CALCIFYING ODONTOGENIC CYST IN THE POSTERIOR MAXILLA INVOLVING THE MAXILLARY SINUS FLOOR: CASE REPORT AND NARRATIVE REVIEW OF THE LITERATURE
Keywords:
calcifying odontogenic cyst; Gorlin cyst; ghost cells; maxilla; case report; oral pathologyAbstract
DOI: https://doi.org/10.46296/yc.v10i18.0891
Abstract
Background: Calcifying odontogenic cyst (COC), also known as Gorlin cyst, is an uncommon odontogenic lesion characterized by odontogenic epithelium, ghost cells and calcifications. Its clinical and radiographic presentation may be heterogeneous, making preoperative diagnosis challenging, particularly when the lesion occurs outside its usual sites. Case presentation: A 44-year-old male patient presented with progressive swelling in the posterior left maxilla, mild intermittent pain and ipsilateral nasal obstruction. Cone-beam computed tomography showed a well-demarcated mixed unilocular intraosseous lesion with hyperdense foci, buccal cortical thinning and elevation of the maxillary sinus floor. Differential diagnoses included odontogenic keratocyst, calcifying epithelial odontogenic tumor, unicystic ameloblastoma and odontoma-associated odontogenic lesion. Intervention and outcome: Incisional biopsy suggested COC and complete enucleation with conservative peripheral curettage was performed while preserving the sinus membrane. Histopathology confirmed ameloblastoma-like odontogenic epithelium, abundant ghost cells, dystrophic calcifications and dentinoid material. At 12 months, no clinical or radiographic recurrence was observed and progressive bone healing was documented. Conclusion: Posterior maxillary COC involving the sinus floor is an unusual presentation that may mimic more common odontogenic lesions. Clinicoradiographic and histopathological correlation is essential to avoid under- or overtreatment.
Keywords: calcifying odontogenic cyst; Gorlin cyst; ghost cells; maxilla; case report; oral pathology.
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