For dentated patients, to do my best treatment planing to manage this cystic lesion, I have to confirm a diagnosis of keratocystic tumor preoperatively, not to treating it as ordinary cysts, to avoid recurrence. aspiration biopsy and radiographic examination (If was atypical for KCT) enough to make me assured its KCT when manage it surgically.
To confirm the diagnosis of KZOT, a histological examination is required either as a biopsy or examination of the entire primary remote cyst . Also immuno-histochemical methods can be used. Aspiration biopsy will not have a sufficient diagnostic confidence.
I would not confirm the diagnosis of KCOT based on aspiration cytology and radiographic features only. This position for me holds very true when I have a lesion that is readily accessible for an incisional biopsy. Where the lesion is very small and or not readily accessible for an incisional biopsy, I would go utilize the results of FNAC and radiographic investigations, and go ahead with a procedure which I would tag "excisional biopsy". If FNAC suggests that it is KCOT, I would take every precaution to avoid a recurrence. My definitive diagnosis will however be obtained only after the excisional biopsy specimen has been processed.
Apart from clinical and radiographic findings histological examination confirms the diagnosis.
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