骨外型牙源性钙化上皮瘤1例报告

牙源性钙化上皮瘤是一种良性肿瘤，也称Pindborg瘤，可分为骨内型和骨外型2种，主要发生于颌骨内，偶见于颌骨外。本文报告1例发生于口底的牙源性钙化上皮瘤，其临床症状与口底皮样囊肿相似．术后经组织病理学确诊，主要组织病理学特征是嗜酸性环状钙化团块。因其具有局部侵袭性，为避免复发，提倡完整切除肿物。     

牙源性角化囊性瘤恶变1例

牙源性角化囊性瘤（KCOT）是一种常见的颌骨牙源性囊性病损,临床上牙源性角化囊性瘤复发常见,而恶变较少见。本文报道1例由牙源性角化囊性瘤恶变为原发性骨内鳞状细胞癌的病例。     

牙源性角化囊性瘤恶变1例

牙源性角化囊性瘤（KCOT）有潜在的侵袭性和较高的术后复发率,但恶变却很罕见。本文报道1例KCOT术后多次复发及感染,最终恶变为鳞状细胞癌的病例,并结合文献对其进行临床病理分析。     

Central granular cell odontogenic tumor: a systematic review

Central granular cell odontogenic tumor (CGCOT) is a rare benign odontogenic neoplasm reported with various terms and is not included in the 2005 WHO classification of odontogenic tumors. It shows a predilection for middle‐aged women, usually presenting as an asymptomatic swelling of the mandibular premolar–molar region. Radiographic manifestations include unilocular or multilocular radiolucent lesion, but mixed density lesions can also occur. Histopathology shows sheets and lobules of round to polygonal cells with abundant eosinophilic, granular cytoplasm and eccentrically placed nuclei. Immunohistochemical and ultrastructural features suggest the histiocytic origin of granular cells. The neoplasm does not exhibit an aggressive biological behavior and hence enucleation or curettage ensuring complete removal remains the treatment of choice. We present a systematic review on clinical, radiological, histopathological, immunohistochemical and treatment aspect of CGCOT. Published articles were identified through a literature search using online databases (PubMed, MEDLINE, Scopus) and cross‐references for papers published from the year 1950 to March 2013. From a total of 37 papers, 26 (38 cases) were extracted from the database for systematic review.     

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.     

Calcifying epithelial odontogenic tumor of the maxilla with ulcerative stomatitis: a case report

Calcifying epithelial odontogenic tumor (CEOT) is a rare benign odontogenic tumor, known as Pindborg tumor. Although ulcer formation was reported in one previously involving the peripheral maxilla, such change of the overlying mucosa has been reported in intraosseous CEOT. We report maxillary CEOT in a patient who complained of spontaneous pain due to extensive ulcer formation of the oral mucosa.     

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.     

Squamous odontogenic tumor (SOT): a benign neoplasm of the periodontium

Abstract True neoplasms are rarely localised to the periodontium. However, early recognition and diagnosis of neoplastic lesions resides within the realm of responsibility of the dentist. In recent years, a number of odontogenic tumors has been described characterized by an occurrence on the gingiva or in the intrabony part of the periodontium. One such neoplasm, the squamous odontogenic tumor (SOT) originally described 20 years ago is now a well-recognized entity localized to the periodontium, be it in the periodontal ligament or in the gingivae. A review of 36 acceptable cases of this tumor published sofar, forms the basis of the present paper.     

颞下窝软组织外周性角化囊肿1例报告

角化囊肿是口腔颌面部常见的牙源性肿物，多见于颌骨，特别是下颌支和下颌体，罕见在软组织中发生。本文报告1例发生在颞下窝软组织中的外周性角化囊肿，并结合文献，对外周性角化囊肿的组织来源及临床诊断进行了讨论。     

Ameloblastoma, calcifying epithelial odontogenic tumor, and glandular odontogenic cyst show a distinctive immunophenotype with some myoepithelial antigen expression

Background:  Odontogenic neoplasms have some morphologic overlap with salivary gland neoplasms, many of which show myoepithelial differentiation. In the 1980s, an ultrastructural study identified a population of myoepithelial-like cells in calcifying epithelial odontogenic tumor. Myoepithelial derived tumors have since been shown to have distinct immunohistochemical profiles.
Methods:  We examined a series of odontogenic neoplasms, including 11 ameloblastomas, four calcifying epithelial odontogenic tumors, five glandular odontogenic cysts (GOCs), and five keratocystic odontogenic tumors with a panel of myoepithelial-associated immunohistochemical stains. We also assessed representative control examples of oral mucosa, odontogenic rests, and dentigerous cysts.
Results:  All of the neoplastic and non-neoplastic oral epithelium-derived entities share a p63-positive, high molecular weight cytokeratin (CK5/6)-positive immunophenotype. Calponin reactivity was at least focally present in two of four calcifying epithelial odontogenic tumors, three of five GOCs, and 10 of 11 ameloblastomas; the sole completely non-reactive ameloblastoma represents a lung metastasis. One case of calcifying epithelial odontogenic tumor was focally positive for glial fibrillary acidic protein. However, other more definitive markers of myoepithelial differentiation, including S-100 and smooth muscle actin, were negative. Two of three calcifying epithelial odontogenic tumors and five of five GOCs were also positive for a low molecular weight cytokeratin (CK7).
Conclusions:  Ameloblastomas, GOCs, and calcifying epithelial odontogenic tumors show a distinctive immunophenotype which overlaps with that of myoepithelial-derived salivary gland neoplasms but does not provide definitive support for myoepithelial differentiation.     

Immunoprofile of the adenomatoid odontogenic tumor

This study was focused on the immunohistochemical profile of the adenomatoid odontogenic tumor. A Pub/Medline search revealed a number of immunohistochemical studies including cytokeratin profiles, extracellular matrix proteins, Integrins, ameloblast‐associated proteins resorption regulators (RANK, RANKL), p53, PCNA, MDM2 protein, cyclin D1, Ki‐67, Bcl‐2 metallothionein, metalloproteinases, D56 hepatocyte growth factor, c‐met, DNA methyltransferase, podoplanin, TGF‐βI, Smad‐2/3, Smad‐I‐5/‐8, Smad 4, beta‐ catenin, calretinin, and clonality. Careful interpretation of the findings indicates that the adenomatoid odontogenic tumor may be more of a hamartomatous than neoplastic nature.     

Clear cell odontogenic tumor in the mandible: report of a case with duct-like appearances and dentinoid induction

A case of clear-cell odontogenic tumor with unusual histological features is presented. A 61-year-old Japanese man was admitted because of swelling of the left premolar-molar region of the mandible. Radiological examination revealed a multilocular radiolucency with irregular margins. Histological examination of the resected specimen showed infiltrative proliferation of both clear and eosinophilic cells into the adjacent soft tissue without encapsulation, suggesting the malignant potential of the tumor. The tumor cells sporadically formed cystic lesions. In addition, several tumor cell nests showed duct-like characteristics, and many eosinophilic dentin-like structures were attached to the tumor cell nests, suggesting the potential for epithelial-mesenchymal induction. Histochemically, the clear tumor cells possessed cytoplasmic glycogen granules. Both clear and eosinophilic tumor cells showed positive immunoreactivities for cytokeratin 19, epithelial membrane antigen and filaggrin, indicating an odontogenic epithelial origin.     

New World Health Organization classification of odontogenic tumours: impact on the prevalence of odontogenic tumours and analysis of 1231 cases from Turkey

The aims of this study were to describe the frequency of odontogenic tumours (OT) based on the World Health Organization’s (WHO) 4^th edition of Head and Neck Tumours in Turkey, to compare the results with other regions and to assess the frequency changes of OT worldwide after the new WHO classification. OT were selected from the pathology department’s files between 1971-2018. In a total of 1231 OT, 1215 (98.7%) were benign, whereas malignant OT were only 16 cases (1.3%). The three most common tumours were ameloblastoma (n = 366, 29.7%), odontoma (n = 335, 27.2% both complex and compound types), and odontogenic myxoma (n = 190, 15.4%), respectively. After the 2017 classification, the decrease of OT frequency was found among 20%-42% in the selected epidemiological series because of re-classification of some lesions. The pattern of incidence in the Turkish population is similar to that in other populations. However, there are some differences in the frequency of the tumour types. It is obvious that the relative frequency of odontogenic tumours worldwide will change based on the new classification. It should be kept in mind that this is not a real decrease of OT cases. These marked changes in the frequency and prevalence of OT is just related to reclassification of some entities.     

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.     

Squamous odontogenic tumor and squamous odontogenic tumor-like proliferations in odontogenic cysts: An updated analysis of 170 cases reported in the literature

Purpose

To integrate the available data published on squamous odontogenic tumors (SOT) and squamous odontogenic tumor-like proliferations in odontogenic cysts (SOT-LPOC) into a comprehensive analysis of their clinical/radiologic features.

Significance of podoplanin expression in keratocystic odontogenic tumor

J Oral Pathol Med (2010) 39 : 110–114
Background:  The most important clinical features of the keratocystic odontogenic tumor (KCOT) are its potential for locally destructive behavior, a tendency to recur, and its origin in the odontogenic epithelium. The clinical features of KCOT are similar to those of ameloblastoma (AM). Histologically, KCOT is distinguished from jaw cyst with keratinization (orthokeratinized odontogenic cyst; OOC). However, current scientifically based clinical parameters cannot predict any potential for neoplastic behavior, or aggressive and localized invasiveness, in patients with KCOT. We have shown that podoplanin, a lymphatic endothelial marker, is highly expressed in AM. The purpose of this study was to determine the usefulness of podoplanin for reclassification of the odontogenic keratocyst (OKC) from cyst to tumor status.
Methods:  Paraffin-embedded tissue specimens of 57 OKCs (46 KCOTs and 11 OOCs) and 15 dentigerous cysts (DCs) were immunohistochemically examined using antibody against podoplanin.
Results:  Immunohistochemical reactivity for podoplanin was detected in the cell membrane and cytoplasm of most of the basal and suprabasal layer, areas of budding basal cell proliferation, epithelial nests and peripheral cells of daughter cysts in the stromal connective tissue in KCOTs. In the case of OOC and DC, only cases associated with inflammation were positive for podoplanin.
Conclusion:  Podoplanin is strongly expressed in KCOTs in comparison with OOCs. The pattern of staining for podoplanin in KCOT could be related to its neoplastic nature, and suggests a role of the protein in tumor invasiveness.     

Prognostic factors for keratocystic odontogenic tumor (odontogenic keratocyst): analysis of clinico-pathologic and immunohistochemical findings in cysts treated by enucleation

Background:  The purpose of this study was to determine prognostic factors for the recurrence of keratocystic odontogenic tumors (KCOTs) following simple enucleation by examining clinico-pathologic and immunohistochemical findings.
Methods:  Following enucleation, the frequency of recurrence among 32 subjects diagnosed with KCOT was analyzed for tumor site, radiographic and histologic features, and immunopositivity for Ki-67 and p53.
Results:  Keratocystic odontogenic tumors in four out of 32 subjects (12.5%) recurred during the follow-up period (median: 33 months, range: 7–114 months). Three out of four subjects (75.0%) among recurrent group showed high expression of Ki-67 (LI >10%) in basal layer and four (4/28; 14.3%) among non-recurrence group ( P  = 0.025). Expression of p53 among non-recurrent group was observed in 11 subjects (11/28; 39.3%), and in three subjects (3/4; 75.0%) among the recurrent group ( P  = 0.295). Hazard risk for the recurrence of KCOT was 4.02 (95% CI 1.42–18.14) for high Ki-67 expression in the basal layer by the Cox proportional hazard model ( P   =  0.009). In our study, none of the other clinico-pathologic variables were associated with the recurrence of KCOT.
Conclusion:  The results suggested that the evaluation of Ki-67 expression in KCOT at the time of pathological diagnosis might be helpful for consideration of appropriate adjunctive surgical procedures to avoid a recurrence and may serve as a prognostic marker.     

牙源性钙化上皮瘤2例

牙源性钙化上皮瘤（CEOT）是一种具有局部浸润性生长特点的良性牙源性上皮性肿瘤,可分为骨内型（中央型）、骨外型（外周型）两种,后者罕见。本文报道2例牙源性钙化上皮瘤,并结合文献探讨其临床、影像表现特点。