Indian Journal of Pathology and Microbiology

: 2008  |  Volume : 51  |  Issue : 1  |  Page : 83--84

Sebaceous differentiation in odontogenic keratocyst

T Shamim, V Ipe Varghese, PM Shameena, S Sudha 
 Department of Oral Pathology and Microbiology, Government Dental College, Calicut 673008, Kerala, India

Correspondence Address:
T Shamim
Shangrila, Parappanangadi - 676 303


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.

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;51:83-84

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 2022 Dec 6 ];51:83-84
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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

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.


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.


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