Keratocystic odontogenic tumor: Case report, treatment review and future diagnostic trends

Odontogenic keratocyst (OKC, currently designated by the World Health Organization as a keratocystic odontogenic tumor) is a locally aggressive, cystic jaw lesion with a putative high-growth potential and a propensity for recurrence. Although it is generally agreed that some features of OKCs are those of a neoplasia, notably the relatively high proliferative rate of epithelial cells, controversies over the behavior and management of OKCs still exist. Although the question of whether the OKC is a cyst or a neoplasm is yet to be answered with certainty, recent advances in genetic and molecular research i.e. PTCH1 mutations and involvement of the Hedgehog signaling pathway have a facilitated better understanding of its pathogenesis, hinting at potential novel treatment options. While some surgeons suggest a more conservative approach to treating OKCs, notably marsupialization and decompression, future treatment strategies focus on molecular approaches that may eventually reduce or eliminate the need for aggressive surgical intervention. In addition to describing a case that was managed conservatively, we review the treatment of odontogenic keratocyst, briefly discussing recent trends that help make diagnosis and therapy more specific and effective.