A case of recurrent odontogenic keratocyst progressing to pterygopalatine fossa

Abstract

Odontogenic keratocysts are mainly treated in the dentistry and oral surgery departments and are rarely treated in the otolaryngology and head and neck surgery departments. We herein report a case in which recurrent odontogenic keratocysts affecting the maxilla and pterygopalatine fossa developed 22 years after the initial surgery.
A 70-year-old woman visited the oral surgery department with a chief complaint of trismus. CT scan revealed multiple cystic lesions located within the maxilla and pterygopalatine fossa and osteogenesis was found between the cysts. A diagnosis of odontogenic keratocysts was made based on the examination of a biopsy specimen from the gingiva. She then visited our hospital. At 48 years of age she had undergone surgery treatment for a left maxillary mass. Although the details were unknown, we diagnosed the patient with recurrent odontogenic keratocysts. Due to the presence of multiple lesions in the maxilla and the pterygopalatine fossa, total maxillectomy was performed and the masses were excised en bloc. No recurrence was observed at one year and three months after surgery.
Based on the CT findings, it is thought that the cysts were in the maxillary sinus at the time of initial treatment. Collaboration between dentists and otolaryngologists is important in order to prevent recurrence in such cases.