Surgical enucleation is the first choice treatment for keratocystic odontogenic tumor (KOT), but marsupialization has been used in some cases to reduce morbidity related to the treatment. The objective of this study is to present long-term results of six cases of sporadic and one case of syndromic KOT, treated by marsupialization or enucleation. Marsupialization was done in two cases as a single treatment, considering the large size of the lesion. These cases had been followed up for 8 and 11 years respectively. Other five cases were treated by enucleation, in three of them with additional procedures (liquid nitrogen, two cases, including the syndromic case, Carnoy’s solution, one case. These cases were followed for 4, 5, 6, 6 and 15 years, respectively. There was no recurrence in any of the seven cases. Despite marsupialization has been associated with higher risk of recurrence than enucleation, the former can be used with success for the treatment of KOT. These findings open new perspectives towards less invasive and more conservative approach in selected cases in order to avoid major surgeries in large lesions with KOT diagnosis.

Key words: keratocystic odontogenic tumors; keratocystic odontogenic