Alsabbagh Rami, Speakman Gabriella, Wang Daren, Mallery Susan R, Tatakis Dimitris N
Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA.
Division of Oral and Maxillofacial Pathology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA.
Clin Adv Periodontics. 2024 Sep 28. doi: 10.1002/cap.10314.
Calcifying odontogenic cysts (Gorlin cysts) most commonly present centrally and have only rarely been reported in peripheral locations. The purpose of this report is to describe a new case of peripheral calcifying odontogenic cyst (PCOC) occurring in the anterior maxillary gingiva and to review the management and differential diagnosis of such a lesion.
A 37-year-old female presented with a long-standing submucosal nodule on the gingiva between the maxillary central incisors, with asymptomatic growth over the last three years. Following an initial incisional biopsy, a diagnosis of PCOC was established. To exclude the possibility of a central process, a corresponding small field of view cone beam CT scan was obtained and the patient returned for a 6 mm excisional biopsy to the depth of the periosteum.
Results of these additional assessments supported the original diagnosis of PCOC. Following uneventful healing of the second biopsy, no recurrence or other clinical findings were noted at 1-year follow-up.
While rare, the peripheral variant of calcifying odontogenic cyst, and other peripheral counterparts to recognized central cysts and tumors, should be considered in a differential diagnosis for a benign gingival nodule. Gingival tissue should be submitted for histologic evaluation to ensure a neoplastic process is not present.
Various lesions may present on the gingiva as a "bump"; these can represent common clinical entities, such as pyogenic granuloma, peripheral ossifying fibroma, peripheral giant cell granuloma, and fibroma, or more rare conditions that may not be adequately considered in the differential diagnosis. A rarely documented case of peripheral calcifying odontogenic cyst (PCOC; Gorlin cyst) on the maxillary anterior gingiva of an adult female is reported here and compared with the few other similar PCOC cases in the literature. A biopsy of gingival lesions is always necessary to establish the correct diagnosis and provide the appropriate treatment.
Several different lesions can appear on the gingiva (gums). Some are quite common, and some are rare. This report documents the occurrence of a new case of calcifying odontogenic cyst (Gorlin cyst), a type of cyst that has been rarely found outside the jawbone, presenting as a "bump" on the gingiva between the maxillary central incisor teeth of an adult female. Because of the patient history, a peripheral calcifying odontogenic cyst (PCOC) was not initially suspected. Following a biopsy, a PCOC diagnosis was given. The possibility of a lesion within the bone was then excluded by an X-ray (cone beam CT) scan examination. A second, more extensive biopsy confirmed the diagnosis and the removal of the lesion. The patient had no complications or recurrence for the following 12 months. This case highlights the need to always biopsy lesions presenting on the gums to obtain a proper diagnosis and provide the correct treatment.
牙源性钙化囊肿（戈林囊肿）最常见于颌骨中央，很少有外周发病的报道。本报告旨在描述一例发生于上颌前部牙龈的外周牙源性钙化囊肿（PCOC）新病例，并回顾此类病变的处理及鉴别诊断。
一名37岁女性，上颌中切牙间牙龈有一长期存在的黏膜下结节，过去三年无症状生长。初步切开活检后，确诊为PCOC。为排除中央性病变的可能，进行了相应的小视野锥形束CT扫描，并让患者再次接受手术，切除达骨膜深度的6mm组织进行活检。
这些额外评估结果支持PCOC的最初诊断。第二次活检顺利愈合后，1年随访未发现复发或其他临床症状。
虽然罕见，但牙源性钙化囊肿的外周型以及其他公认的中央性囊肿和肿瘤的外周对应病变，在鉴别诊断良性牙龈结节时应予以考虑。应提交牙龈组织进行组织学评估，以确保不存在肿瘤性病变。
多种病变可表现为牙龈上的“肿块”；这些病变可以是常见的临床病症，如化脓性肉芽肿、外周骨化性纤维瘤、外周巨细胞肉芽肿和纤维瘤，也可能是鉴别诊断中未充分考虑的罕见病症。本文报告了一例成年女性上颌前部牙龈罕见的外周牙源性钙化囊肿（PCOC；戈林囊肿）病例，并与文献中其他少数类似的PCOC病例进行了比较。牙龈病变活检对于明确诊断和提供恰当治疗始终是必要的。
牙龈上可出现几种不同的病变。有些很常见，有些则很罕见。本报告记录了一例牙源性钙化囊肿（戈林囊肿）新病例，这种囊肿在颌骨外很少见，表现为一名成年女性上颌中切牙间牙龈上的“肿块”。由于患者病史，最初未怀疑是外周牙源性钙化囊肿（PCOC）。活检后，确诊为PCOC。然后通过X线（锥形束CT）扫描检查排除了骨内病变的可能性。第二次更广泛的活检证实了诊断并切除了病变。患者在接下来的12个月内无并发症或复发。该病例强调了对牙龈上出现的病变始终进行活检以获得正确诊断并提供正确治疗的必要性。
