Extensive odontogenic keratocyst with mandibular cortex perforation in a 67-year-old woman: A case report

Introduction: One of the most common odontogenic cysts is odontogenic keratocyst (OKC). It often occurs in men and diagnosis is most common in the second and third decades of life. These cysts have an expansive growth and often without clinical symptoms and bone expansion. The aim of this study was to report an uncommon OKC with unusual characteristics. Case report: A 67-year-old female patient was referred to a maxillofacial surgeon with a complaint of swelling of the left lower jaw. The patient was edentulous and had no pain and tenderness. Intraoral examination showed a swelling on the facial aspect of the alveolar bone with a boney consistency. Panoramic radiograph and CT scan examination showed a multilocular radiolucent lesion with corticated margins, which extended into the ramus and angle of the mandible with perforation of buccal and lingual cortices. The histopathological examination of the lesion after incisional biopsy was performed. Partial resection was carried out and OKC was confirmed. Conclusion: Due to the aggressive nature and high recurrence rate of OKC they should be diagnosed in early stages. Therefore, it is recommended that dentists be aware of the possibility of unusual characteristics of this cyst and follow it after treatment because of its high recurrence rate.   Key words: Jaw cysts, Mandible, Odontogenic keratocyst