The odontogenic keratocyst (OKC) is a unique type of odontogenic cyst. The current nomenclature recommended by the World Health Organization is KCOT, because it better reflects the neoplastic nature of the lesion than the previously used term OKC.1 The KCOT is locally aggressive because it has a high mitotic activity and epithelial turnover rate, prostaglandin-induced bone resorption, and active collagenases in the fibrous cystic wall. These characteristics lead to its potential for local destructive behavior, its propensity for recurrence, and its tendency to multiply, especially when it is associated with nevoid basal cell carcinoma syndrome (Goltz-Gorlin syndrome).1,2