogenic tumour. [[H&E stain]].
| Synonyms  = odontogenic keratocyst (old term)
| Micro      = stratified epithelium with "ribbon-like appearance" with palisaded basal cell layer, parakeratosis, artefactual separation of epithelium from the basement membrane
| Subtypes  =
| LMDDx      = odontogenic cyst ([[dentigerous cyst]]), [[squamous cell carcinoma]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = usually mandible - see ''[[odontogenic tumours and cysts]]''
| Assdx      =
| Syndromes  = [[nevoid basal cell carcinoma syndrome]]
| Clinicalhx =
| Signs      = mass lesion
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  =
| Other      =
| ClinDDx    = [[ameloblastoma]]
| Tx        =
}}
{{ Infobox external links
| Name            = {{PAGENAME}}
| EHVSC          = 10179
| EHVSC_mult      = {{EHVSC2|10178}}
| pathprotocols  =
| wikipedia      = keratocystic odontogenic tumour
| pathoutlines    = {{Pathologyoutlines|topic/mandiblemaxillakeratocyst}}
| rosaicollection = 14023
}}
'''Keratocystic odontogenic tumour''', abbreviated '''KOT''', is an uncommon [[Odontogenic tumours and cysts|odontogenic tumour]].
 
It was previously known as '''odontogenic keratocyst''', abbreviated '''OKC'''.<ref name=pmid18353202>{{Cite journal  | last1 = Madras | first1 = J. | last2 = Lapointe | first2 = H. | title = Keratocystic odontogenic tumour: reclassification of the odontogenic keratocyst from cyst to tumour. | journal = J Can Dent Assoc | volume = 74 | issue = 2 | pages = 165-165h | month = Mar | year = 2008 | doi =  | PMID = 18353202 }}</ref>
==General==
*May be associated with ''[[nevoid basal cell carcinoma syndrome]]''.
*Very rarely transforms to a [[squamous cell carcinoma]].<ref name=pmid21493332>{{Cite journal  | last1 = Lee | first1 = JW. | last2 = Gates | first2 = R. | last3 = Wignall | first3 = A. | title = Squamous cell carcinoma arising from a keratocystic odontogenic tumor. | journal = Otolaryngol Head Neck Surg | volume = 145 | issue = 2 | pages = 356-7 | month = Aug | year = 2011 | doi = 10.1177/0194599811399270 | PMID = 21493332 }}</ref><ref name=pmid23374486>{{Cite journal  | last1 = Tan | first1 = B. | last2 = Yan | first2 = TS. | last3 = Shermin | first3 = L. | last4 = Teck | first4 = KC. | last5 = Yoke | first5 = PC. | last6 = Goh | first6 = C. | last7 = Balakrishnan | first7 = A. | title = Malignant transformation of keratocystic odontogenic tumor: Two case reports. | journal = Am J Otolaryngol | volume = 34 | issue = 4 | pages = 357-61 | month =  | year =  | doi = 10.1016/j.amjoto.2013.01.002 | PMID = 23374486 }}</ref>
 
===Clinical===
Features:<ref name=pmid17928730>{{Cite journal  | last1 = Habibi | first1 = A. | last2 = Saghravanian | first2 = N. | last3 = Habibi | first3 = M. | last4 = Mellati | first4 = E. | last5 = Habibi | first5 = M. | title = Keratocystic odontogenic tumor: a 10-year retrospective study of 83 cases in an Iranian population. | journal = J Oral Sci | volume = 49 | issue = 3 | pages = 229-35 | month = Sep | year = 2007 | doi =  | PMID = 17928730 }}</ref>
*Most common presentation: swelling.
 
==Gross==
*Location: usually mandible.
*May mimic [[ameloblastoma]] radiologically.
 
==Microscopic==
Features: <ref>Thompson LDR. Head and neck pathology - (Foundations in diagnostic pathology). Goldblum JR, Ed.. Churchill Livingstone. 2006. ISBN 0-443-06960-3.</ref>
*Stratified epithelium (resembling squamous epithelium) with:
**"Ribbon-like appearance" - '''important'''.
***Typically 8-10 cell layers thick - with relatively uniform thickness.
***Lacks rete ridges. 
**Palisaded basal cell layer.
*Parakeratosis (keratinized cells with nuclei) - '''key feature'''.
*Artefactual separation of epithelium from the basement membrane.
 
DDx:
*Odontogenic cyst.
**Orthokeratinized odontogenic cyst<ref name=pmid21062939>{{Cite journal  | last1 = Macdonald-Jankowski | first1 = DS. | title = Orthokeratinized odontogenic cyst: a systematic review. | journal = Dentomaxillofac Radiol | volume = 39 | issue = 8 | pages = 455-67 | month = Dec | year = 2010 | doi = 10.1259/dmfr/19728573 | PMID =  }}</ref> - usu. [[dentigerous cyst]] - has [[orthokeratosis]] instead of [[parakeratosis]].
***Orthokeratosis = keratinized cells no nuclei; parakeratosis = keratinized cell with nuclei.
 
===Images===
<gallery>
Image:Keratocystic_odontogenic_tumour_-_2_-_intermed_mag.jpg | KOT - intermed. mag. (WC)
Image:Keratocystic_odontogenic_tumour_-_2_-_very_high_mag.jpg | KOT - very high mag. (WC)
Image:Keratocystic_odontogenic_tumour_-_intermed_mag.jpg KOT - another case - intermed. mag. (WC)]
Image:Keratocystic_odontogenic_tumour1.jpg | KOT - poor quality. (WC)
Image:Keratocystic_odontogenic_tumour2.jpg | KOT - showing artefactual clefting - poor quality. (WC)
</gallery>
www:
*[http://ars.els-cdn.com/content/image/1-s2.0-S0968605305000992-gr5.jpg KOT (els-cdn.com)].<ref>URL: [http://www.sciencedirect.com/science/article/pii/S0968605305000992#fig5 http://www.sciencedirect.com/science/article/pii/S0968605305000992#fig5]. Accessed on: 11 March 2013.</ref>
 
==See also==
*[[Odontogenic tumours and cysts]].
*[[Head and neck pathology]].
 
==References==
{{Reflist|2}}
 
[[Category:Diagnosis]]
[[Category:Odontogenic tumours and cysts]]
Michael
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