Archive of Clinical Cases

The keratocystic odontogenic tumor (KCOT), earlier considered as the odontogenic keratocyst (OKC), is now classified as a benign neoplasm owing to its aggressive nature which includes a high recurrence rate. This case report describes a symptomatic large intraosseous odontogenic cystic neoplasm in the left mandible presenting radiographically as a large multilocular radiolucency and associated with an impacted tooth. The typical clinical and distinguishing histological features of KCOT morphed by the presence of inflammation are discussed here together with an intriguing clear cell component and epithelial theques and their clinical relevance. The newly acknowledged neoplastic potential serving significant role in treatment planning has also been addressed. Various lesions can present intraosseously as large multilocular radiolucencies in the jaws. Histopathological examination remains the mainstay for the diagnosis of such lesions.