A retrospective study of 220 cases of keratocystic odontogenic tumor (KCOT) in 181 patients

Odontogenic keratocyst is one of the most aggressive odontogenic cyst due to its relatively high recurrence rate, fast growth, and its tendency to invade adjacent tissue. The aim of the present study is to analyze retrospectively the clinico-pathological characteristics of the 220 KCOTs cases in 181 and find the relationship among the various factors. And the following data were obtained: patient age ranged from 8 to 77 years with an average of 33.06 years. There were 111 male and 70 female patients. The mandibular angle and ascending ramus was the most frequent site of KCOTs. Swelling, the most presenting sign, was noted in 97 cases, followed by the pain, 85 cases, and 78 cases showed no presenting signs and symptoms. On radiologic findings, the primary KCOTs appeared as a unilocular in 59 cases or multilocular in 39 cases. The KCOTs can achieve the size of which may vary from 1.0 cm to 13.0 cm, and the mean size was 4.07 cm. The KCOTs were associated with the displacement of impacted teeth, the mandibular third molar; 47 cases, was the most frequent impacted teeth. Four patients (2.21%) were confirmed to be associated with nevoid basal cell carcinoma syndrome. Enucleation or curettage was the most common employed treatment modality (164 cases), followed by marsupialization or decompression (17 cases), and lateral decortication (13 cases). The recurrence rate was 10.78%. Most of the recurrences (21 cases) were found during the first 5 years after the first treatment for the KCOTs.