A Clinically Silent Mandibular Odontogenic Keratocyst in a Geriatric Patient: Diagnostic and Therapeutic Insights

Odontogenic keratocyst (OKC) is an aggressive, benign, cystic lesion arising from the mandible. A 65-year-old male presented with increasing left jaw swelling for 20 years was diagnosed as OKC with the help of the radiological and pathological correlation. A computed tomography scan revealed the well-defined expansile solid-cystic lesion involving the left mandible with multiple foci of calcification and cortical breach. The patient was managed surgically with segmental mandibulectomy and mandibular reconstruction. Histopathology revealed the fibrous cyst wall lined by keratinized stratified squamous epithelium with a prominent basal cell layer. Due to the aggressive nature and high recurrence rate of the OKC, early diagnosis and precise surgical resection with clear margins are required. Radiological and histopathological correlation is needed for the accurate diagnosis, surgical planning and to prevent complications for the management of OKC.