The role of interdisciplinary communication in the proper diagnostics of jaw cysts

Abstract

Introduction: Proper diagnosis of jaw cysts requires the parallel evaluation of clinical, radiological and histopathological findings. Lack of clinico-radio-pathological correlation can lead to inconsistent diagnoses. Objective: To evaluate the rate of lacking clinico-pathological communication and demonstrate how this may influence diagnostics. Method: Data of a former retrospective analysis were re-evaluated to quantify the lack of clinical data communicated to pathologists and estimate the rate of final diagnoses requiring alteration after review of all available clinical data. 10 anonymized reports on odontogenic cysts from 3 university pathology departments each were analysed for the lack of relevant clinical information. Results: Only the age and gender of patients were documented in 100% for 85 jaw cysts diagnosed in 2 departments of pathology. Adequate information about cyst localization and size were communicated in 62% and 29%, respectively. Overall, information relevant to the diagnosis was given in 52% of the cases. Revision based on clinico-radiopathological correlation led to alterations of the diagnosis in 38/85 cases (45%). Based on reports from other institu-tions, the communication of clinical data is estimated to be between <50% and 100%. 25 pathologists were involved in reporting 105 cysts. 5 cases illustrate how diagnosis may fail without good communication: a paradental, an inflamed dentigerous and a lateral periodontal cyst, each misdiagnosed as radicular cyst; a cyst raising the differential diagnosis of nasopalatine duct versus radicular cyst; a botryoid odontogenic cyst. Conclusion: Proper diagnosis of jaw cysts requires improvements from both pathological and clinical sides, and could probably be improved through education.