Available online: http://saspjournals.com/sjds 535 Scholars Journal of Dental Sciences (SJDS) ISSN 2394-4951 (Print) Abbreviated Key Title: Sch. J. Dent. Sci. ISSN 2394-496X (Online) ©Scholars Academic and Scientific Publisher A Unit of Scholars Academic and Scientific Society, India www.saspublisher.com Keratocystic Odontogenic Tumor of the Maxilla Revealed By a Diffused Cellulitis: A Case Report Rahma Ayachi 1,2* , Wafa Hasni 1,2 , Nozha Mhamdi 3 , Ghada Bouslama 1 , Souha Ben Youssef 1,2 , Abdellatif Boughzela 1,2 1 Oral Surgery Unit, Dental Medicine Department in University Hospital Farhat Hached, Sousse, Tunisia 2 Research Laboratory, LR 12SP10, Functional and Aesthetic Rehabilitation of Maxillary, Tunisia 3 Departement of Anatomopathology, University Hospital Farhat Hached, Sousse, Tunisia Case Report *Corresponding author Rahma Ayachi Article History Received: 03.12.2017 Accepted: 12.12.2017 Published: 30.12.2017 DOI: 10.21276/sjds.2017.4.12.2 Abstract: Keratocystic odontogenic tumor (KCOT) is a unique cyst because of its locally aggressive behavior, high recurrence rate, and histological characteristic appearance. The maxillary presentation is rare. This paper reports a case of maxillary KCOT successfully treated with radical enucleation. A 23-year-old female patient was referred to our department to search for a possible dental etiology to a right upper facial cellulitis. Radiology showed a well-limited unilocular radiolucent area, between the teeth 15 and 16 which were displaced. Initially, a lateral periodontal cyst was suspected. An enucleation of the cyst was performed. Histology concluded on a maxillary KCOT. A follow up at 9 months showed complete healing with no signs of recurrence. No consensus exists concerning KCOT management. The most conservative treatment used is enucleation. However, it had a high recurrence rate of 56% up to 10 years after treatment compared with other methods which explain the need for long-term follow-up. Keywords: Odontogenic tumors, odontogenic cysts, periodontal cyst, maxilla, therapeutics INTRODUCTION Keratocystic odontogenic tumor (KCOT) is a unique cyst because of its locally aggressive behavior, high recurrence rate, and histological characteristic appearance. In 62% of cases, KCOT is diagnosed incidentally during routine dental examination [1]. However, only 38% of the cases produce symptoms including pain, discharge, swelling and cellulitis [1, 2]. As for the site of predilection, the most common one is the mandible with 81%, most frequently affecting the body, angle and vertical ramus. The maxillary presentation is not pathognomonic and accounting for only 16% [1]. The aim of this report was to present a case of KCOT in the maxilla, discovered through a right facial cellulitis. The goal was also to provide the clinical and radiological diagnosis criteria of KCOT, its differential diagnosis and the treatments modalities. CASE REPORT A 23-year-old female patient, with non- contributory medical and surgical history, was referred to our unit by the Otorhinolaryngology (ENT) department at Farhat Hached Hospital Sousse to search for a possible dental etiology to a right upper facial cellulitis. The medical history revealed that the cellulitis had been progressing since 5 days. Before being admitted to ENT department, she consulted a general practitioner who prescribed two injections of corticosteroids with no significant improvement. On initial examination, an unlimited right cheek swelling covered with an erythematous and painful skin on palpation was noted. An extension to the eyelid region was evident. Intra oral examination showed swelling of the mucosa in region 15-16 with a purulent discharge through a fistula (Figure 1). There was a first-degree mobility of these teeth with an increased periodontal probing depth (10 mm). No caries were noticed on these teeth which tested positive for vitality (ethyl chloride and cavity test).