bromochloroacetic-acid and Jaw-Cysts

Basal cell nevus syndrome, also known as Gorlin-Goltz syndrome, is an autosomal dominant inherited disorder which is characterised by the presence of multiple maxillary keratocysts and facial basal cell carcinomas, along with other less frequent clinical characteristics such us musculo-skeletal disturbances (costal and vertebrae malformations), characteristic facies, neurological (calcification of the cerebral falx, schizophrenia, learning difficulties), skin (cysts, lipomas, fibromas), sight, hormonal, etc. On occasions it can be associated with aggressive basal cell carcinomas and malignant neoplasias, for which early diagnosis and treatment is essential, as well as family detection and genetic counselling. Currently there are new lines of investigation based on biomolecular studies, which aim at identifying the molecules responsible for these cysts and thus allowing an early diagnosis of these patients. In its clinical management and follow up, the odonto-stomatologist, the maxillofacial surgeon and several other medical specialists are involved. In this paper a review of the literature, and six cases of patients affected by multi-systemic and varied clinical expression of basal cell nevus syndrome, are presented.

Topics: Adolescent; Adult; Basal Cell Nevus Syndrome; Facial Neoplasms; Female; Humans; Jaw Cysts; Keratins; Male; Skin Neoplasms

The odontogenic keratocyst is an intra-osseous cystic lesion which generally affects the posterior part of the mandible and is characterized by the presence of a keratinized epithelium. Being asymptomatic, it is usually detected through a routine radiographic exam and it is considered to be an important lesion because of its agressiveness and its high recurrence rate. Surgery is the recommended treatment and the mode of management should take into account the agressiveness of the lesion while trying to preserve maximal anatomical and functional integrity for the patient. This paper reviews the recent literature on odontogenic keratocysts and reports our experience with three cases successfully managed in three different ways: marsupialization, decompression followed by enucleation with primary closure and finally by enucleation with packing for secondary intention healing.

Topics: Adult; Child; Female; Humans; Jaw Cysts; Keratins; Mandibular Diseases; Odontogenic Cysts

We conducted a retrospective study to analyze the histologic and immunohistochemical findings in three main types of odontogenic cyst. We studied 90 archived cystic jaw lesions: 30 dentigerous cysts, 30 keratocystic odontogenic tumors, and 30 radicular cysts. The cyst types were identified on the basis of clinical, radiologic, and histopathologic findings. Immunohistochemical analyses included staining with Ki-67, p53, epidermal growth factor receptor (EGFR), cytokeratin (CK) 8, CK14, CK17, and CK18. Cell immunopositivity was evaluated for the entire epithelium. The criteria for Ki-67 and p53 positivity were dense and/or faint nuclear staining, and cells were considered EGFR-positive if they exhibited membrane staining and/or cytoplasm staining. For the cytokeratins, cells exhibiting cytoplasm staining were considered positive. Five representative fields of each lesion were selected and identified in each of the Ki-67- and p53-stained slides. We found a statistically significant difference in the ratio of Ki-67-positive cells in the entire layer between the keratocystic odontogenic tumors and both the dentigerous cysts and the radicular cysts. A statistically significant difference was observed in the ratio of p53-positive cells between the keratocystic odontogenic tumors and the radicular cysts. Cytokeratins proved to be useful in differentiating radicular cysts from other types of cystic jaw lesions because of their CK8-positive and CK17-negative immunolabeling.

Topics: Biomarkers; Biopsy; Cell Proliferation; Cytoplasm; Dentigerous Cyst; Diagnosis, Differential; ErbB Receptors; Humans; Immunohistochemistry; Jaw; Jaw Cysts; Keratins; Ki-67 Antigen; Odontogenic Cysts; Odontogenic Tumors; Radicular Cyst; Retrospective Studies; Tumor Suppressor Protein p53

Orthokeratinised jaw cyst (OJC) is an entity distinct from odontogenic keratocyst (OKC) that has not been fully characterised at the molecular level.. To compare the proliferative activity of the epithelial linings of OKC and OJC immunohistochemically, using Ki-67 and cyclin D1 as markers of cellular proliferation and activity.. The total numbers of positively stained cells per 10 consecutive lengths of a light microscope calibration ruler were counted in each case (OKC, n = 15; OJC, n = 15) and the composite data were statistically compared.. OJC showed significantly fewer Ki-67 and cyclin D1 positive cells than OKC, a finding consistent with the clinically more indolent behaviour of the OJC. Ki-67 expression was mainly detected in the suprabasal cell layers in OKC. Expression of Ki-67 was more uniform in OJC and notably without a significant predilection for the supra-basal compartment. The accumulation of Ki-67 positive cells supra-basally in OKC raises the possibility that a process of asymmetrical cell division may be operational in OKC. Expression of Ki-67 and cyclin D1 differed significantly quantitatively and by distribution pattern in OKC and OJC respectively thereby suggesting that the presence of cyclin D1 protein in OKC and OJC may not necessarily reflect production of this molecule by cycling cells.

Topics: Cell Count; Cell Division; Cell Nucleus; Cell Proliferation; Coloring Agents; Cyclin D1; Eosine Yellowish-(YS); Epithelial Cells; Epithelium; Fluorescent Dyes; Hematoxylin; Humans; Jaw Cysts; Keratins; Ki-67 Antigen; Odontogenic Cysts

The KAI-1 tumor suppressor gene is widely distributed in normal tissues and its down-regulation may be correlated with the invasive phenotype and metastases in several different epithelial tumors. The aim of the present study was an evaluation of KAI-1 expression in radicular cysts (RC), follicular cysts (FC), orthokeratinized keratocysts (OOKC), and parakeratinized keratocysts (POKC). Eighty-five odontogenic cysts, 28 RC, 22 FC, and 35 OKC (16 OOKC, 19 POKC) were selected. All the POKC were negative and only four of 16 of the OOKC were positive for KAI-1. On the contrary, all RC and FC cases were positive and immunoreactivity for KAI-1 was detected throughout all the layers of the cyst epithelium. The lack of KAI-1 expression in POKC could help to explain the differences in the clinical and pathologic behavior of OKC and, according to what has been reported for epithelial tumors, could be related to the increased aggressive behavior and invasiveness of OKC.

Topics: Follicular Cyst; Gene Expression; Humans; Immunohistochemistry; Jaw Cysts; Kangai-1 Protein; Keratins; Odontogenic Cysts; Odontogenic Tumors

The odontogenic keratocyst has been well documented and extensively studied. It is of particular interest because of its high recurrence rate and aggressive nature. The material for this study consisted of 70 cases of odontogenic keratocysts in predominantly ethnic Chinese patients who were treated from 1981 to 1996. The cases were retrospectively studied to compare characteristics of the lesion in this population with those in previous reports. Most of the patients in this series were 21 to 30 years of age. Association with an impacted mandibular third molar was found in more than 50% of the cases. The recurrence rate was 20% for 35 patients with a follow-up period of at least 5 years. The follow-up period for the whole series ranged from 1 to 16 years. Treatment was surgical enucleation with peripheral ostectomy. There were no significant differences in characteristics with respect to presentation and prognosis between this series and those described in previous publications.

Topics: Adolescent; Adult; Aged; Basal Cell Nevus Syndrome; Child; China; Female; Humans; Jaw Cysts; Jaw Neoplasms; Keratins; Malaysia; Male; Middle Aged; Odontogenic Cysts; Recurrence; Retrospective Studies; Sex Ratio; Singapore; Tooth, Impacted

The clinico-pathologic, immunohistochemical and radiological features of 12 jaw cysts with a prominent orthokeratinized epithelial lining were studied and compared with those of typical odontogenic keratocysts and dentigerous cysts. They differed significantly from odontogenic keratocysts in terms of biologic behavior and histopathologic findings. Although immunohistochemical staining of the epithelial linings for cytokeratins, EMA, CEA and involucrin has not shed any light on the histogenesis of these lesions, staining patterns for these markers were significantly different from those of odontogenic keratocysts and non-keratinized dentigerous cysts. Radiologically, nine cases appeared as dentigerous cysts; two cases, one with sebaceous differentiation, as non-dentigerous unilocular cysts, and the remaining one was exceptional as it showed multiple epidermal cysts with prominent dermal appendages histologically. It is suggested that most of the orthokeratinized jaw cysts may belong to clinico-pathological entities different from odontogenic keratocysts with the majority representing dentigerous cysts with orthokeratinization. The possibility of the existence of rare central dermoid or epidermoid cysts is also to be considered.

Topics: Adolescent; Adult; Child; Child, Preschool; Dentigerous Cyst; Dermoid Cyst; Female; Humans; Immunohistochemistry; Jaw Cysts; Keratins; Keratosis; Male; Odontogenic Cysts

Primary intraosseous carcinoma (P1OC) of the jaws is rare. They either arise de novo or as a consequence of malignant transformation of a benign cyst or tumor. A 56-year-old patient with a P1OC of the mandible arising from an odontogenic keratocyst is described.

Topics: Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; Humans; Jaw Cysts; Keratins; Male; Mandibular Diseases; Mandibular Neoplasms; Middle Aged; Odontogenic Tumors

Keratins and secretory component (SC) were immunohistochemically examined in fresh tissue samples from 45 odontogenic and 35 non-odontogenic cysts. Lining epithelia of almost all cases contained keratins which reacted with polyclonal antibodies (Dako, Bio-Science), and no difference could be found between the two groups of lesions. By staining with two monoclonal antibodies against keratins, i.e., RGE53 (Bio-Science) and RKSE60 (Bio-Science), it was revealed that the epithelia of non-odontogenic cysts, which were columnar epithelium in most cases, had fully and positively reacted with RGE53, while none of the cases was positive for RKSE60. In contrast, the squamous linings of odontogenic cysts except for two cases did not react with RGE53, and few cases possessed RKSE60-reactive keratin. SC was also contradictory. All non-odontogenic cysts exhibited SC. Regarding each pair of non-odontogenic and odontogenic cysts covered with RGE53 and SC-positive, and RKSE60-negative squamous epithelium, it seemed reasonable from the staining results to conclude that the squamous linings were metaplastic from the columnar epithelium. Based on the results, concomitant examinations of SC with keratins will be helpful in deciding the epithelial derivation of jaw cysts.

Topics: Dentigerous Cyst; Epithelium; Humans; Immunohistochemistry; Jaw Cysts; Keratins; Metaplasia; Molecular Weight; Nonodontogenic Cysts; Odontogenic Cysts; Radicular Cyst; Secretory Component

Lectin-binding patterns were examined in epithelial walls of 65 jaw cysts (30 post-operative maxillary cysts: POMCs, 20 radicular and 15 follicular cysts), and characteristic lectin staining for each kind of jaw cysts is presented. Between squamous and columnar epithelia, the staining intensity of WGA, Con A and UEA-I was not different, but SBA bound more remarkably to squamous than to columnar epithelia. In both epithelia the outer layers did react more strongly with the lectins examined. Concerning odontogenic cysts, the lectin-binding affinities of outer and intermediate layer cells were nearly the same in both follicular and radicular cysts. Basal cells of radicular cyst walls were however, more markedly positive for lectin binding than of follicular cysts. Furthermore, basal cells of keratinized (RKSE 60 keratin-positive) epithelium were inferior to those of non-keratinized linings in the bindings. Lectin-binding patterns of metaplastic squamose epithelia of POMCs which were positive for RGE53-keratin (principally columnar epithelium-specific keratin) were similar to originally squamous linings of odontogenic cysts. Columnar linings of unusual radicular cysts were positively stained with SBA. By these results, lectin-binding sugar residues of the epithelium seem to be related to the epithelial morphology.

Topics: Antibodies; Epithelium; Follicular Cyst; Histocytochemistry; Humans; Jaw Cysts; Keratins; Lectins; Staining and Labeling

The epithelial ultrastructure of six radicular cysts, four follicular cysts, and five keratocysts was studied with special attention to the epithelium-connective tissue junction. Inflammation was found to cause widened interepithelial cell spaces which often harbored inflammatory cells in the radicular and follicular cysts. The characteristic structures at the epithelium-connective tissue junction (plasma membrane, lamina lucida and basal lamina) were not affected by inflammation. Fibrous structures were seen to connect the basal lamina to the underlining collagenous connective tissue. The keratocyst specimens, however, showed juxtaepithelial collagenolysis that was not associated with the degree of inflammation. Desmosomes were rare in the inflamed keratocysts' spinous layer but the cell-to-cell interactions still appeared close. Inflammatory cells were not detected within epithelium of the keratocyst specimens.

Topics: Adult; Aged; Cell Membrane; Cell Nucleus; Child; Cytoplasm; Female; Humans; Intercellular Junctions; Jaw Cysts; Keratins; Male; Middle Aged; Odontogenic Cysts; Radicular Cyst; Vacuoles

Topics: Adult; Aged; Child; Female; Humans; Jaw Cysts; Keratins; Male

Topics: Diagnosis, Differential; Humans; Jaw Cysts; Keratins; Odontogenic Cysts; Radiography