Odontogenic Keratocyst or Mimickers: Highlighting the Importance of Excisional Biopsy

Abstract

Odontogenic keratocyst (OKC) is a odontogenic cyst characterized by its aggressive behavior and high recurrence rate. OKC typically presents as a unilocular lesion, however bilateral or multiple OKCs can be present. Usually they are often associated with bifid-rib basal cell nevus syndrome (Gorlin syndrome). Many a times when these lesions are associated with impacted tooth , they mimic Dentigerous cyst or when associated with nonvital tooth they mimic radicular cyst. Radiographically when lesion is multilocoular it can mimic Ameloblastoma, central giant cell granuloma. When multiple cyst present, possibility of Gorlin Goltz Syndrome should be ruled out. Thus such lesions need through clinical, radiographic and histopathological evaluation. Sometimes incisional biopsy can be inconclusive in certain cases. Hence histopathological evaluation of excisonoal biopsy remains a gold standard. This case series includes 5 cases of mimickers of OKC on clinical, radiographic and histopathological assessment of incisional biopsy. Histopathological characterstics of OKC was met by excisional biopsy for final diagnosis.