OOC with calcification: A rare case report of a distinct ent
Orthokeratinized odontogenic cyst (OOC) is a relatively rare odontogenic cyst, distinct from odontogenic keratocyst (OKC). The following case has been reported in the J Oral Maxillofac Pathol.

An 18-year-old female patient presented with pain and swelling in the left back region of the lower jaw of one-month duration. On intraoral examination, 37 was found missing, with partially erupted 38. A diffuse swelling in relation to 37 and 38 was seen obliterating the buccal vestibule. The overlying mucosa was intact. The swelling was hard and nontender on palpation. Expansion of buccal cortical plate was evident.

OPG showed a well-defined unilocular radiolucent lesion distal to crown of impacted 37 along with expansion and displacement of mandibular canal. Tooth 38 was displaced superiorly. However, there was no resorption of 37 and 38.

Based on clinical and radiographic findings, provisional diagnosis of dentigerous cyst in relation to 37 was rendered. The lesion was treated conservatively by complete enucleation along with removal of 37 and 38. Two-year follow-up was uneventful.

Macroscopic examination of submitted tissue showed thin grayish-white pieces of cystic lining which was partly attached to impacted 37. Hematoxylin and eosin stained sections under microscopic examination showed, 4–6 layers thick, uniform cystic epithelial lining of stratified squamous epithelium with prominent orthokeratinization.

The cyst wall demonstrated patchy areas of inflammation along with single concentric mass of calcified material. Multiple serial sectioning of the tissue did not reveal any features of OKC such as parakeratinization and basal palisading.

Based on these histopathological features, a final diagnosis of OOC was established.

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