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Gorlin Cyst

(keratinizing & calcifying odontogenic cyst )


Cyst: It’s a pathological cavity lining by
epithelial contain fluid or semifluid.

Classification of Cyst:
1-according to type of epithelial lining:

Odontogenic Non Pseudo Soft Tissue cyst

These arise from epithelial Odontogenic cyst


remnants of developmental
teeth

Claffication of Odontogenic
According to causes

IFLAMATORY DEVELOPMENTAL

-Apical -Dentigrous cyst


-Prymordyal Cyst
-Lateral
-Residual
-Keratinazed and calcifying
odontogenic cyst
(GORLIN CYST)
Keratinazed and calcifying odontogenic cyst
(GORLIN CYST)

Definition: Its Developmental odontogenic lesion


has Same feature of CYST and many characters of
NEOPLASM.

Pathogenesis: Epithelial rest of serres OR


Epithelial rest of malassez.

Clinical features:
Age: before 40 Y
Sex: common in Females
Site: 70% in maxilla – 30% in mandible
Size: The diameter ranges from 2 to 4
Trestment: by Enucleation

*Intrabony expansions may produce hard bony expansion


and may perforate cortical bones.

*It can present asymptomatically The CCOT is believed to


arise from odontogenic epithelial remnants trapped within
the bones of the maxilla and mandible or gingival tissues,

*displacement of the roots happen after the enlargement


of the cyst.
*this type is painless , in case of infection it becomes
painful . therefore CCOTs can develop either centrally
(intraosseous) or peripherally (extraosseous) . The
majority of cases (86–98%)

Radiographic picture :
*it may appears unilocular or multilocular
radiolucency with scattered radiopacity which
are calcifications
*it has irregular size and shape
*it has the appearance of salt and pepper
Differential diagnosis:
Early Primordial cyst
Pindborg tumors (CEOT)
Adenomatoid odontogenic tumors

Histopathology:
*The microscopic examination revealed a cystic lesion with a
fibrous capsule lined by an outer layer of odontogenic
epithelium four to six cells in thickness.
*The basal cells of the outer layer were columnar resembling
ameloblasts. A layer composed of loosely arranged epithelium
resembling stellate reticulum was noted overlying the first layer
* Numerous ghost cells and calcifications were identified within
the epithelial lining
* Formation of calcified tissues in the lumen of the cyst
wall showing dystrophic calcification. Proliferation of
tissues is similar to an Ameloblastic Fibroma

Epithelial: Stratified squamous Epithelial


A)basel cell layer: The microscopic examination revealed a
cystic lesion with a fibrous capsule lined by an outer layer of
odontogenic epithelium four to six cells in thickness. The
basal cells of the outer layer were columnar or cuboidal
with dark stained nuclei Polarized away from basement
membrane (Like ameloblasts)
a) Above basal cell layer: stellate reticulum Like cell

b) GHOST CELLS: some cell become swollen with hyaline


homogenous eosinophilic cytoplasm and their nuclei
undergo karyolysis. Cluster of GHOST CELLs may under go

C) DYSTROPHIC CALCIFICATION and become BASOPHILIC.


(a) (Case 1) Panoramic view shows unilocular radiolucencies with
a well-defined border in the right mandible canine to molar area.
Root absorption (arrowhead) and root divergence are observed
(arrow), with radio-opaque material seen in the lesion.
(b) Intra-oral view shows buccolingual bony expansion in the right
mandible canine to molar area and radio-opaque material in the
lesion (arrow).
(c) Axial CT image shows unilocular radiolucencies with a well-
defined border in the right mandible canine to molar area and
buccolingual bony expansion. Radio-opaque materials are located
at the periphery. The shape appears to be linear (arrow). The CT
value of this radio-opaque material is 170.3 HU.
(d) Coronal CT image shows unilocular radiolucencies with a well-
defined border in the right mandible canine to molar area and
buccolingual bony expansion. Radio-opaque materials are located
at the periphery. The shape appears to be linear (arrow). The CT
value of this radio-opaque material is 170.3 HU.
References:
1. Gorlin RJ, Pindborg JJ, Clausen FP, Vickers RA. The calcifying
odontogenic cyst—a possible analogue to the cutaneous calcifying
epithelioma of Malherbe. An analysis of fifteen cases. Oral Surg Oral
Med Oral Pathol 1962;15:1235–43 [PubMed]
2. Yoshiura K, Tabata O, Miwa K, Tanaka T, Shimizu M, Highchi Y, et al.
Computed tomographic features of calcifying odontogenic cysts.
Dentomaxillofac Radiol 1998;27:12–16 [PubMed]
3. Iida S, Fukuda Y, Ueda T, Aikawa T, Arzipe JE, Okura M. Calcifying
odontogenic cyst: radiologic findings in 11 cases. Oral Surg Oral Med
Oral Pathol Oral Radiol Endod 2006;101:356–62 [PubMed]
4. Barnes L, Eveson J, Reichart P, Sidransky D, editors. , World Health
Organization classification of tumors. Pathology & genetics of head and
neck tumors. Lyon, IARC Press; 2005
PRESENTED BY

Abdalrahman bahaa 151331


Kamel jamal saker 081353
Romario nabil 144517
Ahmed mostafa 106125
Ahmed Samir 122291
Ahmed mohammed 125383
Ahmed nasr uldin 111709
Mohamed abdelhalim 141779
Mohab farrag 105995