Glandular Odontogenic Cyst Mimicker: A Novel Entity Journal of Contemporary Dentistry, May-August 2016;6(2):145-148 145 JCD Glandular Odontogenic Cyst Mimicker: A Novel Entity 1 Kehkashan E Azmi, 2 Shilpa Patel, 3 Jigna Pathak, 4 Niharika Swain ABSTRACT Glandular odontogenic cyst (GOC) is an uncommon develop- mental odontogenic cyst of jaws with a frequency of approxi- mately 0.2%. Because of its aggressive biological behavior including its malignant transformation potential, recently col- laborative efforts by few researchers have laid down certain histopathological criteria segregating it from its mimickers which include dentigerous cyst, lateral periodontal cyst (LPC), or botryoid cyst, radicular cyst, and central low-grade muco- epidermoid carcinoma. Therefore, cautious histopathological evaluation is necessary of GOC mimickers in order to prevent its overdiagnosis. Here, we present a case of GOC mimicker in a 12-year-old male patient in left maxillary region. Keywords: Glandular odontogenic cyst mimicker, Hobnail cell, Sialo-odontogenic cyst. How to cite this article: Azmi KE, Patel S, Pathak J, Swain N. Glandular Odontogenic Cyst Mimicker: A Novel Entity. J Contemp Dent 2016;6(2):145-148. Source of support: Nil Conflict of interest: None INTRODUCTION Glandular odontogenic cyst (GOC) was first documented as “sialo-odontogenic cyst” by Padayachee and Van Wyk in 1987. 1 However, in 1988, Gardner et al 2 proposed it as a distinct entity and gave a term “GOC” whereas High et al 3 proposed the term “polymorphous odontogenic cyst” which is characterized by a potentially aggressive behavior with a high recurrence rate. 4 Glandular odon- togenic cyst is a rare lesion comprising only 0.2% of all odontogenic cysts. The cyst is most frequently encoun- tered in the age range of 14 to 75 years with male predilec- tion (1.3:1), with predilection for mandible (70%) affecting both anterior and posterior areas. Radiographically, it is radiolucent, well-defined, either unilocular (53.8%) or multilocular (46.2%) with frequent perforation (61%) and thinning of cortical plates (24.4%). Furthermore, English literature revealed recurrence rate which varies from 1 Postgraduate Student, 2 Professor and Head, 3 Professor 4 Lecturer 1-4 Department of Oral Pathology and Microbiology, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India Corresponding Author: Kehkashan E Azmi, Postgraduate Student, Department of Oral Pathology and Microbiology, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India Phone: +918588912729, e-mail: drkehkashan.azmi@gmail.com JCD CASE REPORT 10.5005/jp-journals-10031-1160 21 to 55% 5,6 which indicates its aggressiveness. 7 Therefore, a confirmatory diagnosis is critical for treatment and follow-up. However, similar histopathological features are shared between GOC and other odontogenic cysts, such as botryoid odontogenic cyst, dentigerous cyst with metaplasia, radicular cyst, or central mucoepidermoid carcinoma (CMEC), thereby making the diagnosis more cumbersome. 7 However, even though the microscopic features of GOC have been described in detail, there is no consensus on its diagnostic features. It is sometimes dif- ficult to discern whether a particular cyst having some but not all of the described features of GOC represents a true GOC or another cyst with GOC-like features imposing a need to introduce a new group “glandular odontogenic cyst mimickers” (GOC mimicker). The most recent World Health Organization classifica- tion includes a definition of the GOC – “A cyst arising in the tooth bearing areas of the jaws and characterized by an epithelial lining with cuboidal or columnar cells, both at the surface and lining, with crypts or cyst-like spaces within the thickness of the epithelium.” 8 Few authors have selected parameters based on previously reported microscopic features for GOC from the literature. 9,10 Kaplan et al 7 proposed major and minor microscopic criteria for GOC based on the frequency of each feature in reported cases from the literature. Fowler has empha- sized on certain criteria which are mandatory in differ- entiating a true GOC from GOC mimicker. The purpose of this paper is to present a case report depicting the clinical, radiographic, and histopathologic features of a GOC mimicker with particular emphasis on microscopic parameters necessary for diagnosis. CASE REPORT A 12-year-old male patient reported in the Department of Oral Pathology, MGM Dental College and Hospital, Navi Mumbai with a chief complaint of painful swelling in upper left anterior region of the jaw since 3 months. Extraorally, a diffuse swelling was evident which resulted in facial asym- metry. Intraoral examination revealed a solitary diffuse buccal swelling in the left maxillary region extending from 21 to 25, approximately 3 × 2 × 1 cm in size (Figs 1A and B). The swelling extended superoinferiorly from attached gingiva obliterating the buccal vestibule. Displacement of 21 was also evident. Overlying mucosa was smooth and erythematous. On palpation, the swelling was firm, tender, nonmobile, and nonpulsatile. Radiographic examination