Calcifying odontogenic cyst in a 91-year-old man

Background: Calcifying odontogenic cyst (COC) is a developmental odontogenic cystic lesion that is Lined by ameloblastoma Like epithelium, that includes focal ghost cells. COC is rare, representing less than 1% of odontogenic lesions. COCs are diagnosed at all ages and they have a mean age of about 30 years with a similar male and female genders distribution. The purpose of the present article is to present and discuss the diagnosis and management of a 91-year-old man affected by COCs. Case presentation: A 91-year-old male subject was referred for a swelling in the left body of the mandible. Intraoral examination revealed a hard blueish swelling in correspondence of the lingual side of the left mandibular body, extended to the oral floor. It was decided to perform a CT scan, that revealed a well-defined, unilocular, radiolucent lesion extending from the lingual corticle of the left mandibular body to the oral floor. Under local anesthesia, the cyst underwent en bloc enucleation and curettage and was sent for pathological examination, that confirmed the diagnosis of calcifying odontogenic cyst. Conclusions: Enucleation with curettage still represents the treatment of choice for COCs. Resection may be considered in selected cases when an aggressive clinical behavior is observed or a high recurrence rate is suspected. A strict follow-up is advised to monitor eventual recurrences. In large lesions, or when the patient is affected by severe comorbidities, conservative treatments such as decompression and marsupialization may still be proposed.