Publication:

Odontogenic keratocyst: wolf in a sheep’s coat

Odontogenic keratocyst (OKC) is a benign yet locally aggressive odontogenic lesion with a high recurrence rate. Although more commonly found in the mandible, OKCs may rarely involve the maxilla, posing diagnostic and surgical challenges. We report the case of a 65-year-old female with a recurrent, painful swelling in the upper gingiva, radiologically presenting as a well-defined expansile lytic lesion in the maxilla. The cyst was surgically enucleated under general anesthesia, and histopathology confirmed the diagnosis of odontogenic keratocyst. The patient remained asymptomatic with no recurrence at five months follow-up. This case highlights the need for awareness of atypical presentations of OKC, the importance of histopathological confirmation, and the role of long-term follow-up to monitor for recurrence or malignant transformation.