Wu Ruo-Yi, Shao Zhe, Wu Tian-Fu
The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan 430072, Hubei Province, China.
World J Clin Cases. 2019 Jul 6;7(13):1686-1695. doi: 10.12998/wjcc.v7.i13.1686.
Orthokeratinized odontogenic cyst (OOC) is a benign odontogenic cyst. It is a variant of the common odontogenic keratocyst (OKC). This case report describes a rare malignant transformation of OOC, with the aim of raising awareness of the malignant potential of OOC and distinguishing it from OKC.
In August 2018, a 52-year-old man was referred to the Department of Oral Maxillofacial and Head-Neck Oncology of Wuhan University. The patient presented with severe pain in the left mandible for 2 mo, and had a 5-year history of osteomyelitis and mandibular cyst with three recurrences. His latest diagnosis by pathological examination was OOC of the left mandible with mild-to-moderate local proliferation. However, the cyst showed malignant potential by radiographic examination. We performed partial mandibulectomy and sent the lesion tissue for pathological examination. As expected, the cyst had deteriorated to moderately differentiated squamous cell carcinoma. During postoperative follow-up, the patient went for chemotherapy in September 2018 and successfully completed four cycles.
Surgeons should be more aware of OOC, which is usually benign but can become malignant.
正角化牙源性囊肿（OOC）是一种良性牙源性囊肿。它是常见牙源性角化囊肿（OKC）的一种变体。本病例报告描述了一例罕见的OOC恶性转化，旨在提高对OOC恶性潜能的认识，并将其与OKC相鉴别。
2018年8月，一名52岁男性被转诊至武汉大学口腔颌面-头颈肿瘤科。患者左下颌骨剧痛2个月，有骨髓炎和下颌囊肿病史5年，复发3次。其最新病理检查诊断为左下颌骨OOC伴轻至中度局部增生。然而，影像学检查显示该囊肿具有恶性潜能。我们实施了部分下颌骨切除术，并将病变组织送去做病理检查。不出所料，囊肿已恶变为中分化鳞状细胞癌。术后随访期间，患者于2018年9月接受化疗并成功完成4个周期。
外科医生应更多地了解OOC，其通常为良性，但可能恶变。
