Page 21 - GP Spring 2025

ically, periapical cysts often present as References: 11. Ruddocks LA, Fitzpatrick SG, Bhattacharyya
well-defined, unilocular, radiolucent lesions 1. Neville BW, Damm DD, Allen CM, Chi AC. I, Cohen DM, Islam MN. Calcifying epithelial
at the apex of a non-vital tooth. Howev- Oral and maxillofacial pathology. Fifth edition. odontogenic tumor: a case series spanning 25
1, 3
years and review of the literature. Oral Surg Oral
ed. St. Louis, Missouri: Elsevier; 2023.
er, there have been rare cases of mixed ra- 2. Gorlin RJ, Pindborg JJ, Odont, Clausen FP, Med Oral Pathol Oral Radiol 2021;131(6):684-
diopaque, radiolucent lesions. 12, 13 In case Vickers RA. The calcifying odontogenic cyst- 93.
reports by Krithika et al and Ramos-Pe- -a possible analogue of the cutaneous calcify- 12. Krithika C, Kota S, Gopal KS, Koteeswaran
rez et al, a patient with a maxillary swell- ing epithelioma of Malherbe. An analysis of D. Mixed periapical lesion: differential di-
ing which radiographically presented as a fifteen cases. Oral Surg Oral Med Oral Pathol agnosis of a case. Dentomaxillofac Radiol
2011;40(3):191-4.
1962;15:1235-43.
mixed periapical lesion, was microscopi- 3. Wright, JM, Tekkesin MS. WHO classifica- 13. Ramos-Perez FM, Pontual Ados A, Franca
cally diagnosed as a radicular cyst. 12, 13 The tion of head and neck tumours. Lyon, France: TR, et al. Mixed periapical lesion: an atypical
cyst lining of a periapical inflammatory cyst International Agency for Research on Cancer radicular cyst with extensive calcifications. Braz
is composed of stratified squamous epithe- (IARC); 2022. Dent J 2014;25(5):447-50.
lium overlying inflamed fibrous connective 4. Ledesma-Montes C, Gorlin RJ, Shear M, et
al. International collaborative study on ghost cell
tissue. 1, 3, 7 As these cysts age, dystrophic odontogenic tumours: calcifying cystic odonto-
calcifications, some of which create central genic tumour, dentinogenic ghost cell tumour and Dr. Arthi Kumar is a Dip-
luminal radiopacities, may form. 12, 13 Dys- ghost cell odontogenic carcinoma. J Oral Pathol lomate, American Board
trophic calcifications are the precipitation Med 2008;37(5):302-8. of Oral and Maxillofa-
of calcium in primary sites of inflammation 5. Wright JM, Vered M. Update from the 5th cial Pathology and is a
Edition of the World Health Organization Classi-
or infection. 1, 12, 13 This subtype of calcifica- fication of Head and Neck Tumours: Odontogen- Clinical Assistant Profes-
tion forms from degenerating, diseased, and ic and Maxillofacial Bone Tumors. Head Neck sor, Department of Oral
dead tissue, despite normal serum calcium Pathol 2022 Mar;16(1):63-75. & Maxillofacial Pathology, Radiology
and phosphate levels. The treatment for a 6. Li TJ, Yu SF. Clinicopathologic spectrum of the & Medicine at New York University
12
periapical cyst is extraction of the associat- so-called calcifying odontogenic cysts: a study of College of Dentistry. Her email address is
21 intraosseous cases with reconsideration of the
ed tooth or endodontic therapy. In our case, terminology and classification. Am J Surg Pathol Kumara16@nyu.edu.
due to the vitality of teeth #21-#25, and the 2003;27(3):372-84.
final histopathologic findings, an inflamma- 7. Bilodeau EA, Collins BM. Odontogen-
tory periapical cyst was ruled out. ic Cysts and Neoplasms. Surg Pathol Clin
2017;10(1):177-222.
CONCLUSIONS: 8. More CB, Das S, Gupta S, Bhavsar K. Man-
dibular adenomatoid odontogenic tumor: Ra-
The COC is a rare odontogenic pathology diographic and pathologic correlation. J Nat Sci
presenting a diagnostic challenge as a result Biol Med 2013;4(2):457-62.
of varying clinical and radiographic pre- 9. Philipsen HP, Reichart PA, Siar CH, et al. An
sentations. A review of possible differential updated clinical and epidemiological profile of
diagnoses for a mixed lesion in the gnathic the adenomatoid odontogenic tumour: a collab-
orative retrospective study. J Oral Pathol Med
bones was presented with associated rele- 2007;36(7):383-93.
vant details. In conclusion, the unique his- 10. Philipsen HP, Reichart PA. Calcifying epithe-
topathologic features of each entity confirm lial odontogenic tumour: biological profile based
the importance of microscopic examination on 181 cases from the literature. Oral Oncol
in rendering a final diagnosis for ultimate 2000;36(1):17-26.
case management.

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