Odontogenic Keratocyst of Mandible in 20 Years Old Male Patient

Abstract

Introduction: Odontogenic keratocyst (OKC) is a benign yet potentially aggressive cystic lesion of odontogenic origin, commonly affecting the posterior mandible in young adults. It is characterized by a high recurrence rate and distinctive histopathological features. This case report presents a 20-year-old male who reported right mandibular pain and swelling following a road traffic accident. Non-contrast computed tomography (NCCT) revealed a large, well-defined multiloculated radiolucent lesion extending to the condylar base with cortical expansion but no soft tissue invasion. Ultrasonography confirmed a hypoechoic cystic lesion, and fine-
needle aspiration cytology was inconclusive. Histopathological examination revealed parakeratinized stratified squamous epithelium with palisading basal cells, consistent with OKC. Surgical management involved enucleation, peripheral ostectomy, and application of Carnoy's solution. The procedure was completed under general anesthesia via an intraoral approach, with care taken to preserve vital structures, including the inferior alveolar nerve. Postoperative recovery was uneventful, with resolution of symptoms within a week, no infection or nerve injury, and normal masticatory function. Follow-up radiographs at one and three months showed progressive bone healing, and no recurrence was noted at six months. This case emphasizes the importance of detailed imaging, histopathological correlation, and a multidisciplinary surgical approach in successfully managing OKC. The use of adjunctive chemical cauterization and vigilant follow-up contributed to the favorable short-term outcome. The findings support evidence in the literature regarding individualized surgical planning and long-term monitoring to prevent recurrence and ensure optimal recovery in young patients.