Long-term observation of a large keratocystic odontogenic tumour of the mandible treated by a single enucleation procedure: A case report and literature review

INTRODUCTION: Keratocystic odontogenic tumours (KCOTs) are benign lesions of the jaw that are characterised by expansive growth and high rates of recurrence. Herein, we present a novel minimally invasive method for the surgical treatment of KCOTs. CASE PRESENTATION: We present a 49-year-old woman with a rare, large KCOT of the mandible extending from tooth 37 to tooth 47. A single enucleation procedure was selected as the surgical technique combined with a titanium plate. Teeth interfering with the cystic lumen were preserved. The bone surrounding the cyst was partially removed and rinsed with Carnoy’s solution. Recurrence was observed 1 year later between teeth 43 and 45, and was treated by single enucleation with Carnoy’s solution. After the second operation, the teeth interfering with the KCOT still elicited a positive response to dental pulp testing. No further signs of recurrence were observed after a total observation period of 7 years. DISCUSSION: Various surgical interventions have been described for KCOTs. However, a general guideline for a specific surgical intervention has not yet been established owing to the heterogeneity of these tumours. CONCLUSION: Immediate enucleation in combination with a titanium plate offers an effective surgical approach for the treatment of large KCOTs of the mandible without the need for radical tooth removal or resection of the afflicted side.