CALCIFYING ODONTOGENIC CYST IN AN OLDER PATIENT: A CASE REPORT

Calcifying odontogenic cyst (COC) is a rare odontogenic developmental cyst representing less than 2.0% of all odontogenic lesions. We report a case of an 89-year-old female presenting with a massive painful swelling in the right posterior mandible. Cone beam CT scans showed a large, hypodense unilocular lesion, causing loss of bone structure in the angle, body, and ramus of the mandibular right side. An incisional biopsy was performed. Histologically, there were pathologic cavity lines by odontogenic epithelium rich in ghost cells and foci of dystrophic calcifications, surrounded by a fibrous capsule. The diagnosis was COC. A segmental resection followed by reconstruction was carried out, and the patient has been in follow-up since August 2018. COC is one of the rarest lesions in the oral region. Despite its benign nature, cases of aggressive COC have been reported. A discussion on the pathologic analysis and surgical approach will be provided in this presentation.