Department of Radiology, University of Ilorin Teaching Hospital, Ilorin, Nigeria

Abstract

The calcifying epithelial odontogenic cyst (CEOC) is a rare lesion of the jaws first described as a distinct entity by Gorlin et al., in 1962. [1] The condition is also referred as Gorlin’s cyst, keratinizing ameloblastoma or melanotic ameloblastic odontoma. [1] CEOC is often referred as an asymptomatic slow growing swelling of the jaws. It is a well circumscribed, solid or cystic lesion derived from odontogenic epithelium (OE) which develops from reduced enamel epithelium or remnants of OE in the follicle, gingival tissue or bone but contains “ghost cells” and spherical calcifications. It is considered a unique entity with both cystic and neoplastic behavior. [2] We report a case of CEOC which occurred in the maxillary sinus.

A 45-year-old female patient came with a chief complaint of asymptomatic swelling in the right upper jaw since 6 months. The lesion had been slowly increasing in size since it was first noticed. The lesion was extending from right lateral incisor to first molar on the same side intraorally and soft in consistency on palpation. A panoramic radiograph showed a well-circumscribed radiolucency in relation to upper right premolars with impacted canine and supernumerary tooth causing root resorption and displacing roots of premolars [Figure 1]. Computed tomography (CT) scan axial section revealed well-circumscribed radiolucency in the maxillary sinus thus obliterating the sinus [Figure 2], enucleation and aggressive curettage was done under local anesthesia using intraoral Caldwell-Luc approach [Figure 3]. Histopathology reviewed presence of cystic space lined by OE with ghost cells suggestive of CEOC [Figure 4]. Postoperative follow-up was done for 1 year and no recurrence was
observed.