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Stojanov IJ, Ho D, Huss J, Gopalakrishnan R, Yoest JM, Koutlas IG. An Unusual Gingival (Peripheral) Tumor with Features of Keratoameloblastoma with Cytologic Atypia or Possible Malignant Transformation Exhibiting ARID1A Mutation. Head Neck Pathol 2023; 17:808-814. [PMID: 37195520 PMCID: PMC10514248 DOI: 10.1007/s12105-023-01549-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/23/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Keratoameloblastoma is a poorly characterized and rarely reported odontogenic neoplasm that can exhibit overlapping histopathologic features with conventional ameloblastoma and keratocystic odontogenic tumor (KCOT), with an ambiguous relationship to the so-called solid KCOT. METHODS A peripheral maxillary tumor causing bone saucerization in a 54-year-old male is described and investigated with immunohistochemistry and Next-Generation Sequencing (NGS). RESULTS Microscopically, the tumor comprised of a predominantly plexiform proliferation of odontogenic epithelium with central keratinization and evidence of surface origin. Peripheral cells exhibited nuclear palisading with variable reverse polarization, while stellate reticulum-like areas were observed internally. A few follicles and a few foci in the lining of cystic spaces revealed increased cellularity with cells exhibiting small but conspicuous nucleoli, focal nuclear hyperchromatism, and a few mitoses mostly seen in the peripheral outer cell layer. Nuclear staining for ki-67 was increased in those areas when compared with the other cystic, follicular, and plexiform areas. These features were interpreted as cytologic atypia suggesting also the possibility of a malignant process. Immunohistochemically, the tumor was positive for CK19 and negative for BRAF VE1, calretinin, and CD56. Ber-Ep4 was only focally positive. By sequencing, an ARID1A c.6527_6538delAG frameshift mutation (VAF: 5.8%), classified as likely oncogenic, and an FBXW7 c.1627 A > G missense mutation (VAF: 8.0%), classified as a variant of uncertain significance, were detected. Two mutations, probably germline (VAF ~ 50%), were recorded for RNF43 and FBXW7. No pathogenic variants were identified in PTCH1, BRAF, NRAS, HRAS, KRAS, FGFR2, or SMO genes. CONCLUSION The significance of an ARID1A variant in keratoameloblastoma is uncertain since this variant has not been reported in ameloblastoma or KCOT, to date. Alternatively, it may characterize malignant transformation in the present case since ARID1A mutations have been encountered in various cancers. Sequencing of additional cases is necessary to determine whether this may represent a recurrent genomic event.
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Affiliation(s)
- Ivan J Stojanov
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Dan Ho
- School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Joseph Huss
- Associated Oral and Maxillofacial Surgeons, PA, Maple Grove, MN, USA
| | - Rajaram Gopalakrishnan
- Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota, 515 Delaware Street SE #16-116B, Minneapolis, MN, 55455, USA
| | - Jennifer M Yoest
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Ioannis G Koutlas
- Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota, 515 Delaware Street SE #16-116B, Minneapolis, MN, 55455, USA.
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Robinson L, Smit C, Fonseca FP, Abrahão AC, Romañach MJ, Khurram SA, Hunter KD, Speight PM, van Heerden WFP. Keratoameloblastoma: A Report of Seven New Cases and Review of Literature. Head Neck Pathol 2022; 16:1103-1113. [PMID: 35861917 PMCID: PMC9729669 DOI: 10.1007/s12105-022-01470-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/16/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Keratoameloblastoma (KA) is an uncommon and controversial variant of ameloblastoma exhibiting central keratinisation. Due to their rarity, there is limited information in the literature on their clinical, radiologic and histologic features. This study adds seven additional cases of KA to the literature, and reviews the current published literature on this rare entity. METHODS KAs were retrospectively reviewed over a 20-year period from three Oral and Maxillofacial Pathology Laboratories. Included cases were examined and the diagnosis confirmed under conventional microscopy. Immunohistochemistry with the use of a monoclonal antibody against calretinin was performed on included cases. The clinical, radiologic and histologic features of the seven new cases of KA were analysed and compared to existing cases in the literature. RESULTS KAs presented at a mean age of 40 years with a nearly equal gender distribution and a mandibular predilection (65%). The majority (92%) of cases presented with localised swelling with associated pain in 32% of cases. Mixed density or internal calcifications were noted in 40% of cases. All tumours presented with bony expansion, with cortical destruction noted in 62% of cases. Histologically, all tumours consisted of solid and cystic follicles with surface parakeratinisation and lamellated accumulations of central keratin. In areas the cystic follicles had an epithelial lining suggestive of an OKC. There were focal luminal areas of loosely arranged polygonal cells reminiscent of the stellate reticulum. The basal cells consisted of columnar cells with evidence of palisading and prominent subnuclear vacuolisation. Of the cases treated via tumour resection, 27% presented with tumour recurrence. CONCLUSION This case series reports seven additional cases of KA, taking the total to 26 reported cases. The identification of subtle histologic features, including focal stellate reticulum-like central areas, subnuclear vacuolisation and lamellated-type central keratinisation, are key in diagnosing KA. The radiologic features will often indicate signs of aggressiveness such as cortical destruction, differentiating KA from OKC. All cases were completely negative for calretinin IHC, limiting its use in distinguishing KA from OKC. Further large series are needed to expand the current understanding of this rare variant of ameloblastoma.
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Affiliation(s)
- Liam Robinson
- grid.49697.350000 0001 2107 2298Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Chané Smit
- grid.49697.350000 0001 2107 2298Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Felipe Paiva Fonseca
- grid.49697.350000 0001 2107 2298Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa ,grid.8430.f0000 0001 2181 4888Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Aline Corrêa Abrahão
- grid.8536.80000 0001 2294 473XDepartment of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Mário José Romañach
- grid.8536.80000 0001 2294 473XDepartment of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Syed Ali Khurram
- grid.11835.3e0000 0004 1936 9262Academic Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Keith D. Hunter
- grid.49697.350000 0001 2107 2298Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa ,grid.10025.360000 0004 1936 8470Molecular and Clinical Cancer Medicine Unit, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Paul M. Speight
- grid.11835.3e0000 0004 1936 9262Emeritus Professor in Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Willie F. P. van Heerden
- grid.49697.350000 0001 2107 2298Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Ide F, Ito Y, Nishimura M, Ogawa I, Kikuchi K. Keratoameloblastomatous transformation of a recurrent unicystic ameloblastoma: a novel case raising diagnostic and classification difficulties. Pathology 2022; 54:386-388. [PMID: 35151490 DOI: 10.1016/j.pathol.2021.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/30/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Fumio Ide
- Department of Diagnostic Pathology, Tsurumi University Dental Hospital, Yokohama, Japan; Division of Oral Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
| | - Yumi Ito
- Department of Diagnostic Pathology, Tsurumi University Dental Hospital, Yokohama, Japan.
| | - Michiko Nishimura
- Division of Oral Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
| | - Ikuko Ogawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Kentaro Kikuchi
- Division of Oral Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
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Should the solid variant of odontogenic keratocyst and keratoameloblastoma be classified as the same entity? A clinicopathological analysis of nine cases and a review of the literature. Pathology 2021; 53:478-486. [PMID: 33551126 DOI: 10.1016/j.pathol.2020.09.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/31/2020] [Accepted: 09/08/2020] [Indexed: 11/24/2022]
Abstract
The solid variant of odontogenic keratocyst (SOKC) is an extremely rare odontogenic lesion, which remains poorly defined even in the 2017 World Health Organization odontogenic tumour classification. It is difficult to distinguish between SOKC and so called keratoameloblastoma (KAB), both rare lesions that have similarities in clinical, histological and biological characteristics. Here, we report clinicopathological data and results of molecular analysis of nine cases with a literature review. First, they were compared to previously reported cases of SOKC and/or KAB, and many overlaps were found in clinical and pathological characteristics. Second, we performed PCR analysis for BRAF V600E mutation. Although ameloblastoma-like epithelia were often encountered, none exhibited BRAF V600E mutation, which has been reported to occur frequently in ameloblastomas but not in odontogenic keratocysts (OKCs). One of two cases of SOKC in the present series from which fresh frozen tissue specimens were available was found to harbour PTCH1 mutations, indicating that these were more likely to be a subtype of OKC. Moreover, we also examined the differences between SOKC and primary intraosseous carcinoma (PIOC) with regard to the expression of cytokeratins (pan-CK, CK5/6, CK7, CK8/18, CK10, CK14 and CK19), p53 and Ki-67. The proportions of p53-and Ki-67-positive cells were significantly higher in PIOC than in SOKC. These findings suggest that immunostaining for p53 and Ki-67 would be useful to differentiate between SOKC and PIOC. We also conducted a review of SOKC and KAB cases reported in the English language literature.
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Kuberappa PH, Anuradha A, Kiresur MA, Bagalad BS. Papilliferous keratoameloblastoma - A rare entity: A case report with a review of literature. J Oral Maxillofac Pathol 2020; 24:S2-S6. [PMID: 32189894 PMCID: PMC7069145 DOI: 10.4103/jomfp.jomfp_42_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 05/13/2019] [Accepted: 06/12/2019] [Indexed: 11/10/2022] Open
Abstract
Ameloblastoma is the most common odontogenic tumor which presents with a variety of histopathological patterns. Among all, papilliferous keratoameloblastoma (PKA) is a very rare type which is characterized by multiple epithelial cysts of varying size, which are lined by non-keratinized papilliferous epithelium which is filled with necrotic desquamated epithelial cells. In this study, we reported PKA with characteristic ameloblastic features in a 65-year-old male patient who presented with a swelling in the right mandibular body region. This is the seventh case of PKA to be reported in the English literature till date. Present case showed multicystic areas in incision biopsy which lead to misdiagnosis as calcifying odontogenic cyst with adenomatoid odontogenic tumor, but in excision biopsy which turned out to be papilliferous keratoameloblastoma, further in this paper we had discussed all the areas which lead to misdiagnosis of calcifying odontogenic cyst with adenomatoid odontogenic tumor. In outlook, more cases will put an insight to the behavioral aspects of this rare histological type of ameloblastoma.
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Affiliation(s)
- Puneeth H Kuberappa
- Department of Oral Pathology and Microbiology, Saint Joseph Dental College, Eluru, Andhra Pradesh, India
| | - Ananthaneni Anuradha
- Department of Oral Pathology and Microbiology, Saint Joseph Dental College, Eluru, Andhra Pradesh, India
| | - Mohammad Asif Kiresur
- Department of Oral Pathology and Microbiology, Saint Joseph Dental College, Eluru, Andhra Pradesh, India
| | - Bhavana S Bagalad
- Department of Oral Pathology and Microbiology, Saint Joseph Dental College, Eluru, Andhra Pradesh, India
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Kahraman D, Gunhan O, Celasun B. A series of 240 odontogenic keratocysts: Should we continue to use the terminology of ‘keratocystic odontogenic tumour’ for the solid variant of odontogenic keratocyst? J Craniomaxillofac Surg 2018; 46:942-946. [DOI: 10.1016/j.jcms.2018.04.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/20/2018] [Accepted: 04/04/2018] [Indexed: 10/17/2022] Open
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Parikh N, Nandini C, Jain S, Mansata AV. Peripheral keratoameloblastoma: A novel case report. J Oral Maxillofac Pathol 2018; 22:249-253. [PMID: 30158780 PMCID: PMC6097355 DOI: 10.4103/jomfp.jomfp_24_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Keratoameloblastoma is an exceptionally rare subtype of ameloblastoma that has been reported <20 times previously in the literature. All present as intraosseous lesions. We report an unusual case of keratoameloblastoma localized in the palate without involving palatal bone, thus presenting as a peripheral lesion. To the best knowledge of the authors, no case of peripheral keratoameloblastoma has been reported in the English literature till now, probably rendering this case to be the first one. Therefore, the purpose of this article is to present a rare and the first case of peripheral keratoameloblastoma with histopathological features of this tumor.
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Affiliation(s)
- Neelampari Parikh
- Department of Oral and Maxillofacial Pathology, Karnavati School of Dentistry, Gandhinagar, India
| | - C Nandini
- Department of Oral and Maxillofacial Pathology, Karnavati School of Dentistry, Gandhinagar, India
| | - Shikha Jain
- Department of Oral and Maxillofacial Pathology, Karnavati School of Dentistry, Gandhinagar, India
| | - Anuj V Mansata
- Department of Health and Family Welfare, Government of Gujarat, Jamnagar, Gujarat, India
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8
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Rathore AS, Juneja S, Khurana N, Shetty DC. Papilliferous Keratoameloblastoma: A Rare Case Report. Int J Appl Basic Med Res 2017; 7:139-142. [PMID: 28584748 PMCID: PMC5441264 DOI: 10.4103/ijabmr.ijabmr_136_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Ameloblastoma is true odontogenic tumor of epithelial origin, which is described as locally aggressive with varying chances of recurrence. It is believed to derive from enamel organ, remnants of dental lamina, lining of odontogenic cysts, or basal cells of oral epithelium. Radiologically, it may present as unilocular or multilocular radiolucency commonly. Although conventional ameloblastoma presents typical histological features as described by Vickers and Gorlin, few unusual variants have been reported with different histological patterns. However, the clinical and biological behavior of these lesser known variants has not been established yet due to the scarcity of cases reported. Here, we report an extremely rare case of papilliferous ameloblastoma in a young male patient with 2-year follow-up and presenting with unusual histological presentation than conventional ameloblastoma.
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Affiliation(s)
- Ajit Singh Rathore
- Department of Oral Pathology, I. T. S. Dental College, Ghaziabad, Uttar Pradesh, India
| | - Saurabh Juneja
- Department of Oral Pathology, I. T. S. Dental College, Ghaziabad, Uttar Pradesh, India
| | - Neha Khurana
- Department of Oral Pathology, Manav Rachna Dental College, Faridabad, Haryana, India
| | - Devi Charan Shetty
- Department of Oral Pathology, I. T. S. Dental College, Ghaziabad, Uttar Pradesh, India
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Abstract
INTRODUCTION Keratoameloblastoma is an extremely rare odontogenic tumor, as only 18 cases have been reported in the literature. CASE REPORT The authors report a case of keratoameloblastoma in a 32-year-old woman and review the literature concerning the clinical features, radiological appearance, histopathological findings and treatment options. DISCUSSION Keratoameloblastoma is a rare tumor observed more frequently in males (sex ratio: 3:1) characterized by extensive keratin production in odontogenic islets and fibrous stroma.
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Konda P, Bavle RM, Muniswamappa S, Makarla S, Venugopal R. Papilliferous Keratoameloblastoma of the Mandible - A Rare Case Report. J Clin Diagn Res 2016; 10:ZD08-11. [PMID: 27656576 DOI: 10.7860/jcdr/2016/18862.8232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 04/25/2016] [Indexed: 11/24/2022]
Abstract
Ameloblastomas are common odontogenic tumours that are benign and locally aggressive. Histopathologically, the tumor exhibits significant diversity with common and rare variants. Here, we report an unusual variant of a common odontogenic tumour in the mandibular posterior region on the right side in a 44-year old male patient. This is the sixth case of Papilliferous Keratoameloblastoma (PKA) to be reported in the English literature till date. More case reports are vital to determine the clinical, radiological, histopathological and behavioural aspects of this extremely rare histological type of ameloblastoma. This tumour awaits re-inclusion as a distinct entity in the future classifications of the WHO Classification of head and neck tumours upon further case accrual.
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Affiliation(s)
- Paremala Konda
- Reader, Department of Oral Pathology, Krishnadevaraya College of Dental Sciences , Bengaluru, Karnataka, India
| | - Radhika Manoj Bavle
- Professor and Head, Department of Oral Pathology, Krishnadevaraya College of Dental Sciences , Bengaluru, Karnataka, India
| | - Sudhakara Muniswamappa
- Reader, Department of Oral Pathology, Krishnadevaraya College of Dental Sciences , Bengaluru, Karnataka, India
| | - Soumya Makarla
- Reader, Department of Oral Pathology, Krishnadevaraya College of Dental Sciences , Bengaluru, Karnataka, India
| | - Reshma Venugopal
- Senior Lecturer, Department of Oral Pathology, Krishnadevaraya College of Dental Sciences , Bengaluru, Karnataka, India
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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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Bedi RS, Sah K, Singh A, Chandra S, Raj V. Keratoameloblastoma or Kerato-odontoameloblastoma: report of its soft tissue recurrence with literature review. Quant Imaging Med Surg 2016; 5:898-908. [PMID: 26807371 DOI: 10.3978/j.issn.2223-4292.2015.09.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Keratoameloblastoma (KA) is a rare histological variant of the ameloblastoma with extensive keratin production within the odontogenic islands as well as in the fibrous stroma. Pindborg first reported it in 1970, since then only 18 cases have been reported in the literature. We report a soft tissue recurrence of KA, involving right posterior region of the lower jaw in a 27-year-old female.
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Affiliation(s)
- Ravinder S Bedi
- 1 Department of Oral & Maxillofacial Surgery, 2 Oral Pathology & Microbiology, 3 Oral Medicine and Radiology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Kunal Sah
- 1 Department of Oral & Maxillofacial Surgery, 2 Oral Pathology & Microbiology, 3 Oral Medicine and Radiology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Anil Singh
- 1 Department of Oral & Maxillofacial Surgery, 2 Oral Pathology & Microbiology, 3 Oral Medicine and Radiology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Sunira Chandra
- 1 Department of Oral & Maxillofacial Surgery, 2 Oral Pathology & Microbiology, 3 Oral Medicine and Radiology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Vineet Raj
- 1 Department of Oral & Maxillofacial Surgery, 2 Oral Pathology & Microbiology, 3 Oral Medicine and Radiology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
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Lee C, Park BJ, Yi WJ, Heo MS, Lee SS, Huh KH. Keratoameloblastoma: a case report and a review of the literature on its radiologic features. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:e219-25. [DOI: 10.1016/j.oooo.2015.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Revised: 06/12/2015] [Accepted: 07/08/2015] [Indexed: 11/16/2022]
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Palaskar SJ, Pawar RB, Nagpal DD, Patil SS, Kathuriya PT. Keratoameloblastoma a rare entity: a case report. J Clin Diagn Res 2015; 9:ZD05-7. [PMID: 25954709 DOI: 10.7860/jcdr/2015/10111.5637] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 01/19/2015] [Indexed: 11/24/2022]
Abstract
Ameloblastoma is the second most common odontogenic tumour of oral cavity; which has several different histological variants such as follicular, plexiform, acanthomatous, granular cell, desmoplastic, basal cell, clear cell, hemangiomatous, mucous cell differentiation and keratoameloblastoma. It is common in posterior mandible and has high male predilection in the ratio of 3:1. This report presents a case of keratoameloblastoma in 65-year-old female patient in the anterior mandible region with literature review on clinical features, histopathological findings, radiological appearance and treatment options.
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Affiliation(s)
- Sangeeta J Palaskar
- Professor and Head, Department of Oral Pathology and Microbiology, Sinhgad Dental College and Hospital , Vadagaon (bk), Pune, Maharashtra, India
| | - Rasika B Pawar
- Postgraduate Student, Department of Oral Pathology and Microbiology, Sinhgad Dental College and Hospital , Vadagaon (bk), Pune, Maharashtra, India
| | - Deepakkumar D Nagpal
- Reader, Department of Oral Pathology and Microbiology, Sinhgad Dental College and Hospital , Vadagaon (bk), Pune, Maharashtra, India
| | - Swati S Patil
- Postgraduate Student, Department of Oral Pathology and Microbiology, Sinhgad Dental College and Hospital , Vadagaon (bk), Pune, Maharashtra, India
| | - Pargatsingh T Kathuriya
- Postgraduate Student, Department of Oral Pathology and Microbiology, Sinhgad Dental College and Hospital , Vadagaon (bk), Pune, Maharashtra, India
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Vera-Sirera B, Forner-Navarro L, Vera-Sempere F. NCAM (CD56) expression in keratin-producing odontogenic cysts: aberrant expression in KCOT. Head Face Med 2015; 11:3. [PMID: 25889612 PMCID: PMC4337090 DOI: 10.1186/s13005-015-0060-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 01/20/2015] [Indexed: 01/09/2023] Open
Abstract
Objective To investigate immunohistochemically the expression of neural cell adhesion molecule (NCAM), which has been identified as a signaling receptor with frequent reactivity in ameloblastomas (AB), in a series of keratin-producing odontogenic cysts (KPOCs). Material and methods Immunohistochemical expression of NCAM, using a monoclonal antibody, was determined in a series of 58 KPOCs comprising 12 orthokeratinized odontogenic cysts (OOCs) and 46 keratocystic odontogenic tumors (KCOTs), corresponding to 40 non-syndromic KCOT (NS-KCOTs) and 6 syndromic KCOT (S-KCOTs), associated with nevic basocellular syndrome (NBCS). Results NCAM expression was negative in all OOCs, but 36.45% of KCOTs exhibited focal and heterogeneous expression at the basal cell level, as well as in basal budding areas and the basal cells of daughter cysts. The latter two locations were especially applicable to S-KCOTs, with focal NCAM reactivity occurring in 66.66% of cases. Conclusions Aberrant NCAM expression, in KCOTs but especially in S-KCOTs, together with its immunomorphological location, suggests that this adhesion molecule and signaling receptor plays a role in the pathogenesis of KCOTs, with a probable impact on lesional recurrence. Electronic supplementary material The online version of this article (doi:10.1186/s13005-015-0060-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | - Francisco Vera-Sempere
- Departaments of Pathology, University of Valencia, Valencia, Spain. .,Service of Pathology, Hospital Universitario y Politécnico La Fe, Avda Campanar 21, Valencia, 46009, Spain.
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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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Solid variant of keratocystic odontogenic tumor of the mandible: report of a case with a clear cell component and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:e393-8. [DOI: 10.1016/j.oooo.2013.02.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 02/18/2013] [Accepted: 02/25/2013] [Indexed: 11/18/2022]
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Papilliferous keratoameloblastoma: an extremely rare case report. Case Rep Dent 2013; 2013:706128. [PMID: 23862079 PMCID: PMC3686074 DOI: 10.1155/2013/706128] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 05/13/2013] [Indexed: 11/29/2022] Open
Abstract
Odontogenic tumors develop in the jaw bones from the odontogenic tissue-oral epithelium in tooth germ, enamel organ, dental papilla, reduced enamel epithelium, remnants of Hertwig's root sheath or dental lamina, and so forth. Hence, a bewildering variety of tumors are encountered in the maxilla and mandible. Ameloblastoma is the second most common odontogenic neoplasm after odontomes, and it has numerous clinical and histologic variants. We report a very rare histologic variant: the papilliferous keratoameloblastoma which is the fifth reported case in the English literature.
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Ide F, Ito Y, Muramatsu T, Saito I, Abiko Y. Histogenetic relations between keratoameloblastoma and solid variant of odontogenic keratocyst. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:812-3; author reply 813-4. [DOI: 10.1016/j.oooo.2012.06.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 06/19/2012] [Indexed: 11/28/2022]
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20
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Differentiating solid variants of keratocystic odontogenic tumors and keratoameloblastomas. Oral Surg Oral Med Oral Pathol Oral Radiol 2012. [DOI: 10.1016/j.oooo.2012.08.441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Geng N, Lv D, Chen QM, Zhu ZY, Wu RQ, He ZX, Chen Y. Solid variant of keratocystic odontogenic tumor with ameloblastomatous transformation: a case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:223-9. [PMID: 22769408 DOI: 10.1016/j.oooo.2011.11.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Revised: 10/16/2011] [Accepted: 11/16/2011] [Indexed: 11/30/2022]
Abstract
The solid variant of keratocystic odontogenic tumor is an extremely rare tumor. Its clinical and pathologic features remain poorly defined, even in the 2005 World Health Organization odontogenic tumor classification. We report an unusual lesion in a 38-year-old female Chinese patient. The lesion demonstrated the solid or multiple cystic architecture of a keratocystic odontogenic tumor, but also exhibited ameloblastomalike lining epithelium in some areas. The complex histopathology made a pathologic diagnosis difficult. Finally, the lesion was diagnosed as solid variant of keratocystic odontogenic tumor with ameloblastomatous transformation. We present the clinical and pathologic details of the case, and review the relevant literature.
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Affiliation(s)
- Ning Geng
- State Key Laboratory of Oral Diseases, Sichuan, China
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Keratoameloblastoma: Complex Histologic Variant of Ameloblastoma. J Oral Maxillofac Surg 2012; 70:860-4. [DOI: 10.1016/j.joms.2011.03.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2010] [Revised: 03/21/2011] [Accepted: 03/28/2011] [Indexed: 11/18/2022]
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23
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Solid Keratocystic Odontogenic Tumor—Report of a Nonaggressive Case. J Oral Maxillofac Surg 2012; 70:865-70. [DOI: 10.1016/j.joms.2011.02.140] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2010] [Revised: 02/09/2011] [Accepted: 02/12/2011] [Indexed: 11/17/2022]
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Abstract
Keratoameloblastoma is a very rare ameloblastoma variant defined by extensive squamous metaplasia and keratinization. There are 13 previously reported cases in the literature, with a male predilection of 3:1. A 38-year-old male presented with a painless mandibular swelling which had been progressively increasing in size for 18 months. The incisional biopsy was misdiagnosed as basaloid squamous carcinoma. Owing to financial constraints, the patient had mandibular resection a decade after first noticing the growth, during which the clinical course was essentially benign, thus casting doubt on the initial diagnosis. The final histological diagnosis for both the incisional and resection biopsy specimens was keratoameloblastoma.
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Affiliation(s)
- Bf Adeyemi
- Department of Oral Pathology, University of Ibadan, Nigeria
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25
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Won JH, Na HY, Kim HS, Kim J, Nam W, Cha IH, Kim HJ. Keratoameloblastoma of the maxilla: a case report. J Korean Assoc Oral Maxillofac Surg 2011. [DOI: 10.5125/jkaoms.2011.37.6.520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Ji-Hoon Won
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hye-Young Na
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyun-sil Kim
- Department of Oral Cancer Research Institute, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jin Kim
- Department of Oral Cancer Research Institute, College of Dentistry, Yonsei University, Seoul, Korea
| | - Woong Nam
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
- Department of Oral Cancer Research Institute, College of Dentistry, Yonsei University, Seoul, Korea
| | - In-Ho Cha
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
- Department of Oral Cancer Research Institute, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyung Jun Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
- Department of Oral Cancer Research Institute, College of Dentistry, Yonsei University, Seoul, Korea
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Tubulopapillary hidradenoma-like tumor of the mandible. Int J Oral Maxillofac Surg 2009; 38:903-7. [PMID: 19375892 DOI: 10.1016/j.ijom.2009.03.708] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2008] [Revised: 12/18/2008] [Accepted: 03/18/2009] [Indexed: 11/22/2022]
Abstract
Tubulopapillary hidradenomas are uncommon benign tumors of the dermis, most commonly occurring in the skin of the head or of the extremities. Complete excision is generally curative and recurrences are rare. The authors describe an unusual case of an intraosseous tubulopapillary hidradenoma of the mandible that recurred 1 year after initial curettage and required en-bloc resection.
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Ide F, Mishima K, Saito I, Kusama K. Diagnostically challenging epithelial odontogenic tumors: a selective review of 7 jawbone lesions. Head Neck Pathol 2009; 3:18-26. [PMID: 20596984 PMCID: PMC2807539 DOI: 10.1007/s12105-009-0107-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Accepted: 01/16/2009] [Indexed: 10/25/2022]
Abstract
Considerable variation in the clinicopathologic presentation of epithelial odontogenic tumors can sometimes be confusing and increase the chance of misdiagnosis. Seven diagnostically challenging jawbone lesions are described. There were 2 cases of mistaken identity in our ameloblastoma file. One unicystic type, initially diagnosed and treated as a lateral periodontal cyst, showed destructive recurrence 6 years postoperatively. The other globulomaxillary lesion was managed under the erroneous diagnosis of adenomatoid odontogenic tumor and recurred 4 times over an 11-year period. This tumor was found in retrospect to be consistent with an adenoid ameloblastoma with dentinoid. The diagnosis of cystic squamous odontogenic tumor (SOT) occurring as a radicular lesion of an impacted lower third molar was one of exclusion. Of two unsuspected keratocystic odontogenic tumors, one depicted deceptive features of pericoronitis, while the other case has long been in our files with the diagnosis of globulomaxillary SOT. Two cases of primary intraosseous squamous cell carcinoma appeared benign clinically and exhibited unexpected findings; an impacted third molar began to erupt in association with the growth of carcinoma and another periradicular carcinoma showed dentinoid formation. Cases selectively reviewed in this article present challenging problems which require clinical and radiographic correlation to avoid potential diagnostic pitfalls.
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Affiliation(s)
- Fumio Ide
- Department of Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan.
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Ide F, Mishima K, Yamada H, Horie N, Saito I, Shimoyama T, Kusama K. Unsuspected small ameloblastoma in the alveolar bone: a collaborative study of 14 cases with discussion of their cellular sources. J Oral Pathol Med 2008; 37:221-7. [DOI: 10.1111/j.1600-0714.2007.00628.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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