A rare case report of an adenomatoid odontogenic tumor associated with odontoma in the maxilla

IntroductionThe adenomatoid odontogenic tumor (AOT) associated with odontoma has been described as a new entity with overlapping features of adenomatoid-like structures and odontoma. Presentation of the case: We report the second case of AOT associated with odontoma in the posterior maxillary region. A 22-year-old patient presented expansion of the vestibular and palatine cortical wall of maxilla. Radiographic examination and computed tomography confirmed erosion of maxillary walls, root resorption, displacement of a neighboring tooth and radiopacities within the lesion. Histopathological analysis showed a cystic cavity lined by odontogenic epithelium, organized as duct like structures and tubular dentin. The diagnosis established was AOT associated with odontoma.DiscussionAs fewer cases have been described, the aim of this study is to report clinical behavior and evolution of adenomatoid odontogenic tumor associated with odontoma, as it have not yet been described and its origin is not completely established. The hamartomatous or neoplastic origin of this tumor is under debate.ConclusionsTherefore, it is necessary similar cases to be published to increase the knowledge about the clinical behavior and evolution of this tumor, to enable such lesions to be more clearly defined in the next classification of odontogenic tumors.     

Multifocal calcifying epithelial odontogenic tumor.

The calcifying epithelial odontogenic tumor (CEOT), or Pindborg tumor, is a rare and benign odontogenic neoplasm that affects the jaw. The most common manifestation of CEOT is a unifocal or localized lesion of the involved jaw, which may appear clinically as a hard tissue swelling and radiographically as a mixed radiolucent-radiopaque mass. In this article, we present a unique case of CEOT affecting multiple sites in the maxilla and mandible of a 51-year-old white man. Though biopsy samples from all involved sites revealed similar histopathologic features consistent with CEOT, the fact that there was a multifocal presentation is an unusual phenomenon for CEOT and has never been reported. Multifocal odontogenic lesions are not typical but have been observed in conditions associated with known genetic mutations. For example, multiple odontogenic keratocysts are the most common feature of the inherited condition known as nevoid basal cell carcinoma syndrome. This case, however, is the first one to demonstrate that there may be a multifocal variant of CEOT that has not been previously recognized.     

Malignant calcifying epithelial odontogenic tumor of the mandible: report of a case with pulmonary metastasis showing remarkable response to platinum derivatives.

We describe a case of CEOT of the mandible, which underwent malignant transformation and developed metastatic tumors of the lung after repeated local recurrence. The primary tumor revealed typical histological features of benign CEOT showing sheets of polyhedral epithelial cells associated with abundant eosinophilic amyloid-like materials. On the other hand, the locally recurrent tumors had malignant features, such as increased nuclear pleomorphism with frequent mitotic figures and vascular invasion of tumor cells, as well as increased proliferative activity assessed by immunostaining for Ki-67. Chemotherapy was carried out against the pulmonary metastatic lesions, which showed a drastic response after 3 courses of intravenous administration of cisplatin (CDDP). To date, a total of 6 courses of CDDP and 6 courses of nedaplatin (CDGP) have been done, and the remaining pulmonary tumors have been dormant. This suggests that platinum derivatives could be a chemotherapeutic agent of choice against this rare tumor.     

Cystic variant of calcifying epithelial odontogenic tumor.

Calcifying epithelial odontogenic tumor (CEOT) is a benign, locally aggressive odontogenic neoplasm characterized by sheets and nests of epithelial cells with deeply eosinophilic or occasionally clear cytoplasm, calcifications, and eosinophilic amorphous material that stains positive for amyloid. Although many cases of CEOT are associated with impacted teeth and occasionally appear radiographically as dentigerous cysts, a true cystic variant has not been previously reported. We report a 15-year-old white male with a large cystic maxillary lesion that filled most of the left maxillary sinus. It deformed the medial wall, the inferior orbital floor, and caused narrowing of the left inferior meatus. Histologically, the cystic lining showed characteristics of CEOT. An intraluminal component that featured histologic characteristics of CEOT was identified during surgery. The lesion was enucleated and the postsurgical course of the patient was uneventful. Because follow-up has been for less than 1 year, a meaningful long-term prognosis cannot be determined at present. However, the patient has not reported any symptoms or signs of recurrence during the follow-up period.     

Clear cell variant of calcifying epithelial odontogenic tumor: Case report and review of the literature

The calcifying epithelial odontogenic tumor (CEOT) is a rare benign odontogenic neoplasm which was first described by Pindborg in 1955 and accounts for less than 1% of all odontogenic lesions. Recently, a clear cell variant of CEOT has been identified with only eight well-documented cases in the literature. We present an additional case of clear cell CEOT of the mandible and review the salient clinical, radiologic, and histopathologic features of this entity and CEOTs in general. The differential diagnosis of clear cell tumors in the mandible includes: clear cell odontogenic tumor, clear cell ameloblastoma (odontogenic carcinoma), metastatic clear cell adenocarcinoma, primary intraosseous mucoepidermoid carcinoma, acinic cell carcinoma, epithelial-myoepithelial carcinoma, clear cell salivary gland tumors, and clear cell variant of squamous cell carcinoma. Because of the belief that clear cell odontogenic tumors are locally aggressive neoplasms, definitive resection of the entire mass with tumor-free surgical margins and long-term follow-up are recommended. © 1994 John Wiley & Sons, Inc.     

Solid and cystic tumor of the pancreas: a case report

A case of a solid and cystic tumor of the pancreas occurring in a 15 year-old girl is reported. This patient was admitted with epigastric and left upper quadrant pain and vomiting. A mass was detected in the pancreas on CT scan and the patient was referred for surgery. A distal pancreatectomy was performed. A pathological diagnosis of solid and cystic tumor of the pancreas was made and the patient was discharged uneventfully.     

Computerized tomography of Castleman's disease simulating a false renal artery aneurysm: a case report

We report a case of retroperitoneal Castleman's disease of the hyaline vascular type simulating a false renal artery aneurysm. Excretory urography with computerized tomography and angiographic findings are presented. All 3 investigations demonstrated a homogeneously enhancing hypervascular retroperitoneal mass.     

Analysis of ghost cells in calcifying cystic odontogenic tumors by confocal laser scanning microscopy.

OBJECTIVE: The confocal laser scanning microscope represents an effective tool for studying biological samples stained for fluorescence observation. In this study we have used the confocal microscope to analyze ghost cells in calcifying cystic odontogenic tumors. STUDY DESIGN: Specimens from 15 calcifying cystic odontogenic tumor cases were stained with hematoxylin and eosin, and scanned by a confocal laser scanning microscope to generate optically sectioned images. RESULTS: All of the analyzed samples presented autofluorescent cells that were identified as ghost cells. The degree of autofluorescence intensity was variable and may be a result of the presence of hard keratin. CONCLUSION: The confocal laser scanning microscope may be of help in analyzing and defining the nature and extent of keratinization processes in calcifying cystic odontogenic tumor ghost cells.     

Intraosseous calcifying pseudotumor of the axis: a case report

STUDY DESIGN: A case report and review of the literature. OBJECTIVE: To present the first case of intraosseous calcifying pseudotumor arising from the axis. SUMMARY OF BACKGROUND DATA: Calcifying pseudotumor is a very rare disease. Only 24 cases have been previously reported. METHODS: A case of calcifying pseudotumor involving the body, dens, and laminae of the axis in a 60-year-old male patient was managed with total laminectomy of the axis and instrumented occipitocervical fusion, followed by the curettage of the body and dens of the axis and autogenous iliac bone graft. Medical records, imaging studies, microscopic findings, and related literature are reviewed. RESULTS: Microscopic examination showed amorphous, basophilic, and chondroid calcifying masses surrounded with palisading histiocytes and foreign body-type giant cells. The findings were consistent with those of calcifying pseudotumors previously reported in other sites of the body. At 24 months after operation, a significant reduction of neck pain was achieved. But there was evidence of local recurrence of the lesion in the body and dens of the axis with a local progression of the preexisting lesion in the facet joints. CONCLUSION: This is the first report of intraosseous calcifying pseudotumor arising from the axis.     

Benign cystic mesothelioma: A case report on the presentation of an unusual tumor

IntroductionBenign cystic mesothelioma of the peritoneum is a rare, benign abdominal tumor. It can present with vague signs and symptoms and is often found on imaging or incidentally during surgery.Presentation of caseWe report the case of a 30-year-old man presenting with acute abdominal pain that radiated to the right iliac fossa. No masses were found on superficial or deep palpation or on conducting a sonography. The patient underwent a diagnostic laparoscopy with an appendectomy, which revealed a perforated appendix and two cysts in the pelvis and iliac fossa.DiscussionA benign cystic mesothelioma is an inclusion cyst found in the peritoneal cavity and has no specific clinical presentation. It can be symptomatic or found incidentally during surgery. Benign cystic mesotheliomas have a high recurrence rate and may undergo malignant transformation.ConclusionComplete surgical excision of benign cystic mesothelioma must always be the first step of the treatment plan for this condition. It is difficult to treat with no evidence-based treatment modality available; thus, treatment should only be undertaken in a specialized center.     

Intracranial dermoid tumor: diagnosis by computed tomography. A case report

Computed tomography (CT) of an intracranial dermoid tumor in a 43-year-old woman demonstrated a central soft tissue density (hair) in a low density (fat) cavity with a partially calcified wall. There was no contrast enhancement of the tumor. The CT findings were the most conclusive in the diagnosis and were helpful in the management of the patient.     

Prostatic cancer with cystic formation: a case report

An 82-year-old man presented with a huge hypogastric tumor. A pelvic computed tomographic scan and magnetic resonance imaging revealed a multiple cystic mass 14 x 10 x 15 cm in diameter. The prostate specific antigen (PSA) value was elevated to 903 ng/ml. Histological examination of the needle biopsy specimens of the prostate revealed moderately differentiated adenocarcinoma. Bone scintigraphy showed a hot area in part of the costa. No other abnormalities were found. The tumor origin was suspected to be the prostate, but the possibility that it was another organ could not be denied completely since the tumor was located in the anterior portion above the bladder. Treatment with luteinizing hormone-releasing hormone agonist and diethylstilbestrol was initiated considering the patient's age. The PSA value returned to normal and the tumor size was reduced markedly after 28 weeks of therapy. Thirty-seven case of prostatic cancer with cystic formation in the Japanese literature are reviewed.     

Prostatic cancer with cystic degeneration: a case report

A 73-year-old man with prostatic cancer with cystic degeneration is reported. He visited our clinic for postoperative examination of left metastatic lung cancer and treatment of prostatic hypertrophy. When the prostatic biopsy was performed, bloody fluid was aspirated and prostate size on digital examination was reduced. The obtained specimen consisted of scar tissue. Urethrography showed an elongation of prostatic urethra in addition to the compression of urinary bladder from the rear. CT scan demonstrated a prostatic cyst approximately 8 cm in diameter with an irregular margin. Following the transurethral resection of the prostate, the prostatic cyst was opened and papillary tumor observed. Histological examination revealed a well differentiated medullary cancer which coincided with the pathological finding of left metastatic lung cancer. He died from dyspnea caused by pleuritis carcinomatosa 6 years later. Nine cases of prostatic cancer with cystic degeneration in the Japanese literature are reviewed.     

Renal oncocytoma with cystic degeneration: a case report

A 45-year-old man was referred to our department because of a right renal mass which was incidentally found at a health screening. Ultrasound sonography, computerized tomography and magnetic resonance imaging showed a hypovascular tumor 3 cm in diameter with the fluid at the upper pole of the right kidney, implicating that the tumor was renal cell carcinoma originating from a renal cyst wall, or with central necrosis. A radical nephrectomy was therefore performed. The tumor was dark-brown and contained brown fluid. The histopathological findings showed renal oncocytoma with cystic degeneration.