Odontogenic keratocyst in Jamaica: a review of five new cases and five instances of recurrence together with comparative analyses of four treatment modalities.

AIM

Five new cases of odontogenic keratocyst (OKC) together with five instances of recurrence are reviewed with special emphasis on radiology and surgical management. A comparative analysis offour different treatment modalities used in the treatment of OKC in these patients (new and recurrent cases) is reported.

SUBJECTS AND METHODS

The case notes and radiographs ofpatients who had histological confirmation of OKC at both the Cornwall Regional Hospital and Kingston Public Hospital in Jamaica were reviewed for demographics, radiological presentation, treatment modalities and outcome of treatment. Cases of recurrence were separated from new cases. This study was conducted for the period 1980 to 2004.

RESULTS

Five new cases and five instances of recurrence were documented over the 25-year period The new cases of OKC keratocyst accounted for 1.71% of the total jaw bone tumours and 12% of OKC keratocysts over the first 16 years. The posterior mandible appears to be the most favoured site. Of significance, one case of nevoid basal cell carcinoma syndrome (NBCCS) and a case of ameloblastomatous transformation in the wall of an OKC keratocyst were recorded The age range of the new cases was 12 to 44 years.

CONCLUSION

The radiological finding from this review is similar to previous reports. However the authors record a unique and historic case of ameloblastomatous transformation of OKC. A case of OKC in NBCCS is also documented Of all four surgical treatment modalities compared, only cryosurgery was promising, so far with no recurrence after a follow-up period of six years.