Extensive inflamed orthokeratinized odontogenic cyst in the mandible: a case report

The orthokeratinized odontogenic cyst is a relatively uncommon developmental cyst of an unknown etiology not constituting a distinct clinical entity. A 23-year-old man reported episodes of pain and swelling in the posterior right mandible. On clinical examination, erythematous mucosa of the region and an expansion of the vestibular cortical plate was seen. Radiographic examination showed and extensive well-circumscribed unilocular radiolucency in the body region extending to angle of the mandible. A fine needle aspiration was performed revealing purulent content. Histopathologic analysis of surgical specimens from an incisional biopsy revealed fragments of tissue exhibiting cystic lesion, with epithelial lining of stratified squamous epithelium with prominent orthokeratinization on the surface; the cyst wall showed areas of inflammation with lymphocyte predominance. A marsupialization was carried out, and the patient is on 1 year of clinical-radiographic follow-up with no recurrences.