RARE MANIFESTATION OF KERATOCYST IN THE PAROTID GLAND – CLINICAL CASE REPORT

Abstract

Odontogenic keratocysts tend to occur frequently in the posterior region of the mandible and can be asymptomatic in many cases. This condition is often discovered incidentally on radiographs, highlighting the importance of imaging in its early detection. The patient was referred to an oral and maxillofacial surgeon, presenting with mandibular pain, difficulty opening the mouth, and purulent discharge in the left mandibular region, with an initial diagnosis of osteomyelitis. As the team's first approach, en bloc resection of the lesion and the use of a reconstruction plate were chosen. The collected material was sent for histopathological analysis, where we obtained the result "odontogenic keratocyst," in addition to osteomyelitis. Three interventions were performed after the diagnosis, necessary due to recurrences and observed soft tissue infiltration. After invasion of the left parotid gland, the patient was referred to a head and neck surgeon. After referral, three more interventions were necessary. The last one consisted of amputation of the left ear, auditory canal, and part of the base of the skull. Currently, enucleation and curettage, combined with the use of 5-Fluorouracil, is proposed as treatment for keratocyst. This case shows us a rare and extremely aggressive situation of keratocyst associated with osteomyelitis, with soft tissue invasion.