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HISTOPATHOLOGY SECTION - BRIEF COMMUNICATION Table of Contents   
Year : 2008  |  Volume : 51  |  Issue : 1  |  Page : 83-84
Sebaceous differentiation in odontogenic keratocyst


Department of Oral Pathology and Microbiology, Government Dental College, Calicut 673008, Kerala, India

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   Abstract 

Sebaceous glands are common in the oral mucosa, but are not normally present with in the jaws. A case of an odontogenic keratocyst with sebaceous glands in the epithelium in a 12-year-old child is presented here, with special emphasis on its histogenesis.

Keywords: Mandible, odontogenic keratocyst, sebaceous differentiation

How to cite this article:
Shamim T, Varghese V I, Shameena P M, Sudha S. Sebaceous differentiation in odontogenic keratocyst. Indian J Pathol Microbiol 2008;51:83-4

How to cite this URL:
Shamim T, Varghese V I, Shameena P M, Sudha S. Sebaceous differentiation in odontogenic keratocyst. Indian J Pathol Microbiol [serial online] 2008 [cited 2020 Oct 21];51:83-4. Available from: https://www.ijpmonline.org/text.asp?2008/51/1/83/40410



   Introduction Top


Sebaceous glands are dermal adnexal structures aberrantly associated with odontogenic cysts. Hofrath, Gorlin, and Spouge [1],[2],[3] documented the occurrence of sebaceous glands in dentigerous cyst. Brannon [4] in his extensive review of 312 odontogenic keratocysts, makes mention of three cases that contained sebaceous glands. Here we report a case of odontogenic keratocyst with sebaceous differentiation in a 12-year-old girl.


   Case History Top


A female patient aged 12 years reported to Government Dental College, Calicut with a complaint of swelling on right lower half of face of 2 months duration. Extraoral examination revealed an oval swelling of size 2 x 2 cm involving the right lower border of mandible. The swelling was bony hard and nontender.

The swelling was found to extend from middle of ramus to body of mandible and vertically from alveolus to lower border of mandible and lingually from distal to right permanent mandibular first molar to the angle of mandible.

Radiological examination by orthopantomograph (OPG) revealed biloculated radiolucency on right side of mandible extending from mesial of permanent first molar to the middle of the ramus with inferior displacement of permanent second molar and superior displacement of permanent third molar [Figure - 1].

A provisional diagnosis of odontogenic keratocyst or odontogenic tumor was made. All routine lab investigations followed by fine needle aspiration cytology (FNAC) were done. The lesion was surgically excised and on surgical exploration, a glistening cheesy material was found. Specimen was subjected for histopathological examination and a diagnosis of odontogenic keratocyst with sebaceous differentiation was given. The postoperative period was uneventful and every month follow-up for 5-year period was advised for the patient.

Pathological findings

Microscopically, the lesion showed parakeratinized epithelium with palisading basal cell layer. The epithelium was thicker in the regions of sebaceous tissue [Figure - 2]. Sebaceous tissue was scattered along the length of the lining, either in contact with or immediately subjacent to it, opening into the cyst cavity. The epithelial lining was thrown up into folds. The epithelium connective tissue interface was flat and was seen separated at some areas [Figure - 3]. A diagnosis of odontogenic keratocyst with sebaceous differentiation was given.


   Discussion Top


The interpretation of this cyst as an odontogenic keratocyst with sebaceous differentiation needs documentation. Most cases of intraosseous jaw cysts with sebaceous differentiation were tooth associated, usually presenting clinically as dentigerous cysts. The pleuripotentiality of the epithelium has been well documented by Eversole, [5] but well-formed adnexal structures other than sebaceous glands arising from odontogenic epithelium have not been conclusively demonstrated. The interaction of oral epithelium, whether from dental lamina rests or surface epithelium with oral mesenchymal tissues has been insufficiently studied. It seems reasonable to postulate that some factors in the oral mesenchyme could interact with epithelium of almost any source to produce wide variability in structure and potential of the affected epithelium. The multipotentiality of the oral epithelium may be secondary to the influence of the mesenchyme, resulting in the differentiation of sebaceous glands in odontogenic cysts. Most authors [6],[7] believe that odontogenic keratocyst arises from dental lamina rests, while others have speculated an origin from surface epithelium or hamartomatous proliferations of odontogenic epithelium. [8]

The histologic features of the present case were similar to those described by other authors. [9],[10] Adnexal structures other than sebaceous gland was absent in the lining epithelium and connective tissue. Thus we can exclude dermoid and epidermoid cysts.

To conclude, it is important to note that odontogenic keratocyst with sebaceous differentiation do occur and must be separated from other dermoid and epidermoid cysts in a clinical and histological differential diagnosis. We also believe that this variant should be considered as a separate entity.

 
   References Top

1.Hofrath H. Uber das vorkommen Von Talgdrussen in der Wandung einer Zahncyste, Zugelich ein Beitrag zur Pathogenese der kiefer-Zahncysten, Dtsch Monatsschr. Zahn heilkd. 1930;2:65-76.  Back to cited text no. 1    
2.Gorlin RJ. Potentialities of oral epithelium manifest by mandibular dentigerous cysts. Oral Surg 1957;10:271-84.  Back to cited text no. 2  [PUBMED]  
3.Spouge JD. Sebaceous metaplasia in the oral cavity occurring in association with dentigerous cyst epithelium. Oral Surg 1966;21:492-8.  Back to cited text no. 3  [PUBMED]  
4.Brannon RB. The odontogenic keratocyst: a clinicopathologic study of 312 cases. Part II. Histologic features. Oral Surg 1977;43:233-55.  Back to cited text no. 4    
5.Eversole LR, Sabes WR, Rovin S. Aggressive growth and neoplastic potential of odontogenic cysts: with special reference to central epidermoid and mucoepidermoid carcinomas. Cancer 1975;35:270-82.  Back to cited text no. 5  [PUBMED]  
6.Toller PA. Newer concepts of odontogenic cysts. Int J Oral Surg 1973;1:3-16.  Back to cited text no. 6    
7.Brown RM. The pathogenesis of odontogenic cysts: a review. J Oral Pathol 1975;4:31-46.  Back to cited text no. 7    
8.Stoelinga PJW. Etiology and pathogenesis of keratocysts. Oral Maxillofac Surg Clin North Am 2003;15:317-24.  Back to cited text no. 8    
9.Craig GT, Holland CS, Hindle MO. Dermoid cyst of the mandible. Br J Oral Surg 1980;18:230-7.  Back to cited text no. 9  [PUBMED]  
10.Christensen RL, Propper RH. Intraosseous mandibular cyst with sebaceous differentiation. Oral Surg 1982;53:591-5.  Back to cited text no. 10    

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Correspondence Address:
T Shamim
Shangrila, Parappanangadi - 676 303
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0377-4929.40410

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    Figures

  [Figure - 1], [Figure - 2], [Figure - 3]



 

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    Abstract
    Introduction
    Case History
    Discussion
    References
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