OKC vs Ameloblastoma Diagnosis — ORE Part 1 MCQ

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ModerateOral PathologyOKC vs Ameloblastoma DiagnosisORE Part 1

A patient has a radiolucent lesion in the posterior mandible. The differential diagnosis includes an odontogenic keratocyst and an ameloblastoma. Which investigation is most appropriate to establish the diagnosis?

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Correct answer: E — Incisional biopsy with histology

The correct answer is E. Odontogenic keratocyst and ameloblastoma can show overlapping clinical and radiographic appearances, particularly as posterior mandibular radiolucencies. Histopathological examination of an incisional biopsy is therefore the best listed investigation to establish the diagnosis and guide definitive management. Panoramic and periapical radiographs are useful initial imaging tests, but cannot reliably make this distinction alone. Serum tumour markers have no established diagnostic role in these odontogenic lesions. Aspiration may help identify lesion contents or exclude a vascular lesion before biopsy, but cytology alone is not a reliable means of differentiating an odontogenic keratocyst from ameloblastoma.

Reference: Wright JM, Vered M. Diagnosing the most common odontogenic cystic and osseous lesions of the jaws for the practicing pathologist. Modern Pathology. 2017. https://pubmed.ncbi.nlm.nih.gov/32637055/