1 International Journal of Medical and Dental Case Reports (2016), Article ID 010416, 4 Pages CASE REPORT Keratocystic odontogenic tumor  - A case report and review of literature Akshay Shetty 1 , Tejavathi Nagaraj 2 , Keerthi Irugu 2 , Saurabh Kale 1 1 Department of Oral Maxillofacial Surgery, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Cholanagar, Bengaluru, Karnataka, India, 2 Department of Oral Medicine and Radiology, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Cholanagar, Bengaluru, Karnataka, India Abstract The odontogenic keratocyst (OKC) is categorized as one of the developmental epithelial cyst which accounts for 11% of all cystic jaw lesions. The most peculiar clinical feature of OKC tumor is its tendency to occur frequently. This could be the reason for suggesting a variety of treatment modalities for this cyst. Many of the surgeons suggest more aggressive treatment modalities such as resection of the jaws. In this case, we have done a surgical approach in managing a patient with a large OKC of the mandible. Keywords: Developmental, recurrence, resection Correspondence Dr. Keerthi Irugu, Department of Oral Medicine and Radiology, Sri Rajiv Gandhi Dental College and Hospital, Cholanagar, RT Nagar, Bengaluru - 560 032, Karnataka, India. Tel.: +91-9916903205. Email: keerthi.irugu@gmail.com Received 02 Feb 2016; Accepted 15 Apr 2016 doi: 10.15713/ins.ijmdcr.48 How to cite the article: Shetty A, Nagaraj T, Irugu K, Kale S. Keratocystic odontogenic tumour - A case report and review of literature. Int J Med Dent Case Rep 2016;2:1-4. Introduction The identification and description of odontogenic keratocyst (OKC) tumors were done in 1876 as odontogenic developmental cysts of epithelial origin and later in 1956 it was characterized by Phillipsen. [1,2] Pindborg and Hansen in 1962(2) mentioned the histologic criteria required to diagnose OKC. As the origin of this cyst was thought to be the primordium of the tooth the initial terminology was given as “primordial cyst.” Later, in 1992, the World Health Organization preferred the term “odontogenic keratocyst” for such cysts with a keratinized lining in the histologic grading of odontogenic tumors. [3] OKC is best known for its repetitive occurring potential, invasive nature, and its sporadic association with the nevoid basal cell carcinoma syndrome (NBCCS). Three histologic forms were known initially which includes an orthokeratinized variant, a parakeratinized variant, and combination of these two variants. The classification of the orthokeratinized variant as a discrete clinical entity of “orthokeratinized odontogenic cyst” is due to its less invasive clinical nature and repetitive pattern of this variant. The percentage of OKCs versus other cysts of the jaws was given by different authors are as follows; [4] Hjorting-Hansen et al. (1969) and Toller (1972), - 11% Brannon (1976) and Payne (1972) - 9%, Pindborg and Hansen (1963) - 7%. Case Report A 62-year-old patient came to the Department of Oral Medicine and Maxillofacial Radiology with a chief complaint of pain in lower left back tooth region since 1 and ½ months. The pain was persistent, throbbing, dull and continuous which aggravated during lying down and relieved on taking medications. Medical and allergy history were not significant. The patient had the habit of bidi smoking since 20 years around 10-15 bidis/day. Extraoral examination revealed no gross facial asymmetry [Figure 1a]. On palpation, a bony hard swelling was present extending 2 cm away from the distal aspect of 36 which was not tender. Intraoral examination of soft tissue showed a healing extraction socket site present irt 38 with normal appearance of the overlying alveolar mucosa. On palpation overlying mucosa appeared smooth, firmly adhere to underlying periosteum with no evidence of bony expansion on buccal and lingual side of 38. The tooth 37 was tender on percussion [Figure 1b]. Examination of the hard tissue showed the presence of stains and calculus and generalized attrition. With the above findings of the site of lesion and history a provisional diagnosis of keratocystic odontogenic tumor (KCOT) of the left mandible was given.