J Korean Assoc Oral Maxillofac Surg.  2016 Oct;42(5):315-320. 10.5125/jkaoms.2016.42.5.315.

Conservative approach to recurrent calcifying cystic odontogenic tumor occupying the maxillary sinus: a case report

• Kim Y
• Choi BE
• Ko SO

• KMID: 2356260
• DOI: http://doi.org/10.5125/jkaoms.2016.42.5.315

Abstract

Calcifying cystic odontogenic tumor (CCOT) is an uncommon benign cystic neoplasm of the jaw that develops from the odontogenic epithelium. Invasion into the maxillary sinus by a CCOT is not a typical, and the recurrence of the cystic variant of CCOT in the posterior maxilla is rare. This report describes a recurrent CCOT occupying most of the maxillary sinus of a 24-year-old male patient. As a treatment, marsupialization was carried out as a means of decompression, and the involved teeth were all endodontically treated. Afterward, surgical enucleation was performed. The size of the lesion continued to shrink after marsupialization, and the maxillary sinus restored its volume. This patient has been followed-up for 3 years after the surgery, and there have not been any signs of recurrence.

Keyword

Calcifying odontogenic cyst; Calcifying cystic odontogenic tumor; Marsupialization

MeSH Terms

Decompression
Epithelium
Humans
Jaw
Male
Maxilla
Maxillary Sinus*
Odontogenic Cyst, Calcifying
Odontogenic Tumors*
Recurrence
Tooth
Young Adult

Figure

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  Fig. 1 Computed tomography shows recurrence of the lesion after the first functional endoscopic sinus surgery (FESS) procedure. A. Expansile cyst-like lesion at the first visit. B. A recurrent lesion two years after the first FESS.

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  Fig. 2 When the patient was referred to our department, three years after the second functional endoscopic sinus surgery procedure, he showed recurrence in the same region. A. A panoramic radiograph revealing the large extension of unilocular radiolucency in the left maxilla. B. Computed tomography scan showing a large lesion in the left maxillary sinus expanding up to the inferior orbital floor and projecting into the nasal cavity.

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  Fig. 3 A. Cyst marsupialization and placement of an acrylic tube for drainage. B. Five months computed tomography (CT) image after the endodontic treatment and marsupialization. C. Cone-beam CT scan showing the regressed lesion and new bone deposition around the lesion.

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  Fig. 4 Surgical removal of the lesion through enucleation.

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  Fig. 5 Histopathologic examination revealing the presence of several ghost cells within the cyst lining and dystrophic calcification (arrow, ghost cell; arrow head, calcifying dentinoid material; H&E staining, ×200).

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  Fig. 6 Postoperative panoramic view and computed tomography showing the reduced size of the lesion without any recurrences. A. Six months postoperative. B. Thirty-six months postoperative.

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