Resection and Immediate Reconstruction of a Large Mandibular Keratocystic Odontogenic Tumor: A Case Report

Abstract

Keratocystic Odontogenic Tumor (KCOT) is a benign yet aggressive cystic lesion of the jaws, often associated with high recurrence rates and locally destructive behavior. It accounts for 10%–20% of all odontogenic cysts, commonly affecting the mandible and presenting in the second to fourth decades of life. Although the World Health Organization initially classified KCOT as a cystic neoplasm due to its aggressive nature and genetic mutations, it was later reclassified as an odontogenic cyst following evidence that partial treatment may lead to regression. Treatment options for KCOT vary, with resection favored for larger, more aggressive lesions due to high recurrence rates with conservative approaches. This case report presents a 38-year-old male with recurrent jaw pain and locking due to a large KCOT in the right mandibular condyle. The patient underwent resection and immediate reconstruction using a custom-made total joint prosthesis. Post-operative recovery and follow-up are discussed, along with relevant imaging findings.