Surgical conservative approach of odontogenic keratocyst tumor of the jaws

BACKGROUND: Odontogenic keratocyst (OKC) can be classified as an oral lesion representing the third most common cyst of the jaws characterized by a high rate of recurrence. OKC was accepted as a neoplastic lesion in the 2005 WHO classification and it was called keratocystic odontogenic tumor (KCOT). However, in the 2017 classification of odontogenic tumors, OKC was moved back into the cyst category. This study aimed to evaluate clinically, radiographically and through the histological examination, the healing of a patient with OKC who underwent surgery with a marsupialization approach. METHODS: A 83-year-old female patient, presented deformation of the right hemi-mandibular region and paresthesia of the right hemi-labium. During intraoral examination it was possible to detect an eggshell crackle on palpation of the anterior edentulous mandible; moreover, the patient reported a growth of the lesion over time that prevented her from using the removable prosthesis. At the OPT it was possible to appreciate a unilocular area that extended from the parasymphyseal region to the right hemi-mandible. The CT scan showed massive erosion that only partially spared the lower cortex and involvement of the mental foramen. RESULTS: Checks following surgery show healing also confirmed by instrumental check-ups. CONCLUSIONS: Surely this study offers a valid alternative to more invasive and debilitating surgical treatments.