Management of an extensive calcifying odontogenic cyst in the maxilla of a young patient: a case report

Authors

DOI:

https://doi.org/10.5327/2525-5711.411

Keywords:

Calcifying odontogenic cyst, Odontogenic cysts, Conservative treatment

Abstract

The calcifying odontogenic cyst (COC) is a rare developmental lesion with variable clinical behavior, representing less than 1% of all odontogenic cysts. Its management can be challenging but typically involves enucleation and curettage. This case report aims to describe the clinical, radiographic, histopathological findings, and therapeutic approach used in the treatment of a maxillary COC in a young patient. A 19-year-old female patient presented with a complaint of progressive, asymptomatic swelling on the right side of her face, with a 12-month history. Extraoral examination revealed obliteration of the nasolabial fold and facial asymmetry in the right malar region. Intraoral examination showed a noticeable swelling in the right maxillary vestibule. Cone-beam computed tomography revealed a unilocular, hypodense lesion surrounding the crown of the impacted maxillary canine (tooth 13) and extending to the periapical region of adjacent teeth. An incisional biopsy confirmed the diagnosis of calcifying odontogenic cyst. Initial marsupialization was performed for one year, followed by complete enucleation of the lesion with curettage and peripheral osteotomy, along with extraction of tooth 13. In conclusion, COC may clinically and radiographically mimic other more common maxillary lesions. Conservative treatment modalities should be considered to preserve anatomical structures and facilitate future rehabilitation, thereby contributing to the patient’s quality of life.

References

Mulvihill C, Mhaolcatha SN, Brady P, McKenna J, Sleeman D, Fitzgibbon J. Calcifying odontogenic cyst: a case report. Oral Surg. 2020;13(2):177-81. https://doi.org/10.1111/ors.12477

Gorlin RJ, Pindborg JJ, Odont, Clausen FP, Vickers RA. The calcifying odontogenic cyst--a possible analogue of the cutaneous calcifying epithelioma of Malherbe. An analysis of fifteen cases. Oral Surg Oral Med Oral Pathol. 1962;15:1235-43. https://doi.org/10.1016/0030-4220(62)90159-7

Kramer IR, Pindborg JJ, Shear M. The WHO Histological Typing of Odontogenic Tumours. A commentary on the Second Edition. Cancer. 1992;70(12):2988-94. https://doi.org/10.1002/1097-0142(19921215)70:12<2988::aid-cncr2820701242>3.0.co;2-v

Barnes L, Eveson JW, Reichart P, Sidransky D. World Health Organization classification of tumours: pathology and genetics of head and neck tumours. Lyon: IARC Press; 2005.

Wright JM, Vered M. Update from the 4th Edition of the World Health Organization Classification of Head and Neck Tumours: odontogenic and maxillofacial bone tumors. Head Neck Pathol. 2017;11(1):68-77. https://doi.org/10.1007/s12105-017-0794-1

World Health Organization. WHO Classification of Tumours Editorial Board. Head and neck tumours. Lyon: WHO; 2022.

Arruda JA, Silva LV, Silva L, Monteiro JL, Álvares P, Silveira M, et al. Calcifying odontogenic cyst: a 26-year retrospective clinicopathological analysis and immunohistochemical study. J Clin Exp Dent. 2018;10(6):e542-e547. https://doi.org/10.4317/jced.54528

Moraes ATL, Soares HA, Pinheiro JJV, Ribeiro ALR. Marsupialization before enucleation as a treatment strategy for a large calcifying odontogenic cyst: case report. Int J Surg Case Rep. 2020;67:239-44. https://doi.org/10.1016/j.ijscr.2020.01.031

Yeh TH, Chen YC, Lee YP, Chiang CP. Calcifying odontogenic cyst treated by marsupialization and subsequent total enucleation. J Dent Sci. 2022;17(2):1076-8. https://doi.org/10.1016/j.jds.2022.02.001

Samir MC, Lamiae G, Bassima C. Calcifying odontogenic cyst of anterior maxillary: Case report and review. Int J Surg Case Rep. 2021;85:106267. https://doi.org/10.1016/j.ijscr.2021.106267

Ahmad SA, Popli DB, Sircar K, Hasan S. Calcifying odontogenic cyst: report of an uncommon entity with a brief literature review. J Oral Maxillofac Pathol. 2022;26(1):131. https://doi.org/10.4103/jomfp.jomfp_358_21

Arruda JAA, Schuch LF, Abreu LG, Silva LVO, Monteiro JLG, Pinho RF, et al. A multicentre study of 268 cases of calcifying odontogenic cysts and a literature review. Oral Dis. 2018;24(7):1282-93. https://doi.org/10.1111/odi.12906

Kalavari F, Sharbati F, Yazdi SAM, Nazar E. Symptomatic calcifying odontogenic cyst in the maxilla, a case report with a literature review. Int J Surg Case Rep. 2023;105:108112. https://doi.org/10.1016/j.ijscr.2023.108112

Moreno-Rodríguez P, Guerrero LM, Gómez-Delgado A, Castro-Núñez J. Active decompression and distraction sugosteogenesis for the treatment of calcifying odontogenic cyst. Oral Maxillofac Surg. 2021;25(1):89-97. https://doi.org/10.1007/s10006-020-00885-0

Sakai VT, Couto Filho CEG, Moretti ABS, Pereira AAC, Hanemann JAC, Duque JA. Conservative surgical treatment of an aggressive calcifying cystic odontogenic maxillary tumor in the young permanent dentition. Pediatr Dent. 2011;33(3):261-5. PMID: 21703081.

Silva YS, Queiroz AGS, Ferraz FWS, Pinto Júnior DS, Nunes FD, Elias FM. Effectiveness of surgical decompression in the treatment of a calcifying cystic odontogenic tumor. Autops Case Rep. 2014;4(4):43-9. https://doi.org/10.4322/acr.2014.038

Alarcón Á, Barison R, Martínez B, González S. Long-term outcomes of surgical decompression in treating calcifying odontogenic cyst associated with compound odontoma: a 9-year follow-up case report and literature review. Case Rep Dent. 2025;2025:2844784. https://doi.org/10.1155/crid/2844784

Emam HA, Smith J, Briody A, Jatana CA. Tube decompression for staged treatment of a calcifying odontogenic cyst: a case report. J Oral Maxillofac Surg. 2017;75(9):1915-20. https://doi.org/10.1016/j.joms.2017.02.032

Kim Y, Choi BE, Ko SO. Conservative approach to recurrent calcifying cystic odontogenic tumor occupying the maxillary sinus: a case report. J Korean Assoc Oral Maxillofac Surg. 2016;42(5):315-20. https://doi.org/10.5125/jkaoms.2016.42.5.315

Moraes SS, Sousa LM, Soares IMV, Soares LEC, Barros SSLV, Lopes MCA, et al. Functional and cosmetic surgery for management of the calcifying odontogenic cyst intruding into maxillary sinus and nasal cavity: case report. Oral Maxillofac Surg Cases. 2017;3(4):116-21. https://doi.org/10.1016/j.omsc.2017.09.001

Masuda K, Kawano S, Yamaza H, Sakamoto T, Kiyoshima T, Nakamura S, et al. Complete resolution of a calcifying cystic odontogenic tumor with physiological eruption of a dislocated permanent tooth after marsupialization in a child with a mixed dentition: a case report. World J Surg Oncol. 2015;13:277. https://doi.org/10.1186/s12957-015-0697-0

Souza LN, Souza ACRA, Gomes CC, Loyola AM, Durighetto Jr AF, Gomez RS, et al. Conservative treatment of calcifying odontogenic cyst: report of 3 cases. J Oral Maxillofac Surg. 2007;65(11):2353-6. https://doi.org/10.1016/j.joms.2006.09.021

Santana LAM, Felix FA, Ayres LGC, Silva ER, Takeshita WM, Barros HLM, et al. Large calcifying odontogenic cyst in the posterior maxilla. J Bras Patol Med Lab. 2021;57:1-5. https://doi.org/10.5935/1676-2444.20210044

Arruda JAA, Monteiro JLGC, Abreu LG, Silva LVO, Schuch LF, Noronha MS, et al. Calcifying odontogenic cyst, dentinogenic ghost cell tumor, and ghost cell odontogenic carcinoma: a systematic review. J Oral Pathol Med. 2018;47(8):721-30. https://doi.org/10.1111/jop.12727

Hwang MJ, Lang MJ, Jin YT, Chiang CP. Histopathological study of a characteristic calcifying odontogenic cyst. J Dent Sci. 2022;17(1):578-9. https://doi.org/10.1016/j.jds.2021.07.003

Gadipelly S, Reddy VB, Sudheer M, Kumar NV, Harsha G. bilateral calcifying odontogenic cyst: a rare entity. J Maxillofac Oral Surg. 2015;14(3):826-31. https://doi.org/10.1007/s12663-014-0706-9

Khandelwal P, Aditya A, Mhapuskar A. Bilateral calcifying cystic odontogenic tumour of mandible: a rare case report and review of literature. J Clin Diagn Res. 2015;9(11):ZD20-2. https://doi.org/10.7860/JCDR/2015/15817.6776

Urs AB, Jot K, Kumar M. Ghost cell characterization in calcifying odontogenic cysts and dentinogenic ghost cell tumors: an immunohistochemical study. J Oral Biosci. 2020;62(4):336-41. https://doi.org/10.1016/j.job.2020.10.002

Chindasombatjaroen J, Poomsawat S, Klongnoi B. Calcifying cystic odontogenic tumor associated with other lesions: case report with cone-beam computed tomography findings. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113(3):414-20. https://doi.org/10.1016/j.oooo.2011.09.009

Vizuete-Bolaños MX, Salgado-Chavarria F, Ramírez-Martínez CM, Ramos-Nieto JJ, Vazquez-Dávalos NM. Compound odontoma associated with a calcifying odontogenic cyst. Case report and systematic review. J Stomatol Oral Maxillofac Surg. 2022;123(3):e97-e105. https://doi.org/10.1016/j.jormas.2021.10.008

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Published

2026-03-05

How to Cite

1.
Mendes RMO, Filho VF da S, Motta LRD da, Alves CH, Fernandes LO, Noronha MS de, et al. Management of an extensive calcifying odontogenic cyst in the maxilla of a young patient: a case report. J Oral Diagn [Internet]. 2026 Mar. 5 [cited 2026 Apr. 20];11. Available from: https://www.jordi.com.br/revista/article/view/411

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Case Report