The botryoid odontogenic cyst. Report of a case and review of the literature.

The botryoid odontogenic cyst is a morphologic variant of developmental cysts of odontogenic epithelial residue, i.e., lateral periodontal cysts and gingival cysts. Such variants have distinctive clinical and histologic characteristics, including a lobular appearance in situ, multiple cystic spaces lined by thin, nonkeratinized epithelium with focal plaque-like thickenings and occasional glycogen-rich clear cells. Lateral periodontal cysts most likely arise from rests of Malassez, while gingival cysts certainly arise from rests of Serres. When cortical perforation occurs, the origin of the cyst may be determined on the basis of the pattern of bone resorption. The term botryoid odontogenic cyst should be reserved for those developmental cysts of odontogenic epithelial residue that have a grossly lobulated appearance in addition to characteristic histomorphologic features. Its use should be restricted to the gross and histopathologic description rather than as a modifier of the definitive diagnosis. A botryoid variant of a gingival cyst with cortical perforation is presented.