Abstract

The calcifying odotogenic cyst or the Gorlin cyst, now known in the WHO Classification of Tumours as the calcifying cystic odontogenic tumor, is a benign odontogenic tumor of cystic type most likely to affect the anterior areas of the jaws. It is most common in people in their second to third decades but can be seen at almost any age. On radiographs, the calcifying odontogenic cyst appears as a unilocular radiolucency (dark area). In one-third of cases, an impacted tooth is involved. Microscopically, there are many cells that are described as "ghost cells", enlarged eosinophilic epithelial cells without nuclei.

Presentation

frequency:- rare type of cyst

It can occur at any age, mostly between 2nd and 3rd decade of life.

Diameter is 2 to 4 cm

swelling pain maybe present.

intra bony expansions may produce hard bony expansion.

may perforate cortical bones

also it extends to soft tissue

maybe asymptomatic

Pathogenesis

Epithelial lining has ability to induce formation of dental tissues in adjacent c.t wall

Pathogenesis | Histopathology

In general, the epithelium seen is of stratified squamous type and is 2–3 cells thick. Additionally, focal areas of stellate reticulum like cells are seen and near the basement membrane ameloblast-like cells may be seen.

Each type of COC shows special features

Of three types:

1)Type 1A

Ghost cells plus dentinoid are seen

2)Type 1B

Formation of calcified tissues in the lumen of the cyst wall --> Dystrophic Calcification.

Proliferation of tissue similar to an Ameloblastic Fibroma.

3)Type 1C

Ameloblast like proliferation in the connective tissue and lumen of the cyst may be seen.

Diagnosis | Radiographic features

Unilocular radiolucency may be seen and mutilocular also, and mixed too .irregular calcifications may be seen in some cases.

Treatment

The standard treatment of COC is enucleation and curettage (E&C). Recurrence following E&C is rare.