JAPANESE JOURNAL OF ORAL & MAXILLOFACIAL SURGERY

Vol. 53 No. 12                   2007

ISSN: 0021-5163      UBIC: 151-J

ABSTRACT

Keratocystic odontogenic tumors (KCOT) of the maxilla that extensively enter the maxillary sinus are relatively rare. This report describes a case of KCOT arising in the left maxillary sinus that showed histopathological characteristics of aggressive biological behavior. A 27-year-old woman was referred to our clinic for evaluation of a cystic lesion in the maxillary sinus. A CT scan revealed a heterogenious soft tissue density mass that extended widely into the maxillary sinus, resulting in a thinning of the cortical bone of the medial and posterior walls of the maxillary sinus. The cystic lesion was completely enucleated via an intraoral approach under general anesthesia. Histopathologically, the cystic lesion was covered with a parakeratinized stratified squamous epithelium consisting of a few layers. Palisading basal cells with hyperchromatic nuclei, and lamination and mitosis of the nuclei were aiso found. The histopathological diagnosis was KCOT. Furthermore, immunohistochemical staining for Ki-67 and p53 showed a high rate of positively stained cells at the stratified squamous epithelium with dysplasia. The histopathological characteristics suggested that this case of KCOT had an aggressive biological behavior. There has been no evidence of recurrence during the 11-month follow-up. Key words: keratocystic odontogenic tumor, maxillary sinus, aggressive biological behavior.

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