Adenomatoid odontogenic tumor: an uncommon location

Adenomatoid odontogenic tumor is an uncommon tumor of odontogenic origin. It is usually located in the anterior region of the maxilla associated with impacted canines. The purpose of this paper was to present a case of adenomatoid odontogenic tumor in a 14-year-old girl with unusual clinical manifestations involving an impacted mandibular lateral incisor as well as its treatment follow-up.     

Neoplastic potential of odontogenic cysts

Odontogenic cysts and tumors are distinct entities and quite a common occurrence in the jaw bones. The lining of odontogenic cysts shows a potential for neoplastic transformation to non odontogenic malignancies like squamous cell carcinoma and mucoepidermoid carcinoma, and odontogenic tumors like ameloblastoma and adenoamatoid odontogenic tumor (AOT). AOT is a benign, epithelial odontogenic tumor, common site being the anterior maxilla. Its origin from a dentigerous cyst and in the mandible is rare. A case of an AOT arising from a dentigerous cyst associated with an impacted permanent mandibular left lateral incisor is reported.     

Mandibular adenomatoid odontogenic tumor: A report of an unusual case

Adenomatoid odontogenic tumor (AOT) is a slow-growing, benign tumor that appears in the anterior portion of the jaws and more frequently, the anterior maxilla usually in association with the crowns of unerupted teeth. Most of the tumors are diagnosed in second decade of life. A rare case report of AOT associated with an impacted right mandibular first premolar in a 24-year-old female is reported.     

Cystic variant of calcifying epithelial odontogenic tumor

The calcifying epithelial odontogenic tumor is a rare benign odontogenic neoplasm of the jaw. Clinically, calcifying epithelial odontogenic tumor manifests as an intraosseous lesion (central type) in the majority of cases (95%). Extraosseous or peripheral lesions account for less than 5% of cases. Calcifying epithelial odontogenic tumor can be associated with an impacted tooth and give a radiographic simulation of dentigerous cyst. Most calcifying epithelial odontogenic tumors are solid in nature, histopathologically, and might have few cyst-like spaces within them. However, a true cystic calcifying epithelial odontogenic tumor is a rare possibility. We describe a case of a true cystic variant of calcifying epithelial odontogenic tumor in a 30-year-old male, which to our knowledge, is only the second reported case.     

Small Central Odontogenic Fibroma Mimicking Hyperplastic Dental Follicle and Dentigerous Cyst

Central odontogenic fibroma has been defined as a benign odontogenic tumor, representing the intraosseous counterpart of a peripheral odontogenic fibroma. The odontogenic fibroma is a rare tumor. Differential diagnosis of radiolucent lesions in the molar-premolar region of mandible which involve impacted tooth may include central odontogenic fibroma, hyperplastic dental follicle, dentigerous cyst, unicystic ameloblastoma, and keratocystic odontogenic tumor. We describe an example of a small central odontogenic fibroma mimicking hyperplastic dental follicle and dentigerous cyst, resulting in uneruption of a primary tooth.     

Dentigerous cyst associated with an impacted anterior maxillary supernumerary tooth

A dentigerous cyst is a developmental odontogenic cyst which develops from the reduced enamel epithelium in an impacted permanent tooth and is rarely associated with supernumerary teeth. The purpose of this article was to report the case of an 8-year-old Korean boy with a dentigerous cyst associated with an impacted anterior maxillary supernumerary tooth and its dental management.     

Carcinoma arising from reduced enamel epithelium

Intra-osseous squamous cell carcinomas are considered to be derived from odontogenic epithelium. Except for an associated benign odontogenic tumor or a cyst, evidence for an odontogenic origin is only circumstantial. In a 73-year-old male, an intra-osseous squamous cell carcinoma in the mandible could be shown to have originated from reduced enamel epithelium. There were no histological features substantiating the odontogenic origin, other than the continuity of tumor epithelium with reduced enamel epithelium surrounding the crown of an impacted molar tooth. Thus, it is concluded that the odontogenic derivation of an intra-osseous squamous cell carcinoma in the jaw cannot be inferred from specific histological features, but should be based on the exclusion of an oral cavity lining epithelial origin. Still more proof is the demonstration of continuity of the carcinoma with odontogenic epithelium, be it normal, cyst lining or benign odontogenic tumor.     

Carcinoma arising from reduced enamel epithelium

Intra-osseous squamous cell carcinomas are considered to be derived from odontogenic epithelium. Except for an associated benign odontogenic tumor or a cyst, evidence for an odontogenic origin is only circumstantial. In a 73-year-old male, an intra-osseous squamous cell carcinoma in the mandible could be shown to have originated from reduced enamel epithelium. There were no histological features substantiating the odontogenic origin, other than the continuity of tumor epithelium with reduced enamel epithelium surrounding the crown of an impacted molar tooth. Thus, it is concluded that the odontogenic derivation of an intra-osseous squamous cell carcinoma in the jaw cannot be inferred from specific histological features, but should be based on the exclusion of an oral cavity lining epithelial origin. Still more proof is the demonstration of continuity of the carcinoma with odontogenic epithelium, be it normal, cyst lining or benign odontogenic tumor.     

Clinical, radiological and histological features of calcifying epithelial odontogenic tumor: case report

The calcifying epithelial odontogenic tumor (CEOT) is a rare benign odontogenic neoplasm that accounts for approximately 1% of all odontogenic tumors. Its origin is controversial as well as its true malignant potential. A case of an advanced CEOT associated with an impacted right second molar in the mandible of a young black female patient is presented. Computed tomography imaging, radiographic and pathological findings, surgical patterns, gross anatomy of the lesion and the performed treatment are discussed.     

Adenomatoid odontogenic tumor associated with calcifying epithelial odontogenic tumor

A case of odontogenic tumor which contained areas diagnostic for both adenomatoid odontogenic tumor and calcifying epithelial odontogenic tumor arising in the upper left anterior region in a 17-year-old Japanese female is reported. The histopathological observation suggested that the lesion represented primarily adenomatoid odontogenic tumor in which multiple foci of calcifying epithelial odontogenic tumor had developed.     

Recurrent calcifying odontogenic cyst involving the maxillary sinus

The calcifying odontogenic cyst is an uncommon lesion that occurs in both jaws, however involvement of the maxillary sinus is rare. The accepted mode of treatment is enucleation with curettage since it is generally believed that recurrence following such treatment is extremely rare. Of the reported cases of recurrent calcifying odontogenic cysts, none have involved the maxillary sinus. This report is of a large recurrent calcifying odontogenic cyst involving the maxillary sinus, eroding the orbital floor as well as anterior and medial walls of the maxillary sinus and displacing an impacted upper canine into the nasal cavity, in a 45-year-old male patient, 8 years after the initial enucleation.     

Conservative surgical treatment of an aggressive calcifying cystic odontogenic maxillary tumor in the young permanent dentition

Calcifying cyst odontogenic tumor (CCOT) is a rare benign cystic neoplasm of odontogenic origin whose treatment depends on the lesion's localization and histological type. The purpose of this report was to describe a case of extensive calcifying cyst odontogenic tumor involving the maxilla of a 12-year old female patient and the treatment option adopted. The lesion was associated with an impacted first premolar, and the roots of the canine and second premolar were divergently displaced. An incisional biopsy revealed the presence of a highly cellular, densely fibrous connective tissue, with diffuse infiltration of mononuclear inflammatory cells. Cystic marsupialization and extraction of the impacted premolar were performed. No signs of lesion recurrence were noted after 28 months. Therefore, marsupialization should be considered when planning CCOT treatment, primarily in young patients with large lesions, to avoid mutilations and tooth loss.     

Hamartomatous proliferations of odontogenic epithelium within the jaws: a potential histogenetic source of intraosseous epithelial odontogenic tumors

BACKGROUND: The jawbone is replete with a vestige of odontogenesis. The overall consensus is that intraosseous remnants of the enamel organ and dental lamina are the only histogenetic option for central epithelial odontogenic tumors. Curiously, incipient tumors or possible precursor conditions of residual odontogenic epithelium have rarely been reported in the literature. METHODS: We microscopically evaluated 39,660 biopsy samples to determine the presence of a tumor-like odontogenic epithelial nodule in the maxilla and mandible. RESULTS: Seven intraosseous specimens that associated with a focal proliferation of odontogenic epithelium were retrieved. Six hamartomatous processes showed four different morphologic patterns comparable with the tumor nests comprising ameloblastoma (n = 1), squamous odontogenic tumor (n=1), calcifying epithelial odontogenic tumor (n=2) and calcifying cystic odontogenic tumor (n=2). Among six lesions, four were the intrafollicular development. The remaining case of interest was multiple hyperplastic clear rests of Malassez in association with an impacted tooth. CONCLUSION: Although it is impossible to predict the fate of these microscopic structures of hamartomatous character, the present case series indicates that any of the dormant embryonic residues of odontogenic epithelium can return to an active state, capable of non-reactive, probably neoplastic proliferation of pathological significance.     

Odontogenic carcinoma occurring in a dentigerous cyst: case report and clinical management

This case report describes an unusual odontogenic carcinoma, which was detected during routine periodontal examination. The lesion occurred in a dentigerous cyst associated with an impacted third molar in an otherwise asymptomatic 66-year-old male patient. The impacted tooth and lesion were excised based on evidence of radiographic change and clinical findings. An unusual histopathologic presentation is reported. The treatment provided for this tumor and the management of impacted teeth is reviewed.     

Variants of the adenomatoid odontogenic tumor with a note on tumor origin

Three rare variants of the adenomatoid odontogenic tumor (AOT) are described. A follicular AOT associated with an impacted and displaced 28, an extra-follicular variant mimicking a radicular cyst around the apex of 23 and a peripheral (epulis-like) variant exhibiting a periodontal bone defect palatal to 21. On reappraisal of the origin and pathogenesis of the AOT, it would seem that this tumor or hamartomatous lesion is derived from odontogenic epithelium of the dental lamina complex or its remnants.     

Central odontogenic fibroma of mandible: a case report and review of the literature

Central odontogenic fibroma is an extremely rare benign tumor, accounting for less than 0.1% of all odontogenic tumors. The most recent literature review revealed that only 69 cases have so far been reported in the English literature, and only 1 of these cases showed radiologic appearance of a dentigerous cyst and this involved impacted maxillary incisors. A case of central odontogenic fibroma occurring in the mandible of a 30-year old female with radiological appearance of a dentigerous cyst involving an impacted lower first molar, presented here, appears to be the first reported case of central odontogenic fibroma of mandible with radiological appearance of dentigerous cyst in the English-language literature.     

Mandibular dentinoma

Dentinoma is a rare odontogenic tumor showing the inductive effects of odontogenic epithelium on the connective tissue. A case of the tumor occurring in the region of the missing right mandibular second permanent premolar of an 11-year-old male is described. The tumor and the impacted right mandibular second deciduous molar were surgically removed. Histologically, areas of hyalinized collagen, osteodentin and tubular dentin were seen in a stroma varying from mesenchymal to more mature. Immunostaining for the distinct types I, III and IV collagens were negative in the hyalinized areas. Type IV collagen stained as a halo corresponding to the basal membrane zone surrounding the groups of odontogenic epithelial cells. Recovery was uneventful. There was no recurrence of the tumor during the first 10 months of follow-up.     

Cystic complex odontoma associated with an impacted canine

An odontoma is a benign tumor containing all the various component tissues of teeth. Although it is the most common odontogenic tumor, it is usually discovered upon radiographic examination or later in life when it has developed into a cyst causing facial asymmetry and swelling of the face. Here is a case of a cystic complex odontoma associated with an impacted permanent canine.     

Adenomatoid odontogenic tumor: a report of a rare case with recurrence

Adenomatoid odontogenic tumor (AOT) is an uncommon tumor of odontogenic origin, composed of odontogenic epithelium in a variety of histoarchitectural patterns, and characterized by slow but progressive growth. Generally, recurrences seldom, if ever, occur after surgical curettage, while here we report an extremely rare case of AOT with recurrence. The patient was a 36-year-old Chinese man who presented with a palpable bony-hard swelling in the anterior maxillary region initially at the age of 16 and the lesion recurred twice over a 20-year period. The tumor was diagnosed as AOT with well-defined unilocular radiolucency shown in X-ray graphs and solid nodule of cuboidal or columnar cells of odontogenic epithelium forming typical nests or rosette-like structures as well as characteristic duct-like spaces in histologic findings.     

Adenomatoid Odontogenic Tumor (AOT) Arising from a Dentigerous Cyst: Literature Review and Report of a Case

Adenomatoid odontogenic tumor (AOT) is an uncommon benign tumor of odontogenic origin composed of odontogenic epithelium in a variety of histopathological patterns. These lesions are usually solid but are occasionally cystic. AOT has been reported to occur in association with odontogenic cysts. Very few cases have been described that arise in association with a dentigerous cyst. A systematic search of the English-language medical literature in PubMed and Medline search (keywords adenomatoid odontogenic tumor, dentigerous cyst) data bases revealed only ten such cases.The present case is very unique, exceptional and first of this kind that occurred in the posterior mandible associated with an impacted lower first premolar in a 19-year old female patient. The intraosseous follicular AOT, as this case reported here, frequently resemble dentigerous cysts. There is an uncertainty whether the lining of an associated cyst represents a true dentigerous cyst, cystic change within an AOT or may represent a distinct entity. We believe that this case represents an odontogenic cyst with neoplastic change. Hence, in such cases, the final diagnosis should be made on the basis of histological examination of extensive tissue sampling of entire excised tissue specimen. Further studies to determine whether the AOT derived from an odontogenic cyst could represent a distinct variant are to be done.