Management of an extensive calcifying odontogenic cyst in the maxilla of a young patient: a case report

The calcifying odontogenic cyst (COC) is a rare developmental lesion with variable clinical behavior, representing less than 1% of all odontogenic cysts. Its management can be challenging but typically involves enucleation and curettage. This case report aims to describe the clinical, radiographic, histopathological findings, and therapeutic approach used in the treatment of a maxillary COC in a young patient. A 19-year-old female patient presented with a complaint of progressive, asymptomatic swelling on the right side of her face, with a 12-month history. Extraoral examination revealed obliteration of the nasolabial fold and facial asymmetry in the right malar region. Intraoral examination showed a noticeable swelling in the right maxillary vestibule. Cone-beam computed tomography revealed a unilocular, hypodense lesion surrounding the crown of the impacted maxillary canine (tooth 13) and extending to the periapical region of adjacent teeth. An incisional biopsy confirmed the diagnosis of calcifying odontogenic cyst. Initial marsupialization was performed for one year, followed by complete enucleation of the lesion with curettage and peripheral osteotomy, along with extraction of tooth 13. In conclusion, COC may clinically and radiographically mimic other more common maxillary lesions. Conservative treatment modalities should be considered to preserve anatomical structures and facilitate future rehabilitation, thereby contributing to the patient’s quality of life.