Radiographic features of recurrent glandular odontogenic cysts

Introduction

We present a case series of recurrent glandular odontogenic cysts (rGOC), a rare, aggressive odontogenic cyst seen commonly in the anterior mandible of middle-aged women with reported recurrence rates of 22%. Some of the histologic features present in GOCs are nonspecific and may be present in other odontogenic cysts (e.g. mucous cells, apocrine snouting, ciliating, multiple compartments). Our objective is to analyze the radiographic features of rGOCs from our institution.

Study Design

The University of Pittsburgh Pathology archives were searched for rGOCs (1993-2022). In total, 265 glandular odontogenic cysts were diagnosed with a recurrence rate of 2.3%. We reviewed the pathology reports and available imaging for the clinicopathologic features of our recurrent cases and paired primary cases, when available.

Results

We assembled a series of 6 patients with 7 rGOCs, with one patient having 2 recurrences. Average time to recurrence was 10.7 years (range 2.3-22.6 years), with a mean age at initial diagnosis of 50.3 years (range 24-69) and no sex predilection (male:female 1:1). All cases presented in the anterior gnathic region with an even jaw distribution (maxilla:mandible 1:1).

Radiographic descriptions were available on all cases. Primary radiology was available for review in 3 cases. The mean size (greatest dimension) was 2.5 cm (range 1.0-4.0 cm). Lesions were multilocular, associated with the periapex of the teeth. Other features observed included root resorption, perforation of the cortex, and tooth displacement.

Conclusions

In our single institution experience, rGOC are most common in the anterior gnathic region with lower recurrence rates than stated in the literature. Given the overlapping histologic features used criteria for the diagnosis of GOC, radiographic correlation may be important in the diagnosis of equivocal odontogenic cysts with GOC-like features.