Facial Asymmetry Associated with Unusual Odontogenic Lesion in the Anterior Maxillary Region: Case Report

Abstract

Calcifying odontogenic cyst (COC) is a rare odontogenic lesion, accounting for less than 1% of reported odontogenic cysts. On microscopic examination, it is characterized by the presence of ghost cells – cells devoid of a nucleus, but which preserve their contour and frequently present intracellular calcifications, giving the lesion a unique appearance. This report presents the case of a 27-year-old male patient with persistent painless facial swelling in the anterior maxilla for approximately four years, causing significant facial asymmetry. Cone-beam computed tomography revealed a unilocular hypodense lesion, associated with an impacted canine, with hyperdense material inside, indicative of calcifications. Treatment involved complete excision under local anesthesia, and the diagnosis of COC was confirmed by histopathological examination. This case highlights the relevance of clinical-radiological and microscopic observation, essential for the accurate identification of odontogenic lesions with involved involvement and potential calcification. With low recurrence rates after complete enucleation, OCC has a favorable prognosis, reinforcing the importance of early diagnosis and appropriate management for the preservation of the patient's health and facial aesthetics.