Odontogenic keratocysts (OKCs) are typically intraosseous developmental cysts characterized by specific histopathological features and a relatively high recurrence rate. Peripheral odontogenic keratocysts (POKCs) occurring in soft tissues are extremely rare, with the buccal mucosa representing an exceptionally uncommon site. A 71-year-old male presented with a progressively enlarging mass in the right buccal mucosa. Clinical and radiographic examinations, including panoramic radiography and computed tomography, revealed an 18 mm soft tissue mass without bony involvement. Under a clinical impression of a benign soft tissue cyst, the lesion was surgically enucleated. Histopathological examination revealed a cystic cavity lined by a uniform parakeratinized stratified squamous epithelium with a palisaded hyperchromatic basal cell layer and a corrugated luminal surface, confirming a diagnosis of peripheral odontogenic keratocysts (POKCs). The postoperative course was uneventful, and no clinical signs of recurrence were observed at the 2-year follow-up. Although POKCs in the buccal mucosa are rare, they should be considered in the differential diagnosis of solitary soft tissue masses in this region. Clinical features alone are often non-specific and insufficient for diagnosis; therefore, definitive histopathological confirmation of the parakeratinized epithelial lining is essential for appropriate management and long-term follow-up.

• 조형규(전북대학교 치과대학 구강악안면외과학교실) | Hyeong-kyu Jo (Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University, Jeonju 54896, Republic of Korea)
• 백진아(전북대학교 치과대학 구강악안면외과학교실, 전북대학교 치과대학 구강생체과학연구소) | Jin-A Baek (Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University, Jeonju 54896, Republic of Korea, Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University) Corresponding author