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Since the term odontogenic keratocyst first appeared in the literature, controversy has surrounded its terminology and surgical management. Recent articles would suggest that surgical opinion is still divided between aggressive radical resection and a more conservative approach. We present an interesting case of a large keratocystic odontogenic tumour shown to have eroded through bony cortices and present within soft tissues that was satisfactorily managed conservatively by decompression and secondary enucleation., (Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2014.)