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Indu S, Sood A, Mishra D. Hybrid odontogenic tumor masquerading as a salivary gland lesion: A diagnostic predicament. J Oral Maxillofac Pathol 2021; 25:S32-S36. [PMID: 34083967 PMCID: PMC8123243 DOI: 10.4103/jomfp.jomfp_51_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 01/20/2021] [Accepted: 01/29/2021] [Indexed: 11/29/2022] Open
Abstract
Hybrid odontogenic tumors are sporadic, where the distinctive areas of more than one odontogenic tumor tissue type have been reported. The occurrence of adenomatoid odontogenic tumor (AOT) with calcifying epithelial odontogenic tumor (CEOT) like areas histologically simulating salivary gland pathology is an unusual finding that has not been previously reported in the literature. We report the case of a 32-year-old female presenting with slow-growing firm swelling, radiographically as a pear-shaped radiolucent lesion in the interdental region of maxillary incisors. Histologically, the tissue showed nests and anastomosing strands of the bland cuboidal to squamoid epithelial cells showing nuclear pleomorphism, hyperchromatism, and abundant cytoplasm with prominent intercellular bridges focally. Multiple basophilic calcifications, amyloid-like material, duct-like formation, and mucinous spillage are seen. Tumor cells showed immunopositivity for CK 7, CK 19, CK 8/18 and low Ki67, p63, and immunonegativity for S100 suggesting of a hybrid lesion of CEOT with AOT.
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Affiliation(s)
- Sudip Indu
- Army Dental Centre (R and R), New Delhi, India
| | - Anubhuti Sood
- Department of Oral Pathology and Microbiology, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Deepika Mishra
- Department of Oral Pathology and Microbiology, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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Ruddocks LA, Fitzpatrick SG, Bhattacharyya I, Cohen DM, Islam MN. Calcifying epithelial odontogenic tumor: a case series spanning 25 years and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 131:684-693. [PMID: 33737014 DOI: 10.1016/j.oooo.2021.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/09/2020] [Accepted: 01/05/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The calcifying epithelial odontogenic tumor (CEOT) is a rare benign neoplasm that makes up less than 1% of all odontogenic tumors. This study aims to describe a case series of CEOT spanning 25 years and to review and compare our results with the existing literature. STUDY DESIGN With institutional review board approval, all CEOT archival cases from the University of Florida Oral Pathology Biopsy Service between 1994 and 2019 were retrieved. A total of 20 cases were included. Based on current criteria, 2 cases that stained positively for CD1 a were excluded, because these most likely represented the amyloid-rich variant of central odontogenic fibroma. RESULTS Average patient age was 40 years. Females and males were affected equally (n = 10). The mandible was more commonly involved (60%, n = 12) than the maxilla (40%, n = 8). CEOT variants included incipient CEOT (10%, n = 2) and peripheral CEOT (10%, n = 2). One case exhibited features of adenomatoid odontogenic tumor in addition to CEOT. Congo red staining for amyloid was performed in 13 cases, all of which were positive. CONCLUSION Our results align with the literature. Awareness of the different variants of CEOT and of the separate but similar-appearing amyloid-rich variant of central odontogenic fibroma will help to ensure accurate diagnosis and appropriate treatment.
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Affiliation(s)
- Lauren A Ruddocks
- Resident, Oral & Maxillofacial Pathology, Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA.
| | - Sarah G Fitzpatrick
- Adjunct Research Assistant Professor, Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry
| | - Indraneel Bhattacharyya
- Division Director, Oral & Maxillofacial Pathology, Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry
| | - Donald M Cohen
- Department Chair, Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry
| | - Mohammed N Islam
- Program Director, Oral & Maxillofacial Pathology, Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry
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CEOT Variants or Entities: Time for a Rethink? A Case Series with Review of the Literature. Head Neck Pathol 2020; 15:186-201. [PMID: 32642935 PMCID: PMC8010033 DOI: 10.1007/s12105-020-01200-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/01/2020] [Indexed: 10/27/2022]
Abstract
The first detailed description of calcifying epithelial odontogenic tumor (CEOT) are ascribed to Jens Pindborg, but this tumor was described some years previously. Subsequently, CEOT was included in the 1971 WHO classification of odontogenic tumors and a since then number of variants have been described, which have added confusion to the diagnostic criteria. We aimed to survey the literature on the variants of CEOT, in parallel with a review of our single institution experience of CEOTs. Cases identified were collated, including available clinical, radiological and histological information and then reviewed, taking into account changes in the understanding and classifications of odontogenic tumors since initial diagnosis. We identified 26 cases from 1975 to 2017 for which histological material was available. Of these, only 13 (50%) showed the "classic" histological appearance, whilst two cases were identified as recognized variants. In 11 cases, other diagnoses or a differential diagnosis were preferred, with no agreed diagnosis in four of these. The proliferation fraction (Ki67) in the 10 cases tested was 2.1% ± 0.18. These findings illustrate the diagnostic challenges in this group of tumors and highlight the gaps in knowledge. Techniques, such as EWSR1 gene cytogenetic analysis, may be helpful in cases with clear cells. However, in other areas of controversy, including the non-calcifying and Langerhans cell rich variants, further investigation, perhaps utilizing sequencing technologies may be needed to refine the classification. Owing to the relative rarity of these lesions it would be beneficial if future work could be pursued as an international collaboration.
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Singh AK, Mishra R, Jain G, Singh AK. Calcifying epithelial odontogenic tumors (Pindborg tumor) of maxilla in pediatric patients. Natl J Maxillofac Surg 2020; 11:127-131. [PMID: 33041592 PMCID: PMC7518479 DOI: 10.4103/njms.njms_75_15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 04/28/2016] [Accepted: 02/17/2020] [Indexed: 11/29/2022] Open
Abstract
The calcifying epithelial odontogenic tumor (CEOT) was first described by Pindborg as a distinct entity in 1955. Odontogenic tumors are derived from epithelial, ectomesenchymal, and/or mesenchymal elements that are or have been a part of the tooth-forming apparatus. Of all the odontogenic tumors, CEOT accounts for 1% of the cases. There is no sex predilection, with a 2:1 predilection for the mandible, mostly in the premolar/molar region. The CEOT typically presents clinically as an intraosseous, expansile, and painless mass that exhibits slow growth. It is often locally invasive. Most often, it is associated with an impacted tooth, is asymptomatic, and requires biopsy for diagnosis. Although most of these cases are primarily intraosseous, an extraosseous tumor is also known to occur, first observed by Pindborg in 1966. The lesions were surgically enucleated, and histopathological examination confirmed CEOT. The purpose of this article is to describe one additional case of both variants of CEOT.
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Affiliation(s)
- Atul Kumar Singh
- Department of Dentistry, UPUMS, Saifai, Etawah, Uttar Pradesh, India
| | - Rahul Mishra
- Department of Dentistry, UPUMS, Saifai, Etawah, Uttar Pradesh, India
| | - Gourav Jain
- Department of Dentistry, UPUMS, Saifai, Etawah, Uttar Pradesh, India
| | - Arvind Kumar Singh
- Department of Prosthodontics, Chandra Dental College, Barabanki, Uttar Pradesh, India
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Bilodeau EA, Seethala RR. Update on Odontogenic Tumors: Proceedings of the North American Head and Neck Pathology Society. Head Neck Pathol 2019; 13:457-465. [PMID: 30887391 PMCID: PMC6684684 DOI: 10.1007/s12105-019-01013-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 01/19/2019] [Indexed: 12/16/2022]
Abstract
Odontogenic tumors are rare entities, often derived from the epithelial remnants in the gnathic bones following odontogenesis. This brief manuscript will seek to address recent developments pertaining to odontogenic tumors as well as particularly uncommon odontogenic tumors and the difficulties in their diagnosis.
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Affiliation(s)
- Elizabeth Ann Bilodeau
- Department of Diagnostic Sciences, School of Dental Medicine, University of Pittsburgh, 3501 Terrace St., Pittsburgh, PA 15261 USA
| | - Raja R. Seethala
- Department of Pathology and Laboratory Medicine, University of Pittsburgh Medical Center, Pittsburgh, USA
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Santosh N, McNamara KK, Kalmar JR, Iwenofu OH. Non-calcifying Langerhans Cell-Rich Variant of Calcifying Epithelial Odontogenic Tumor: A Distinct Entity with Predilection for Anterior Maxilla. Head Neck Pathol 2018; 13:718-721. [PMID: 30109555 PMCID: PMC6854182 DOI: 10.1007/s12105-018-0958-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 08/10/2018] [Indexed: 11/28/2022]
Abstract
Calcifying epithelial odontogenic tumor (CEOT) is an uncommon locally invasive epithelial odontogenic tumor of the jaws associated with amyloid production. Intraosseous presentations are most common and they frequently occur in the posterior mandible. A non-calcifying Langerhans cell-rich variant of CEOT (NCLC CEOT) has been described with predilection for the anterior maxilla. Interestingly, all reported cases of NCLC CEOT have occurred in Asian population. We present a case of a 43-year old Caucasian female with a large radiolucent lesion involving the left anterior maxilla with histologic features of NCLC CEOT. This is the first reported case of this rare variant of CEOT in a Caucasian individual.
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Affiliation(s)
- Neetha Santosh
- Divison of Oral and Maxillofacial Pathology and Radiology, The Ohio State University College of Dentistry, Columbus, OH, USA
- Department of Oral Pathology, Radiology and Medicine, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Kristin K McNamara
- Divison of Oral and Maxillofacial Pathology and Radiology, The Ohio State University College of Dentistry, Columbus, OH, USA
| | - John R Kalmar
- Divison of Oral and Maxillofacial Pathology and Radiology, The Ohio State University College of Dentistry, Columbus, OH, USA
| | - O Hans Iwenofu
- Department of Pathology & Laboratory Medicine, The Ohio State University Wexner Medical Center, 410 West 10th Avenue, Columbus, OH, 43210, USA.
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Sah K. The so-called "combined epithelial odontogenic tumor": A specific entity or not? J Oral Maxillofac Pathol 2017; 21:192-193. [PMID: 28932026 PMCID: PMC5596667 DOI: 10.4103/jomfp.jomfp_92_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Kunal Sah
- Department of Oral Pathology and Microbiology, Saraswati Dental College, 233 Tiwari Ganj, Faizabad Road, Lucknow - 227 105, Uttar Pradesh, India. E-mail:
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Rosa ACG, Soares AB, Furuse C, Lima SRR, de Araújo VC, Passador-Santos F. A Combined Epithelial Odontogenic Tumor? A 7-Year Follow-Up Case. Head Neck Pathol 2016; 11:519-524. [PMID: 27817004 PMCID: PMC5677059 DOI: 10.1007/s12105-016-0767-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 10/31/2016] [Indexed: 11/29/2022]
Abstract
Adenomatoid odontogenic tumor (AOT) is a benign epithelial odontogenic tumor characterized by slow and progressive growth. When central lesions are associated with an unerupted permanent tooth, they are also known as the follicular type. Histological variants of AOT may complicate diagnosis with possible adverse effects on treatment and prognosis. The aim of this study is to report a case of a follicular AOT with extensive calcifying epithelial odontogenic tumor (CEOT)-like histopathological areas in the anterior region of the mandible that was treated by enucleation. The teeth displaced by the tumor were repositioned with orthodontic treatment, and after 7 years of follow-up, the bone trabeculae were normal with no evidence of recurrence. The clinical, radiographic and histopathologic aspects of these tumors are discussed and the debate surrounding whether these cases are true combined lesions or histologic variants of the primary tumor is raised.
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Affiliation(s)
- Ana Cláudia Garcia Rosa
- Department of Oral Pathology, Lutheran University of Palmas, Palmas, Tocantins Brazil ,Department of Health Sciences, Federal University of Tocantins, Palmas, Tocantins Brazil ,Faculdade de Odontologia, Centro Universitário Luterano de Palmas—CEULP/ULBRA, Av. Teotônio Segurado, 1501 Sul, PO Box no 85, Palmas, Tocantins 77019900 Brazil
| | - Andresa Borges Soares
- Department of Oral Pathology, São Leopoldo Mandic Institute and Research Center, Campinas, São Paulo Brazil
| | - Cristiane Furuse
- Department of Oral Pathology, São Paulo State University, Araçatuba, São Paulo Brazil
| | | | - Vera Cavalcanti de Araújo
- Department of Oral Pathology, São Leopoldo Mandic Institute and Research Center, Campinas, São Paulo Brazil
| | - Fabricio Passador-Santos
- Department of Oral Pathology, São Leopoldo Mandic Institute and Research Center, Campinas, São Paulo Brazil
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Adenomatoid odontogenic tumor with peripheral cemento-osseous reactive proliferation: report of 2 cases and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:e86-92. [DOI: 10.1016/j.oooo.2015.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 11/30/2015] [Accepted: 12/02/2015] [Indexed: 11/24/2022]
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Abstract
This article presents various odontogenic cysts and tumors, including periapical cysts, dentigerous cysts, odontogenic keratocysts, orthokeratinized odontogenic cysts, lateral periodontal cysts, glandular odontogenic cysts, ameloblastomas, clear cell odontogenic carcinomas, adenomatoid odontogenic tumors, calcifying epithelial odontogenic tumors, squamous odontogenic tumors, ameloblastic fibromas, ameloblastic fibro-odontomas, odontomas, calcifying cystic odontogenic tumors, and odontogenic myxomas. The authors provide an overview of these cysts and tumors, with microsopic features, gross features, differential diagnosis, prognosis, and potential diagnostic pitfalls.
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Affiliation(s)
- Angela C Chi
- Division of Oral Pathology, Department of Stomatology, College of Dental Medicine, Medical University of South Carolina, MSC 507, 173 Ashley Avenue, Charleston, SC 29425, USA
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Adenoid ameloblastoma: clinicopathologic description of five cases and systematic review of the current knowledge. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:368-77. [PMID: 26297394 DOI: 10.1016/j.oooo.2015.05.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 05/16/2015] [Accepted: 05/21/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe the clinicopathologic and immunohistochemical features of five cases of adenoid ameloblastoma. STUDY DESIGN Clinicopathologic data were gathered from medical records and compared with those compiled from a systematic review. Slides were also immunohistochemically stained for Ki-67, p16, p53, and cytokeratins (7, 8, 14, 18, and 19). RESULTS There were 3 males (60%) and 2 (40%) females. The mean age was 44 ± 10 years. Of the five adenoid ameloblastomas, 4 (80%) occurred in the posterior maxilla. Patients typically complained of asymptomatic swelling. All patients received surgical resection as primary therapy; 1 (20%) patient also received adjuvant radiotherapy. Recurrence was diagnosed in all patients. Immunohistochemically, the tumors stained focally positive for CK7, 8, 14, and 18 and diffusely positive for CK-19, p16, and p53. The mean Ki-67-positive cells were 72.4 ± 24.9 positive cells per high-power field (range 53-111). CONCLUSIONS To our knowledge, this is the largest series of adenoid ameloblastoma reported in the literature. Our data suggest that this entity demonstrates aggressive behavior characterized by a high likelihood of recurrence.
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Wadhwan V, Sharma P, Bansal V. A rare case of hybrid odontogenic tumor: Calcifying epithelial odontogenic tumor combined with ameloblastoma. J Oral Maxillofac Pathol 2015; 19:268. [PMID: 26604514 PMCID: PMC4611946 DOI: 10.4103/0973-029x.164560] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 07/27/2015] [Indexed: 11/04/2022] Open
Abstract
A hybrid odontogenic tumor comprising two distinct lesions is extremely rare. Nevertheless, such tumors have been reported in the literature for academic and research interest. However, it is still obscure whether they behave as a new entity or they solely present separate histopathologic patterns. Here, we present a true hybrid neoplasm of combined ameloblastoma and calcifying epithelial odontogenic tumor showing intermixed histopathologic patterns of both the tumors.
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Affiliation(s)
- Vijay Wadhwan
- Department of Oral Pathology and Microbiology, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Preeti Sharma
- Department of Oral Pathology and Microbiology, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Vishal Bansal
- Department of Oral and Maxillofacial Surgery, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
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Report of Two Cases of Combined Odontogenic Tumors: Ameloblastoma with Odontogenic Keratocyst and Ameloblastic Fibroma with Calcifying Odontogenic Cyst. Head Neck Pathol 2015; 9:417-20. [PMID: 25552434 PMCID: PMC4542788 DOI: 10.1007/s12105-014-0601-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 12/21/2014] [Indexed: 10/24/2022]
Abstract
Combined odontogenic neoplasms have rarely been documented. Such tumors have also been described by other researchers as "hybrid" lesions. The histologic features are often identical to other individually well-established odontogenic neoplasms such as ameloblastoma, adenomatoid odontogenic tumor, ameloblastic fibroma (AF), and ameloblastic fibro-odontoma. Their clinical presentation is variable, ranging from cysts to neoplasms showing varying degrees of aggressive behavior. Most combined tumors contain features of one of the odontogenic tumors in combination with either a calcifying odontogenic cyst (COC) or a calcifying epithelial odontogenic tumor. We present two new cases of combined odontogenic tumors: an ameloblastoma with an odontogenic keratocyst and an AF with COC. Predicting clinical outcome is challenging when a combination tumor is encountered due to the paucity of such lesions. One must understand salient features of these entities and differentiate them from the more common conventional neoplasms to expand classification and provide prognostic criteria.
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Yamazaki M, Maruyama S, Abé T, Babkair H, Fujita H, Takagi R, Koyama JI, Hayashi T, Cheng J, Saku T. Hybrid ameloblastoma and adenomatoid odontogenic tumor: report of a case and review of hybrid variations in the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:e12-8. [DOI: 10.1016/j.oooo.2013.08.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 08/23/2013] [Accepted: 08/29/2013] [Indexed: 10/26/2022]
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Vinayakrishna K, Soumithran C, Sobhana C, Biradar V. Peripheral and central aggressive form of Pindborg tumor of mandible - A rare case report. J Oral Biol Craniofac Res 2013; 3:154-8. [PMID: 25737906 PMCID: PMC4306990 DOI: 10.1016/j.jobcr.2013.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 07/09/2013] [Indexed: 11/28/2022] Open
Abstract
INRODUCTION The calcifying epithelial odontogenic tumor (CEOT), or Pindborg tumor, is a rare and benign odontogenic neoplasm that affects the jaw. Calcifying epithelial odontogenic tumor can be divided into 2 clinico-topographic variants: Intraosseous (central) or Extraosseous (peripheral), with an incidence of 94% and 6%, respectively. The intraosseous tumors have a predilection for the mandible, and most tumors arise in the molar and premolar region of the mandible. When present, extraosseous tumors are often located in the anterior jaw and involve the gingiva. PURPOSE In this article we present a unique rare variety of Pindborg tumor of mandible with both intraosseous & extraosseous presentation and also locally aggressive behavior. CASE REPORT A 35 year old man presented with Pindborg tumor (CEOT) of mandible with both intraosseous and extraosseous variant in a single lesion, extending from right premolar region to the left molar region. DISCUSSION CEOT is an uncommon neoplasm accounting for less than 1% of all odontogenic tumors. Although CEOT is considered less aggressive clinically than typical infiltrating ameloblastoma, but our case is a rarity which was aggressive and also rapidly progressive in short duration, with intra and extraosseous presentation. Hence it was managed surgically similar to a malignant lesion. CONCLUSION Presentation of two different variants of an odontogenic tumor in a single lesion and aggressive behavior of rather slow growing tumor, mimicking malignant lesion definitely shows possibility of rare variations in different magnitude. Hence proper diagnosis for management with better prognosis of these kinds of tumors is very much essential.
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Affiliation(s)
- K. Vinayakrishna
- Reader, Department of Oral & Maxillofacial Surgery, Yenepoya Dental College, Deralakatte, Mangalore, Karnataka, India
| | - C.S. Soumithran
- Professor & Head, Department of Oral & Maxillofacial Surgery, Government Dental College, Calicut, Kerala, India
| | - C.R. Sobhana
- Professor & Head, Department of Oral & Maxillofacial Surgery, Government Dental College, Trivandrum, Kerala, India
| | - Vijay Biradar
- Asst Professor, Department of Oral & Maxillofacial Pathology, Maharashtra Institute of Dental Sciences and Research, Latur, Maharashtra, India
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Sharma U, Gulati A, Batra H, Singh D. Calcifying epithelial odontogenic tumor in anterior maxilla associated with a supernumerary tooth: a case report. J Dent Res Dent Clin Dent Prospects 2013; 7:51-4. [PMID: 23487408 PMCID: PMC3593206 DOI: 10.5681/joddd.2013.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2012] [Accepted: 11/21/2012] [Indexed: 11/30/2022] Open
Abstract
Odontogenic tumors are derived from epithelial, ectomesenchymal and/or mesenchymal elements that are or have been a part of the tooth-forming apparatus. Of all the odontogenic tumors, calcifying epithelial odontogenic tumor accounts for 1% of the cases. Approximately 200 cases have been reported to date. There is no sex predilection, with a 2:1 predilection for the mandible, mostly in the premolar/molar region. It is often locally invasive. Most often, it is associated with an impacted tooth, is asymptomatic and requires biopsy for diagnosis. Presented here is a rare case of an intraosseous calcifying epithelial odontogenic tumor surrounding a supernumerary tooth. Furthermore, the occurrence of this tumor in the anterior maxilla (an uncommon site) in a pediatric patient makes it rarer. Although the present case was asymptomatic, root resorption and displacement of adjacent teeth necessitated its surgical removal. The lesion was surgically enucleated and histopathological examination confirmed calcifying epithelial odontogenic tumor, showing abundant calcifications in the form of Liesegang rings.
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Affiliation(s)
- Urvashi Sharma
- Assistant Professor, Department of Pedodontics, Dr. HSJ Institute of Dental Sciences and Hospital, Panjab University, Sector 25, Chandigarh, India
| | - Anubha Gulati
- Associate Professor, Department of Oral Pathology, Dr. HSJ Institute of Dental Sciences and Hospital, Panjab University, Sector 25, Chandigarh, India
| | - Hemant Batra
- Professor, Department of Oral & Maxillofacial Surgery, Dr. HSJ Institute of Dental Sciences and Hospital, Panjab University, Sector 25, Chandigarh, India
| | - Devinderpreet Singh
- Assistant Professor, Department of Orthodontics, Dr. HSJ Institute of Dental Sciences and Hospital, Panjab University, Sector 25, Chandigarh, India
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Becker T, Buchner A, Kaffe I. Critical evaluation of the radiological and clinical features of adenomatoid odontogenic tumour. Dentomaxillofac Radiol 2012; 41:533-40. [PMID: 22752319 DOI: 10.1259/dmfr/19253953] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the radiological and clinical features of adenomatoid odontogenic tumours (AOTs). METHODS A total of 272 cases (267 from the English-language literature and 5 new cases) were analysed with special emphasis on their radiological features. RESULTS The patients' ages at time of diagnosis ranged from 3 years to 82 years (mean 18.4 years). The maxilla-to-mandible ratio was 1.7:1. Mandibular lesions were significantly more frequent among patients older than 16 years (p = 0.032). Expansion of the cortex was significantly more prominent among patients older than 16 years (p = 0.045). There was a positive correlation between the size of the lesion and the age of the patient at the time of diagnosis (p = 0.016). The size was also associated with increased root resorption (p < 0.001), ill-defined borders (p < 0.001), expansion (p < 0.001) and perforation of the cortex (p < 0.001). Small opacities were present in 77% of lesions and were associated with expansion of the cortex (p = 0.043). The significant radiological features in patients aged 30 years and above were root resorption (p = 0.013) and lesions crossing the midline (p = 0.019). CONCLUSIONS The size of an AOT is influenced by the patient's age. It is also associated with root resorption, ill-defined borders, expansion and perforation of the cortex, but it cannot be ruled out that those changes reflect a longer duration of the lesion.
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Affiliation(s)
- T Becker
- Department of Oral Pathology and Oral Medicine, The Maurice & gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
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Kim WK, Kim MS, Lee EM, Cha JW, Choi BY, Kim BC, Min SK, Lee J. Calcifying epithelial odontogenic tumor associated with the left mandibular first premolar: a case report and literature review. J Korean Assoc Oral Maxillofac Surg 2012. [DOI: 10.5125/jkaoms.2012.38.3.166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Won-Ki Kim
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, School of Dentistry, Wonkwang University, Daejeon, Korea
| | - Min-Soo Kim
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, School of Dentistry, Wonkwang University, Daejeon, Korea
| | - Eui-Mook Lee
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, School of Dentistry, Wonkwang University, Daejeon, Korea
| | - Jae-Won Cha
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, School of Dentistry, Wonkwang University, Daejeon, Korea
| | - Bo-Young Choi
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, School of Dentistry, Wonkwang University, Daejeon, Korea
| | - Bong-Chul Kim
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, School of Dentistry, Wonkwang University, Daejeon, Korea
| | - Seung-Ki Min
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, School of Dentistry, Wonkwang University, Daejeon, Korea
- Wonkwang Bone Regeneration Research Institute, Daejeon, Korea
| | - Jun Lee
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, School of Dentistry, Wonkwang University, Daejeon, Korea
- Wonkwang Bone Regeneration Research Institute, Daejeon, Korea
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19
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Abstract
Hybrid odontogenic tumors are rare conditions that can affect the oral maxillofacial region and usually occur in adults as an asymptomatic swelling. Hybrid odontogenic tumors exclusively involving adenomatoid odontogenic tumor (AOT) and calcifying cystic odontogenic tumor (CCOT) are rare, with only 4 reported cases. In addition, there are only few studies describing the presence of abortive enamel in AOT and, to our knowledge, CCOT was not present in any of them. We described a rare case of AOT associated with CCOT and abortive enamel formation in a 2-year-old child, a condition not well described in the international literature. Secretory cell activity was assessed by periodic acid-Schiff and Congo red stains.
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Ide F, Mishima K, Kikuchi K, Horie N, Yamachika S, Satomura K, Shimoyama T, Sakashita H, Saito I, Kusama K. Development and growth of adenomatoid odontogenic tumor related to formation and eruption of teeth. Head Neck Pathol 2011; 5:123-32. [PMID: 21380723 PMCID: PMC3098332 DOI: 10.1007/s12105-011-0253-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Accepted: 02/18/2011] [Indexed: 11/26/2022]
Abstract
The number of published cases of adenomatoid odontogenic tumor (AOT) has steadily increased, and about half were reported in Asian populations. Although the clinicopathologic profile of AOT has been extensively reported, factual knowledge of its pathogenesis is rudimentary at best, and there is controversy as to precisely which odontogenic epithelium it arises from. AOT is a successional tooth-associated lesion which develops during the mixed dentition. The permanent successor differs from its deciduous predecessor in that it has an eruptive pathway from the dental follicle to the gingiva, the gubernaculum dentis. With this background in mind, the present review focuses mainly on the early development of AOT. We successfully demonstrated a close spatial relationship between AOT and the gubernaculum dentis in a typical case. From further observations of the same AOT in which an enclosed permanent canine showed enamel hypoplasia, it is possible to pinpoint areas around the crown of a developing successional tooth in continuity with the gubernaculum dentis as starting points. In addition, we discuss the unifying histogenetic concept of three clinical variants, namely, pericoronal (follicular), extracoronal (extrafollicular), (see Article note) and peripheral.
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Affiliation(s)
- Fumio Ide
- Departments of Diagnostic Pathology and Oral Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, Japan.
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21
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Abstract
The calcifying epithelial odontogenic tumor is a benign epithelial tumor with characteristic clinical and histopathologic features. These features are discussed with a typical case presentation along with emphasis on newer variants and management strategies.
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22
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Ide F. Inter-radicular adenomatoid odontogenic tumor of the anterior mandible. J Oral Maxillofac Surg 2010; 68:490-1. [PMID: 20116733 DOI: 10.1016/j.joms.2009.10.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Accepted: 10/20/2009] [Indexed: 11/16/2022]
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23
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da Silveira EJD, Gordón-Núñez MA, Seabra FRG, Bitu Filho RS, Lima EG, de Medeiros AMC, Galvão HC. Peripheral Calcifying Epithelial Odontogenic Tumor Associated With Generalized Drug-Induced Gingival Growth: A Case Report. J Oral Maxillofac Surg 2007; 65:341-5. [PMID: 17236947 DOI: 10.1016/j.joms.2006.05.045] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2005] [Revised: 03/23/2006] [Accepted: 05/25/2006] [Indexed: 11/25/2022]
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24
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Gopalakrishnan R, Simonton S, Rohrer MD, Koutlas IG. Cystic variant of calcifying epithelial odontogenic tumor. ACTA ACUST UNITED AC 2006; 102:773-7. [PMID: 17138180 DOI: 10.1016/j.tripleo.2005.09.029] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2005] [Revised: 09/17/2005] [Accepted: 09/23/2005] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Rajaram Gopalakrishnan
- Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota, Saint Paul, MN, USA
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25
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Patiño B, Fernández-Alba J, Garcia-Rozado A, Martin R, López-Cedrún JL, Sanromán B. Calcifying epithelial odontogenic (pindborg) tumor: a series of 4 distinctive cases and a review of the literature. J Oral Maxillofac Surg 2005; 63:1361-8. [PMID: 16122602 DOI: 10.1016/j.joms.2005.05.302] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2004] [Indexed: 10/25/2022]
Affiliation(s)
- Beatriz Patiño
- Department of Maxillofacial Surgery, Complejo Hospitalario Juan Canalejo, La Coruña, Spain.
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26
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Seim P, Regezi JA, O'Ryan F. Hybrid ameloblastoma and calcifying epithelial odontogenic tumor: case report. J Oral Maxillofac Surg 2005; 63:852-5. [PMID: 15944987 DOI: 10.1016/j.joms.2005.02.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Phillip Seim
- University of the Pacific Oral/Maxillofacial Surgery Residency Program, Department of Oral and Maxillofacial Surgery, Highland General Hospital, Oakland, CA, USA.
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27
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Makos CP, Nikolaidou AJ. Calcifying epithelial odontogenic tumour or Pindborg's tumour: features and behaviour in relation to a case. Int Dent J 2005; 54:457-60. [PMID: 15633503 DOI: 10.1111/j.1875-595x.2004.tb00304.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The calcifying epithelial odontogenic tumour (CEOT) or Pindborg's tumour is a rare benign odontogenic neoplasm composed of epithelioid cells, amorphous amyloid-like substance and calcifications. Its clinical and radiographical pictures are not characteristic depending upon the site, size and developmental stages in a range of its composition degeneration. A case of calcifying epithelial odontogenic tumour in the mandible is presented and the main aspects of the research about this tumour, such as the pathogenesis, histological features, developmental stages, malignancy, recurrence rate, differential diagnosis and therapeutic aspects are discussed.
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28
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Mosqueda-Taylor A, Carlos-Bregni R, Ledesma-Montes C, Fillipi RZ, de Almeida OP, Vargas PA. Calcifying epithelial odontogenic tumor-like areas are common findings in adenomatoid odontogenic tumors and not a specific entity. Oral Oncol 2005; 41:214-5. [PMID: 15695124 DOI: 10.1016/j.oraloncology.2004.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2004] [Accepted: 07/30/2004] [Indexed: 10/25/2022]
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29
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Abstract
A man had a lesion of the anterior mandible that was initially diagnosed at 39 years of age as an adenomatoid odontogenic tumor. The lesion recurred 3 times over a span of 16 years. A consultative review of all histological findings was done and the tumor was reclassified as an ameloblastoma.
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Affiliation(s)
- Brian L Evans
- Department of Periodontics, Louisiana State University School of Dentistry, New Orleans, LA 70119, USA.
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30
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31
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32
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33
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Li L, Jäkel KT, Friedrich RE. [Calcifying epithelial odontogenic tumor of the maxilla (Pindborg tumor)]. ACTA ACUST UNITED AC 2004; 8:46-50. [PMID: 14991421 DOI: 10.1007/s10006-003-0517-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A male patient presented with an extraordinarily large calcifying epithelial odontogenic tumor (CEOT or Pindborg-tumor) that affected the maxilla. The disease became evident due to alterations in the facial aspect, in particular of the perioral region, caused by the expanding tumor. CEOT is characterised by the slowly growing mass of part of the jaws. Multilocular or extraosseous manifestations are extremely rare. Malignant transformation with metastases is rare. Radiography depicts characteristic, but not obligatory, areas of calcification inside the tumor. The surgical therapy for CEOT is complete local resection with safe margins. If tooth bearing parts of the jaws are affected, these teeth almost always have to be removed. The prognosis is excellent for overall survival. Local recurrences have rarely been reported but may be found even decades after primary treatment. Three years following surgical therapy there is no evidence of local recurrence. A long-term follow-up control is recommended.
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Affiliation(s)
- L Li
- Klinik und Poliklinik für Zahn-, Mund-, Kiefer- und Gesichtschirurgie (Nordwestdeutsche Kieferklinik), Universität Hamburg
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34
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Kolareth A, Robinson RA. Pathologic quiz case: a 28-year-old man with an impacted tooth. Arch Pathol Lab Med 2003; 127:e173-4. [PMID: 12653614 DOI: 10.5858/2003-127-e173-pqcaym] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Avina Kolareth
- Department of Pathology, University of Iowa, Iowa City, USA
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35
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Cheng YSL, Wright JM, Walstad WR, Finn MD. Calcifying epithelial odontogenic tumor showing microscopic features of potential malignant behavior. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 93:287-95. [PMID: 11925538 DOI: 10.1067/moe.2002.121991] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Calcifying epithelial odontogenic tumor (CEOT) is a rare benign, but locally aggressive, odontogenic tumor, and only 2 cases of malignant CEOT are reported in the literature. We describe a case of an atypical CEOT that penetrates the blood vessels, invades bone, and perforates the cortical plates of the mandible. On histologic examination, it shows marked pleomorphism and numerous mitotic figures, including a tripolar mitotic figure. Proliferating activity was found to be 5 times higher than typical CEOTs as demonstrated by the proliferating index, Ki-67, and analyzed by a computerized image analysis system. The Ki-67 labeling index of this case was also compared to various previously reported benign and malignant neoplasms. Although there is no clinical finding of metastasis, we believe this neoplasm has malignant potential on the basis of the histologic features of vascular invasion, significant mitotic activity, atypical mitotic figures, and an increased proliferating index.
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Affiliation(s)
- Yi-Shing Lisa Cheng
- Oral and Maxillofacial Pathology, Diagnostic Sciences, Baylor College of Dentistry-Texas A&M University System, Health Science Center, Dallas, TX 75246, USA.
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36
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Ide F, Horie N, Shimoyama T, Sakashita H, Kusama K. So-called Hybrid Odontogenic Tumors: Do they really exist? ACTA ACUST UNITED AC 2001. [DOI: 10.3353/omp.6.13] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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37
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Aviel-Ronen S, Liokumovich P, Rahima D, Polak-Charcon S, Goldberg I, Horowitz A. The amyloid deposit in calcifying epithelial odontogenic tumor is immunoreactive for cytokeratins. Arch Pathol Lab Med 2000; 124:872-6. [PMID: 10835524 DOI: 10.5858/2000-124-0872-tadice] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Calcifying epithelial odontogenic tumor, also known as Pindborg tumor, is a rare benign tumor with locally aggressive behavior. It is characterized by squamous epithelial cells, calcifications, and eosinophilic deposits that have been identified as amyloid. We report a case of calcifying epithelial odontogenic tumor and investigate the nature of the amyloid, using histologic, immunohistochemical, and ultrastructural studies. The amyloid was immunohistochemically negative for basement membrane components and positive for all cytokeratin stains performed (cocktail of cytokeratins 1, 5, 6, 8, 13, and 16, and cytokeratins AE1 and AE3). The amyloid stained focally in a glandular-like pattern, reminiscent of the epithelial glandlike structures of the tumor. We conclude that the amyloid is derived from filamentous degeneration of keratin filaments that originate from the tumor squamous epithelium. The keratin degeneration is part of a developmental or aging process that the tumor undergoes.
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Affiliation(s)
- S Aviel-Ronen
- Department of Pathology, The Chaim Sheba Medical Center, Tel-Hashomer, Israel
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38
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Philipsen HP, Reichart PA. Calcifying epithelial odontogenic tumour: biological profile based on 181 cases from the literature. Oral Oncol 2000; 36:17-26. [PMID: 10889914 DOI: 10.1016/s1368-8375(99)00061-5] [Citation(s) in RCA: 175] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The present profile of the calcifying epithelial odontogenic tumour (CEOT) is based on a literature survey of 181 published tumour cases. The CEOT is a benign, though occasional locally invasive, slow-growing neoplasm occurring as intraosseous (94%) and extraosseous (6%) variants. The intraosseous type appears radiographically as an irregular, uni- or multilocular radiolucent area containing radiopaque masses which increases in size and opacity with time. Some 60% of intraosseous CEOT are associated with an unerupted tooth (or odontoma). CEOT shows a relative frequency of 1-2%. The extraosseous variant is diagnosed slightly earlier (mean age 34.4 years) than the intraosseous type (mean age 38.9 years). Both variants have an almost 1:1 gender ratio. The intraosseous CEOT shows a maxilla:mandible site ratio of 1:2 and are mainly located in the premolar/molar region. The present authors present evidence that the CEOT originates from the complex system of dental laminae or remnants thereof. Histologically, the CEOT is characterized by the occurrence of sheets, nests and masses of polyhedral, eosinophilic epithelial cells which may show cellular abnormalities including giant cell formation and nuclear pleomorphism. Some cells increase in size and produce a homogeneous, eosinophilic, 'amyloid-like' substance which may become calcified and which may be liberated as the cells break down. The true nature of the amyloid-like material is still unresolved. Histological variants including CEOT with cementum-like components, clear-cell CEOT (15 cases reported so far), CEOT-containing Langerhans' cells, combined epithelial odontogenic tumour (CEOT/AOT) and CEOT with myoepithelial cells are discussed in detail. In view of the relatively indolent biological behaviour of the CEOT, mutilating procedures, such as wide resection or hemisection of the mandible, seem unwarranted. Enucleation with a margin of macroscopically normal tissue is, therefore, the recommended treatment for CEOT involving the mandible. Maxillary CEOT should, however, be treated more aggressively, as they tend to grow more rapidly and do not usually remain well confined. Generally, recurrences are rare. Five years is considered the absolute minimum follow-up period. The survey has revealed only one well-documented case of a mandibular CEOT in a 75-year-old man showing features of malignancy.
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Affiliation(s)
- H P Philipsen
- Abteilung für Oralchirurgie und zahnärztliche Röntgenologie, Universitätsklinikum Charité, Humboldt Universität, Berlin, Germany
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39
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Mori M, Kasai T, Nakai M, Sato K, Takeuchi H, Takai Y, Kanematsu N. Dentinogenic ghost cell tumor: histologic aspects, immunohistochemistry, lectin binding profiles, and biophysical studies. Oral Oncol 2000; 36:134-43. [PMID: 10889934 DOI: 10.1016/s1368-8375(99)00056-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Dentinogenic ghost cell tumor accompanied with calcifying odontogenic cyst (COC) was described in terms of its clinical, histological, immunohistochemical, lectin binding and biophysical properties. The case was a 38-year-old Japanese female, in whom the tumor had arisen in the right mandibular premolar and molar region. Material obtained by partial mandibulectomy was used. Decalcified paraffin sections were used to detect keratins, involucrin, and lectin binding; and non-decalcified thin sections were used for biophysical analysis. The lesion comprising dentinogenic ghost cell tumor and COC contained odontogenic epithelium with ghost cells, eosinophilic amorphous materials and osteodentin. Some of the eosinophilic material had undergone transformation into osteodentin. Keratins in odontogenic epithelia showed positive PKK1 staining in peripheral tumor cells, and stainings with KL1 and involucrin were positive in centrally located cells. Lectin binding in the amorphous materials was comparatively strong for PNA, and SBA, moderate for WGA, RCA-1, and UEA-1, and slight for DBA and ConA. Lectin binding affinities were higher in the amorphous materials than in the osteodentin. Elemental analysis with an electron probe X-ray microanalysis of the amorphous materials and osteodentin showed a pattern similar to that found in the normal dentin. The biologic properties of the eosinophilic amorphous materials suggested the material to be poorly calcified osteodentin, which gradually transformed into the well-calcified type.
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Affiliation(s)
- M Mori
- Department of Oral and Maxillofacial Surgery, Asahi University School of Dentistry, Gifu, Japan.
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40
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Affiliation(s)
- C B Fowler
- Oral & Maxillofacial Pathology Services, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, Texas, USA
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41
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Miyake M. In reply. J Oral Maxillofac Surg 1997. [DOI: 10.1016/s0278-2391(97)90271-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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42
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P. Philipsen H, A. Reichart P, Nikai H. The Adenomatoid Odontogenic Tumour(AOT): An Update. ACTA ACUST UNITED AC 1997. [DOI: 10.3353/omp.2.55] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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43
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Ng KH, Siar CH. A clinicopathological and immunohistochemical study of the calcifying epithelial odontogenic tumour (Pindborg tumour) in Malaysians. J Laryngol Otol 1996; 110:757-62. [PMID: 8869610 DOI: 10.1017/s0022215100134887] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We reviewed the clinicopathological characteristics of 13 cases of calcifying epithelial odontogenic tumour (CEOT) (Pindborg tumour) diagnosed in the Division on Stomatology, Institute for Medical Research, Kuala Lumpur, over a 29-year period. There were eight female and five male patients. These consisted of eight (61.5 per cent) Malays, three (23.1 per cent) Chinese, one (7.7 per cent) Indian and one (7.7 per cent) Melanau. Their ages at presentation ranged from 19-61 years (mean age, 31.8 years). There were 12 central and one peripheral CEOT. Of these, 76.9 per cent of cases were located in the maxilla, the remaining in the mandible. The commonest clinical diagnosis was a dentigerous cyst (66.7 per cent). Enucleation was the main mode of treatment. Histologically, sheets and strands of polyhedral epithelial cells containing eosinophilic, homogeneous globules with Liesegang rings were observed. One case also showed extensive calcification and clear cell differentiation. Immunohistochemistry revealed a variable keratin staining of the CEOT epithelium, confirming its heterogeneity.
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Affiliation(s)
- K H Ng
- Division of Stomatology, Institute for Medical Research, Kuala Lumpur, Malaysia
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44
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Miyake M, Nagahata S, Nishihara J, Ohbayashi Y. Combined adenomatoid odontogenic tumor and calcifying epithelial odontogenic tumor: report of case and ultrastructural study. J Oral Maxillofac Surg 1996; 54:788-93. [PMID: 8648489 DOI: 10.1016/s0278-2391(96)90706-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- M Miyake
- Department of Oral and Maxillofacial Surgery, Kagawa Medical School, Japan
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45
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Hicks MJ, Flaitz CM, Wong ME, McDaniel RK, Cagle PT. Clear cell variant of calcifying epithelial odontogenic tumor: case report and review of the literature. Head Neck 1994; 16:272-7. [PMID: 8026959 DOI: 10.1002/hed.2880160311] [Citation(s) in RCA: 79] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
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.
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Affiliation(s)
- M J Hicks
- Department of Pathology, Baylor College of Medicine, Houston, Texas
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46
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Daley TD, Wysocki GP, Pringle GA. Relative incidence of odontogenic tumors and oral and jaw cysts in a Canadian population. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1994; 77:276-80. [PMID: 8170660 DOI: 10.1016/0030-4220(94)90299-2] [Citation(s) in RCA: 249] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The diagnoses of 40,000 consecutively accessioned oral biopsies from the Oral Pathology Diagnostic Service, University of Western Ontario, London, Canada, were reviewed. All odontogenic neoplasm, neoplasm-like lesions (tumors), and true cysts of the oral tissues and jaws were listed. Clinical data were reviewed, and microscopic diagnoses were confirmed for cases in which diagnoses were ambiguous. Records of all cases were examined to identify distant referrals that were not representative of the study population. Of a total of 445 (1.11%) odontogenic tumors, 392 (0.98%) were lesions from patients in the usual local drawing area of the biopsy service; 53 were referred from distant centers. From the local population, odontomas were by far the most common tumor (51.53%) followed by ameloblastomas (13.52%) and peripheral odontogenic fibromas (8.93%). Locally, radicular (periapical) cysts were the most common odontogenic cyst (65.15%) followed by the dentigerous cyst (24.08%) and the odontogenic keratocyst (4.88%). The most common nonodontogenic cyst was the nasopalatine duct cyst that accounted for 73.43% of this subset of cysts. Surprisingly few studies of this type are available, especially for odontogenic tumors. These data are important to assess geographic differences in the incidence of lesions and to allow clinicians to make realistic judgments in counseling patients before biopsy about the probability of diagnosis and risks associated with nonspecific clinical or radiographic lesions.
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Affiliation(s)
- T D Daley
- Department of Pathology, University of Western Ontario, London, Canada
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47
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Montes Ledesma C, Mosqueda Taylor A, Romero de León E, de la Piedra Garza M, Goldberg Jaukin P, Portilla Robertson J. Adenomatoid odontogenic tumour with features of calcifying epithelial odontogenic tumour. (The so-called combined epithelial odontogenic tumour.) Clinico-pathological report of 12 cases. EUROPEAN JOURNAL OF CANCER. PART B, ORAL ONCOLOGY 1993; 29B:221-4. [PMID: 8298426 DOI: 10.1016/0964-1955(93)90026-b] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The combination of two odontogenic tumours is a rarely reported finding. To date only 10 cases of adenomatoid odontogenic tumour (AOT) combined with areas of calcifying epithelial odontogenic tumour (CEOT) have been published. This article describes the clinical, radiographical and microscopic findings of 12 cases of AOT, in which CEOT-like areas of variable sizes were found. These results suggest that such areas may be considered as a normal feature within the histomorphological spectrum of AOT.
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Affiliation(s)
- C Montes Ledesma
- Facultad de Odontologia, Universidad Nacional Autónoma de México, Ciudad Universitaria, México, D.F
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Hicks MJ, Flaitz CM, Batsakis JG. Adenomatoid and calcifying epithelial odontogenic tumors. Ann Otol Rhinol Laryngol 1993; 102:159-61. [PMID: 8427503 DOI: 10.1177/000348949310200215] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The histologic diversity of the odontogenic epithelium's neoplasms is nicely illustrated by the adenomatoid and the calcifying epithelial odontogenic tumors. The former has a predilection for the maxilla, the latter for the mandible. Neither has a malignant variant, and each is controlled by conservative local removal. The recurrence rate of the adenomatoid odontogenic tumor is 0.2%, while the calcifying epithelial odontogenic tumor's rate is 14%.
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Affiliation(s)
- M J Hicks
- University of Texas M.D. Anderson Cancer Center, Houston 77030
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Nelson SR, Schow SR, Read LA, Svane TJ. Treatment of an extensive calcifying epithelial odontogenic tumor of the mandible. J Oral Maxillofac Surg 1992; 50:1126-31. [PMID: 1527671 DOI: 10.1016/0278-2391(92)90507-v] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- S R Nelson
- Baylor College of Dentistry, Dallas, TX 75246
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Abstract
The combined epithelial odontogenic tumour represents a hybrid lesion comprising primarily areas of adenomatoid odontogenic tumour intermixed with foci of calcifying epithelial odontogenic tumour. Five such cases retrieved from the files of the Division of Stomatology, Institute for Medical Research, Kuala Lumpur, and four others from the existing literature were analysed. A mean age of 18.8 years, a female preponderance (66.7%) with a male to female ratio of 1:2 and predilection for the mandible (55.6%) were observed. All cases were treated by conservative surgery and the lack of recurrence confirmed the innocuous nature of this lesion.
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Affiliation(s)
- C H Siar
- Department of Oral Pathology & Oral Medicine, Faculty of Dentistry, University of Malaya, Kuala Lumpur
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