Glandular odontogenic cyst: report of an unusual case in the posterior mandible

The glandular odontogenic cyst (GOC) is an uncommon developmental cyst that presents glandular differentiation and has potential for recurrence. Clinically, it is asymptomatic and it has slow growing. This report proposes to describe a clinical case of GOC diagnosed at the Service of Pathological Anatomy of a university in the northeast of Brazil, in the posterior region of the mandible, which was treated with mandibular resection and bone graft with iliac crest. One may conclude that clinical, microscopic and radiographic parameters were crucial tools for treatment choice.

Key words:
diagnosis; mandibular reconstruction; graft survival

Authorship

Glória Maria França

Universidade Federal do Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil.Universidade Federal do Rio Grande do NorteBrazilNatal, Rio Grande do Norte, BrazilUniversidade Federal do Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil.

Camila Tatyanne S. Freitas

Luis F. Almeida Neto

Luiz Carlos Moreira Jr.

Petrus P Gomes

Hébel C. Galvão CORRESPONDING AUTHOR Hébel Cavalcanti Galvão, 0000-0002-1092-1992 e-mail: hebel.galvao@yahoo.com.br

https://orcid.org/0000-0002-1092-1992

CORRESPONDING AUTHOR Hébel Cavalcanti Galvão, 0000-0002-1092-1992 e-mail: hebel.galvao@yahoo.com.br

SCIMAGO INSTITUTIONS RANKINGS

Figures

Figures (4)

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FIGURE 1
Clinical and radiographic features of the case A) mandibular asymmetry; B) intraoral examination showing left mandibular increased volume with midline deviation and dental malocclusion; C) CT displaying cortical bone swelling; D) multilocular radiolucency, bone cortical expansion and tooth resorption in panoramic radiograph.

CT: computed tomography.

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FIGURE 2
Histopathology of GOC A) multiple cystic cavities (scale bar: 500 μm); B) squamous epithelial lining with flat interface and presence of cubic eosinophilic cells, referred to as hobnail cells (yellow arrow) (scale bar: 50 μm); simple epithelium and capsule with fibrous connective tissue (scale bar: 100 μm); D) microcystic spaces (star), goblet cells (blue arrow) and hobnail cells (yellow arrow) (scale bar: 50 μm); E) epithelium presenting papillary projections towards the cyst lumen (black arrow) (scale bar: 100 μm); F) cells with apocrine secretion (red arrow), microcystic spaces (star) and tuft-like papillary projections (scale bar: 100 μm).

GOC: glandular odontogenic cyst.

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FIGURE 3
GOC treatment plan A) mandible prototyping for surgical planning and adaptation of mandible reconstruction plate; B) intraoperative phase with hemimandibulectomy and insertion of iliac crest graft; C) sagittal section at a 3D-CT image; D) axial section showing the graft at a 3D-CT image; E) panoramic radiograph of the post-operative period.

GOC: glandular odontogenic cyst; CT: computed tomography.

Thumbnail

FIGURE 4
Six months after surgery A) slight asymmetry of the left hemiface; B) oral mucosa adjacent to graft with aspects of normality; C) panoramic radiograph showing bone formation.

FIGURE 1 Clinical and radiographic features of the case A) mandibular asymmetry; B) intraoral examination showing left mandibular increased volume with midline deviation and dental malocclusion; C) CT displaying cortical bone swelling; D) multilocular radiolucency, bone cortical expansion and tooth resorption in panoramic radiograph.
CT: computed tomography.

FIGURE 2 Histopathology of GOC A) multiple cystic cavities (scale bar: 500 μm); B) squamous epithelial lining with flat interface and presence of cubic eosinophilic cells, referred to as hobnail cells (yellow arrow) (scale bar: 50 μm); simple epithelium and capsule with fibrous connective tissue (scale bar: 100 μm); D) microcystic spaces (star), goblet cells (blue arrow) and hobnail cells (yellow arrow) (scale bar: 50 μm); E) epithelium presenting papillary projections towards the cyst lumen (black arrow) (scale bar: 100 μm); F) cells with apocrine secretion (red arrow), microcystic spaces (star) and tuft-like papillary projections (scale bar: 100 μm).
GOC: glandular odontogenic cyst.

FIGURE 3 GOC treatment plan A) mandible prototyping for surgical planning and adaptation of mandible reconstruction plate; B) intraoperative phase with hemimandibulectomy and insertion of iliac crest graft; C) sagittal section at a 3D-CT image; D) axial section showing the graft at a 3D-CT image; E) panoramic radiograph of the post-operative period.
GOC: glandular odontogenic cyst; CT: computed tomography.

FIGURE 4 Six months after surgery A) slight asymmetry of the left hemiface; B) oral mucosa adjacent to graft with aspects of normality; C) panoramic radiograph showing bone formation.

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Sociedade Brasileira de Patologia Clínica, Rua Dois de Dezembro,78/909 - Catete, CEP: 22220-040v - Rio de Janeiro - RJ, Tel.: +55 21 - 3077-1400 / 3077-1408, Fax.: +55 21 - 2205-3386 - Rio de Janeiro - RJ - Brazil
E-mail: jbpml@sbpc.org.br

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Glandular odontogenic cyst: report of an unusual case in the posterior mandible

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[1] CORRESPONDING AUTHOR Hébel Cavalcanti Galvão, 0000-0002-1092-1992 e-mail: hebel.galvao@yahoo.com.br