A panoramic radiograph of a Gorlin syndrome patient shows multiple regions of multilocular radiolucencies. The MOST likely diagnosis is:

Correct answer: B. Odontogenic keratocysts (OKC/KCOT)

• A. Lateral periodontal cysts are small, single lesions between teeth — not a feature of Gorlin syndrome.
• B. Correct. Multiple OKCs (odontogenic keratocysts, now classified as keratocystic odontogenic tumors/KCOT by WHO) are the hallmark odontogenic finding in Gorlin syndrome. They can be numerous, affect multiple quadrants, and are associated with the PTCH1 tumor suppressor gene mutation.
• C. Dentigerous cysts are single lesions associated with unerupted teeth — not typically multiple or associated with Gorlin syndrome.
• D. Ameloblastoma is locally aggressive but not multiple or characteristically part of Gorlin syndrome.