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• adults - rare
Lateral periodontal cyst
• uncommon cyst beside vital tooth
• from nests of Malassez ?
• mandibular premolars
• Mi: thin squamous epithelium + plaque-like
thickenings with clear cells (glycogen)
Lateral periodontal cyst
- variants
• botryoid odontogenic cyst
– multilocular variant of LPC
– lower P and C, may occupy major parts of jaw, > 50
years
– Mi: multilocular cyst with fibrous septa
squamous epithelium + clear cells (glycogen)
– recurrence (20 %)
Glandular odontogenic cyst
(sialo-odontogenic)
– multilocular cyst
– Mi: complex squamous epithelium ~ LPC and
BOC + mucous cells + intraepithelial glandular
spaces
– recurrence (30-50 %)
– diff. dg.: intraosseous mucoepidermoid
carcinoma
Odontogenic cysts
• WHO classification 2005 WHO 2017
• odontogenic keratocyst
keratocystic odontogenic tumor
odontogenic keratocyst
• Orthokeratotic cyst
– rare
– RTG: monolocular cyst
– Mi: orthokeratotic layer
– recurrence 4 %
Calcifying odontogenic cyst
• = Gorlin´s cyst
• M ~ F, ~ 5 - 92Y
• mandible ~ maxilla, incisor-cuspid area, gingiva
• Mi: cyst lined by ameloblastic epithelium
ghost cells calcification
dentin
• recurrence (5 %)
• sometimes association with ameloblastoma
• treatment: enucleation
Odontogenic cysts
• RTG diff. dg. of jaw radiolucency
– anatomical structures (maxillary sinus, foramina)
– odontogenic cysts
– odontogenic tumors, part. ameloblastoma
– giant cell granuloma / cherubism
• wall thickenings
– cholesterol clefts + granulomas
– carcinoma
– ameloblastoma
Odontogenic cysts
• daily biopsy practice
• nonspecific findings – inflammation !!!
• x odontogenic keratocyst
• x calcifying odontogenic cyst
• x unicystic ameloblastoma
• x other cystic tumors
Nasopalatine duct cyst
• uncommon, often asymptomatic
• from nasopalatine duct epithelium
• midline of palate
• position variants (to incisive canal)
– nasopalatine
– palatine papilla
– median alveolar
• Mi: squamous + respiratory epithelium
wall: mucous glands + neurovascular bundle
• enucleation
Nasolabial cyst
• = Klestadt´s, nasoalveolar
• very uncommon
• middle-aged females
• from remnants of nasolacrimal duct
• in soft tissue deep in nasolabial fold
• excision
Surgical ciliated cyst
• maxilla
• site of injury or operation (incl. extraction)
• Caldwell-Luc surgery
• cyst lining = mucosa of maxillary sinus
• respiratory epithelium
• enucleation
Cysts of soft tissues
• thyroglossal duct cyst
• lymphoepithelial cyst
• lingual dermoid
• mucocele
Thyroglossal duct cyst
• uncommon
• from remnants of any part of thyroglossal duct
• early age
• swelling in midline of mouth (foramen caecum) or
neck
• Mi: squamous + respiratory epithelium
wall: thyroid tissue, chronic inflammation
• removal + part of hyoid bone
Lymphoepithelial cyst
• branchiogenic cyst ???
• cystic change of epithelium entrapped in LN
• early age
• lateral part of neck + mandible angle + parotid
• soft swelling
• fistula to skin / oral cavity / pharynx
• Mi: squamous + respiratory epithelium
wall: dense lymphoid tissue + germ centres
• enucleation
• diff. dg.: cystic metastasis of SCC !!!
Sublingual dermoid
• developmental anomaly of branchial arches or
pharyngeal pouches
• between hyoid and jaws or beneath tongue
• no symptoms
• Mi: epidermoid cyst – NO dermal appendages
dermoid cyst – dermal appendages
• dissection
Mucoceles
minor salivary glands
lower lip
• superficial, 1 cm swellings
• extravasation type – damage of duct
– saliva leak inflammation + mucophages
– NO epithelium mucofagic granuloma
• retention type – obstruction of duct
– epithelium of dilated duct
Mucoceles
• ranula (Lat. “small frog“)
= mucocele of submandibular or sublingual
gland
• unilateral painless swelling, 2-3 cm
• floor of mouth