Keratocystic odontogenic tumour
|Keratocystic odontogenic tumour|
|Micrograph of a keratocystic odontogenic tumour. H&E stain.|
|Classification and external resources|
|ICD-10||D16.4 (Maxilla); D16.5 (mandible)|
A keratocystic odontogenic tumour (also keratocystic odontogenic tumor, KCOT) is a rare and benign but locally aggressive developmental cystic neoplasm. It most often affects the posterior mandible.
Signs and symptoms
KCOTs are thought to arise from the dental lamina and are associated with impacted teeth. Multiple odontogenic keratocysts are a feature of nevoid basal cell carcinoma syndrome. Odotogenic Keratocysts are derived from the remnants of the Dental Lamina.
On a CT scan, The radiodensity of a keratocystic odontogenic tumour is about 30 Hounsfield units, which is about the same as amelioblastomas. Yet, amelioblastomas show more bone expansion and seldom show high density areas.
As the condition is quite rare, opinions among experts about how to treat KCOTs differ.
- Wide (local) surgical excision.
- Marsupialization - the surgical opening of the (KCOT) cavity and a creation of a marsupial-like pouch, so that the cavity is in contact with the outside for an extended period, e.g. three months.
- Curettage (simple excision & scrape-out of cavity).
- Peripheral ostectomy after curettage and/or enucleation.
- Simple excision.
- Carnoy's solution - usually used in conjunction with excision.
- Enucleation and cryotherapy 
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