Kerathocyst Odontogenic Tumor: Importance of Selection the Best Treatment Modality and A Periodical Follow-up to Prevent from Recurrence: A Case Report and Literature Review
A 22-year-old male presented to the clinic of oral and maxillofacial radiology of Isfahan dental school for evaluation of a gradually enlarging hard mass in the right mandible on January, 2013. He reported that the swelling had gradually increased in size over a period of 2 years. He has not any other symptoms such as pain, drainage and neurosensory deficit associated with right inferior alveolar nerve. He has a history of surgery on the right side of the mandible at molar region due to the KCOT in this region 5 years ago with the size of 2.5 × 2.5 cm. Unfortunately, all the patient previous documents except the pathological report were lost.\nClinical evaluation showed a slight swelling along all the right mandibular body, second premolar and first molar teeth in this region were extracted. The cone beam computed tomography was performed by Gallileos unit (Sirona dental systems GmbH, Germany, Hessen, Bensheim) with slice thickness and slice interval of 2 mm. Evaluation of coronal, axial and cross-sectional views exhibits a large multilocular radiolucency from the angle of mandible to the symphysis [].\nThe lesion expands the inferior border of the mandible and displaced the inferior alveolar canal inferiorly [].\nIn the right parasymphis region, the buccal cortical plate of the mandible was perforated in some regions [].\nFinally, due to the patient's past history and radiological findings, the temporary diagnosis was recurrence of KCOT that was proved by incisional biopsy and the patient referred for surgical treatment. Surgical resection of the right side of the mandible from an angle to the right parasymphis region was done under the general anesthesia and reconstruction with autologous graft was done. The histhopathologic examination confirmed the diagnosis of recurrent KCOT [.