Perplexity & uniqueness of the Calcifying Odontogenic Cyst (COC) type 1c: A case report

Meenal Verma , Nikhil Verma , Shallu Bansal , Dewin Arnold
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Abstract

Calcifying odontogenic cysts (COCs) are rare developmental odontogenic cystic lesions, accounting for < 1% of all odontogenic cysts. First described by Gorlin in 1962, it usually affects the anterior jaw segments. Owing to its considerable diverse histopathologic presentations and biological behaviour, the true nature of this lesion has been long debated. The “dualistic” concept & classification proposed by Praetorius et al. categorises it into two entities: a cyst & a neoplasm. Its infamous association with other odontogenic tumors has been well established but less frequently reported. We document a case report of massive COC type 1c in the posterior mandible of a 58-year-old patient, evolving over a period of 5 months. Enucleation followed by histopathologic evaluation led to the diagnosis of COC Type 1c. Patient is asymptomatic & is under follow up. We emphasise that COCs may remain asymptomatic or may clinicoradiographically simulate other more common jaw pathologies, thus a meticulous knowledge of its enigmatic histological variants plays a crucial role in definitive diagnosis & better treatment outcome.

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牙源性钙化囊肿(COC)1c 型的复杂性和独特性:病例报告
牙源性钙化囊肿(COCs)是一种罕见的发育性牙源性囊肿病变,占所有牙源性囊肿的 1%。它由Gorlin于1962年首次描述,通常累及颌骨前段。由于其组织病理学表现和生物学行为多种多样,这种病变的真正性质一直存在争议。Praetorius 等人提出的 "二元 "概念和分类法将其分为两个实体:囊肿和肿瘤。它与其他牙源性肿瘤的恶性关联已被证实,但报道较少。我们记录了一份病例报告,一名 58 岁的患者下颌骨后部出现了 1c 型大面积 COC,病程长达 5 个月。经过去核和组织病理学评估,确诊为 COC 1c 型。患者目前无症状,正在接受随访。我们强调,COC 可能没有症状,也可能在临床放射影像学上模拟其他更常见的颌骨病变,因此对其神秘的组织学变异的细致了解对明确诊断和更好的治疗效果起着至关重要的作用。
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