Glandular odontogenic cyst misDx as MEC: a case report
The present case has been reported in the Journal of Dental Sciences. Glandular odontogenic cyst (GOC) is a rare and aggressive developmental odontogenic cyst with a strong predilection for the anterior region of the jaws. This report presents a case of GOC in the anterior region of the mandible.

This 62-year-old female patient visited the oral and maxillofacial surgery department for treatment of a mucoepidermoid carcinoma (MEC) in the anterior mandible, which was confirmed histopathologically in another hospital. Oral examination showed no definite swelling of the anterior mandible, but mobility of teeth 31, 41, 42, and 43 and percussion pain of tooth 42 were noted. Panoramic and periapical radiographs revealed a multilocular radiolucent lesion at the anterior mandibular region from tooth 31 to tooth 44.

Because the initial biopsy of the lesion showed a mucoepidermoid carcinoma, marginal mandibulectomy from tooth 31 to tooth 45 was performed to remove the tumor. Histopathological examination of the specimen showed a cystic lesion lined by non-keratinized stratified squamous epithelium of varying thickness and papillary surface. Mucin-secreting cells and microcysts were discovered in the lining epithelium.

Moreover, small satellite cysts with mucous cells and microcysts in the lining epithelium and a row of eosinophilic cuboidal cells on the lining epithelial surface were found in the fibrous cystic wall. In addition, spherical nodules were occasionally observed in the lining epithelium. The lining epithelium was diffusely and strongly positive for CK 19.

However, the lining epithelial cells were negative for Mastermind-like 2 (MAML2) gene rearrangement detected by fluorescent in situ hybridization (FISH). All these findings supported the diagnosis of a GOC. The clinical course of the patient was uneventful and no recurrence of the lesion was found 3 months after the operation.

Learning Points:-

• This GOC case was initially misdiagnosed as a mucoepidermoid carcinoma, which led the authors to use the marginal mandibulectomy for treating this patient.

• The multilocular GOC is supposed to be an aggressive lesion that is usually treated by a more radical surgery. Therefore, although this patient was misdiagnosed in the beginning, the marginal mandibulectomy was still a proper treatment for our patient.

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