Cisto odontogênico glândular: dois relatos de casos clínicos

Abstract

Glandular odontogenic cyst (COG) is a rare type of odontogenic developmental cyst that may exhibit aggressive behavior. Although generally accepted as having odontogenic origin, it also exhibits glandular or salivary features which are presumably an indication of the pluripotentiality of the odontogenic epithelium. It is defined as a cyst arising in the areas of eruption of the teeth in both arches, characterized by an epithelium formed by cuboid or columnar cells, both on the surface and crypts within the epithelium thickness. It tends to recur, has slow growth and appear as an asymptomatic increase in volume. The literature reports different possibilities of treatments such as local surgical resection, decompression or marsupialization with posterior excision. This paper aims to report 2 clinical cases of COG, in addition to discussing its clinic pathological characteristics that determine the modality of treatment of these lesions, adding more knowledge about this rare pathology. The first clinical case concerns a 54-year-old female patient, who sought out the diagnostic and stomatology outpatient clinic of the Uberlândia Federal University, due to the identification of a multilocular radiolucent lesion ranging from tooth 36 to tooth 47. The aspiration puncture was positive for cystic fluid and an incisional biopsy was compatible with COG. Given the extent of the lesion, decompression was attempted by determining good remission of the lesion, which after 1 year culminated with relapses that justified the new surgical approaches. The patient is still in proservation. In the second case, the patient was referred for evaluation of lesion in the posterior region of ascending mandible branch associated with 3° molar included. Patient without complaint of symptoms, in the clinical examination presented a discrete volumetric increase. An incisional biopsy was made from mineralized material and soft tissue, after microscopic analysis the histological sections were compatible with an atypical presentation of COG. The patient after a period of resistance to undergo the procedure decided that she will do the procedure soon.