Keratocystic odontogenic tumor of the maxilla-a serious entity often misdiagnosed: A report of two cases resembling dentigerous cysts

The most common maxillary location for a keratocystic odontogenic tumor (KCOT) is the canine region where they commonly are mistaken for an inflammatory radicular cyst or dentigerous cyst or a lateral periodontal cyst or even a nasopalatine cyst. This misdiagnosis occurs mainly because of the appearance of KCOT as a unilocular radiolucency in the maxilla, particularly if the KCOT is found coincidentally with a nonvital tooth. Additionally, the cyst is frequently infected producing pus that obscures the typical white cheesy material. A misdiagnosis based solely on clinical information can lead to the possibility of the patient being treated with a conservative endodontic therapy or even conservative surgical techniques thereby greatly increasing the chances of progression or recurrence of this aggressive lesion. Here, we report two such cases diagnosed and treated aggressively.