Calcifying epithelial odontogenic cyst (CEOC) or Gorlin’s cyst, occurs both as a cyst and (less commonly) as a solid tumor, the common characteristics being derivation from odontogenic epithelium, calcification, and so-called ghost cell keratinization (recently identified as coagulative necrosis of proliferated odontogenic epithelium)
(Figure 7-25). Both central and peripherally located lesions are described.Calcifying odontogenic cysts or areas exhibiting these characteristic histologic changes are sometimes found in association with ameloblastomas or other odontogenic tumors, partially accounting for the variety of names under which this lesion has been described in the literature (Figure 7-26, F). Benign and malignant varieties are described, and the lesion mostly occurs in adolescents, appearing as a uni- or multilocular radiopacity enclosing calcified structures of variable size (“pepper-and-salt” appearance). Enucleation usually eliminates the lesion unless it is a component of another odontogenic tumor with a tendency to recur.