Johnson Jessica, Scott Kristin, Bell Cynthia M
Main Street Veterinary Hospital and Dental Clinic, Flower Mound, TX.
Crown Veterinary Dental Specialists, Charlotte, NC.
J Vet Dent. 2022 Jun;39(2):182-193. doi: 10.1177/08987564221088726. Epub 2022 Mar 31.
This retrospective case series presents a unique group of odontogenic cysts that are lined by heavily keratinized epithelium and contain laminated keratin. Keratinized odontogenic cyst (KOC) is proposed as appropriate terminology for the described lesions. The series evaluates cysts from 29 dogs, including clinical presentation, diagnostic imaging, and histopathology. All 29 lesions occurred in tooth bearing regions of the jaws; 21 were maxillary and 8 were mandibular. These keratinized odontogenic cysts were unilocular or multilocular, and some demonstrated considerable expansion resulting in bone destruction. In 13 of 29 cases, there was evidence of tooth displacement associated with the expansion of the KOC. The KOCs did not have a distinctive radiographic appearance. 48% of the cysts had a soft tissue defect through which the keratin contents could be visualized. Cyst contents ranged from hard mineralized keratin to fluid consistency with soft flecks of keratin. The pathoetiology of KOCs is unknown; however, the biological behavior is benign and thought to be slowly progressive despite potential for locally destructive growth. Recurrence is uncommon when cyst enucleation and debridement are aggressive or when solid cysts are excised en bloc.
本回顾性病例系列展示了一组独特的牙源性囊肿，其内衬为高度角化上皮并含有板层状角蛋白。提出将角化牙源性囊肿（KOC）作为所描述病变的恰当术语。该系列评估了29只犬的囊肿，包括临床表现、诊断性影像学检查和组织病理学检查。所有29个病变均发生于颌骨的牙列区域；21个在上颌，8个在下颌。这些角化牙源性囊肿为单房或多房，有些显示出相当程度的膨胀，导致骨质破坏。在29例中的13例，有证据表明囊肿膨胀与牙齿移位有关。角化牙源性囊肿没有独特的放射影像学表现。48%的囊肿有软组织缺损，通过该缺损可观察到角蛋白内容物。囊肿内容物从坚硬矿化的角蛋白到含有柔软角蛋白碎片的液体状不等。角化牙源性囊肿的发病机制尚不清楚；然而，其生物学行为是良性的，尽管有局部破坏性生长的可能，但被认为是缓慢进展的。当囊肿摘除和清创积极或实体囊肿整块切除时，复发并不常见。
