oral pathology
Gingival Cyst of the Adult Case Report and Literature Review Samuel M. Fleisher, B.A.; Scott M. Peters, D.D.S.
ABSTRACT A gingival cyst of the adult (GCA) is a type of odontogenic cyst that is located on the free or attached gingiva, typically in the mandibular canine and premolar region. GCA usually affects people in their fifth and sixth decades of life, with a slight predilection for females. GCA is treated with simple excision, with a low chance of recurrence after surgery. The gingival cyst of the adult (GCA) is an uncommon odontogenic cyst, representing less than 0.5% of all odontogenic cysts.[1] It is seen most frequently in adults in the fifth and sixth decades of life, with a slightly increased predilection for females.[2] The GCA often occurs on the gingiva of the mandibular canine and premolar region, where it presents as a firm-to-fluctuant, bluecolored nodule.[2,3,4] It is distinguished from the lateral periodontal cyst by a lack of findings radiographically.[3] GCA is most often treated by simple excision, with a low recurrence rate.[2,3,5] Herein, we present a case of a gingival cyst of the adult occurring in a 59-year-old female. Case Report A 59-year-old female presented to the emergency clinic of Columbia University College of Dental Medicine with a chief complaint of a bump on her gums. The patient reported that the lesion had been present for approximately two weeks, and she complained of moderate pain at the site when brushing her teeth. The patient’s past medical and surgical history were unremarkable.
30 AUGUST/SEPTEMBER 2021 The New York State Dental Journal ●
Upon presentation, the patient was not in acute distress. The extraoral examination was within normal limits. Intraorally, a partially translucent, blue-tinged, firm nodule was identified on the facial aspect of the left mandibular attached gingiva in the canine region (Figure 1). A periapical radiograph of the site was taken and was unremarkable (Figure 2). The lesion was excised and submitted for histologic analysis. Microscopic examination revealed a cyst lined by a thin layer of epithelium (one to three cells in thickness) with focal areas of thickening (Figures 3a, 3b). Based on these findings, a diagnosis of gingival cyst of the adult was rendered. Discussion Small gingival cysts have been noted histologically as incidental findings on gingival biopsies; however, the term GCA was not coined until Bhaskar and Laskin described a series of cases in 1995.[6] GCAs are of odontogenic origin and comprise fewer than 0.5% of all odontogenic cysts. They typically occur in the fifth or sixth decade of life, with a slight predilection for females. Since many of the cysts are small and asymptomatic, they may, ultimately, go undetected or undiagnosed.[2,7] The epidemiology for GCA is not well-known. Although they are of developmental origin, a triggering event for cyst formation is still under investigation. Some evidence has led researchers to suspect an origin of GCA from junctional epithelium due to the frequent occurrence of lining epithelium of the cysts closely resembling reduced enamel epithelium. Therefore, GCA may be derived from remains of junctional epithelium after tooth eruption.[7]
