Peripheral granular cell odontogenic fibroma

Peripheral odontogenic fibroma in a child with Ellis-van Creveld syndrome: Case report

INTRODUCTION

Ellis-van Creveld (EVC) syndrome is an autosomal recessive disorder predominantly characterized by a disproportionate dwarfism, ectodermal dysplasia, postaxial polydactyly, and congenital heart malformations and pulmonary hypoplasia.

OBJECTIVE

In this article, we hereby present a case of a 6-year-old Brazilian boy with EVC syndrome who presented a rare oral lesion as well as a remarkable number of classical and uncommon oral and dental features.

CASE REPORT

Clinical and radiographic examination revealed multiple enamel hypoplasia, teeth agenesis, conical teeth, lower canine rotation, bilateral posterior crossbite, taurodontism of deciduous and permanent molars and delayed tooth eruption, dental caries, and absent vestibular sulcus. Additionally, a whitish lobulated nodule located in the alveolar ridge in the anterior region of the mandible was noted. Anatomopathological examination was compatible with the diagnosis of peripheral odontogenic fibroma (POF). In a 10-month clinical follow-up, no signs of recurrence were observed.

CONCLUSION

In view of the characteristic oral findings of EVC syndrome and the potential for recurrence of POF, the pediatric dentist plays an essential role in clinical follow-up, planning and preventive, and rehabilitative treatment.

Symphyseal-Sparing Mandibulectomy for Canine Acanthomatous Ameloblastoma in Dogs: 35 Cases

Canine acanthomatous ameloblastoma (CAA) has been reported to be the most prevalent odontogenic tumor in dogs. The most common location of this tumor is the rostral mandible. Symphyseal-sparing mandibulectomy has been shown to be an effective technique to maintain mandibular continuity and promote early return to function. In this retrospective study, 35 dogs with CAA associated with a mandibular canine tooth were evaluated following a symphyseal-sparing rostral mandibulectomy. Dogs with intraoperative transection of the canine tooth root and subsequent root fragment extraction were included. The objective of this study was to evaluate outcome following excision of CAA with mid-root transection. Data retrospectively evaluated in this study included the following: narrowest tumor margin, narrowest tumor margin at the border associated with the transected canine root, tumor size, and prevalence of local recurrence. This study showed that 82.86% of CAA were completely excised with tumor-free margins (N = 29). The median narrowest overall tumor-free margin was 3.5 mm (interquartile range [IQR] 2.0-6.5 mm) and the median tumor-free margin associated with the border of the transected canine root was 5.0 mm (IQR 3.1-7.0 mm). Follow-up data was obtained in 25 cases via phone interviews with referring veterinarians and clients. No local tumor recurrence was reported in cases with incomplete tumor excision (N = 5). All dogs with follow-up data survived at least 1 year following surgery. It was concluded that segmental or rostral mandibulectomy with wide margins to include the entire mandibular canine tooth with subsequent mandibular instability may not be warranted for dogs with CAA associated with this tooth.

Central Granular Cell Odontogenic Tumor of the Mandible: An Uncommon Presentation

Central granular cell odontogenic tumor (CGCOT) is a rare, benign odontogenic tumor resulting from the jaw bone, especially the mandible or maxilla. It affects women of middle age and usually occurs as a painless swelling of the mandibular premolar-molar area. CGCOT is characterized by the presence of granular cells, which are large, eosinophilic, granular-looking cells found in the tumor tissue. We report an unusual CGCOT in a 38-year-old male patient's mandibular region. We also describe the clinical, radiological, and pathological characteristics along with the immunohistochemical investigation of the tumor.

A case of peripheral odontogenic fibroma arising in the mandibular premolar region of a teenager

Peripheral odontogenic fibroma (POdF) is a rare, benign ectomesenchymal tumor. Herein, we report a case of a 15‐year‐old female patient who developed POdF in the mandible. The lesion was resected along with the periosteum. Histopathological findings revealed a small mass and cord‐like epithelium. There was no recurrence 16 months postoperatively.

Peripheral odontogenic fibroma (POdF) is a benign tumor that rarely occurs in the mandibular premolar region of teenagers. For a POdF that develops in a young patient, tumor resection, including the periosteum, and long‐term follow‐up are necessary to minimize the rate of recurrence.

External tooth resorption associated with a peripheral odontogenic fibroma: review and case report

The purpose of the study is to document a rare case of a peripheral odontogenic fibroma with associated cervical and coronal tooth resorption in a 38 year old woman. Histopathological features are described, the clinical management outlined and follow-up observations over 27 years detailed. The exophytic firm lesion, coral pink in appearance, located on the labial aspect of a maxillary right lateral incisor was excised, fixed in formalin and prepared for histological evaluation. The resorption cavity and adjacent soft tissue were treated by the topical application of trichloroacetic acid prior to restoration with a glass-ionomer cement and subsequent root canal treatment. Histologically, the body of the lesion was characterized by the presence of odontogenic epithelium embedded in a mature fibrous stroma. Areas of dystrophic calcification could also be identified. The features were consistent with a diagnosis of a peripheral odontogenic fibroma. The clinical result of treatment assessed 27 years postoperatively showed no evidence of recurrence of the peripheral odontogenic fibroma. External cervical and coronal tooth resorption can, on rare occasions, prove to be a clinical feature associated with peripheral odontogenic fibroma. Treatment of the tumour mass and the resorptive lesion can provide a successful outcome.

S-100 Negative Granular Cell Tumor of the Oral Cavity

Classic granular cell tumor is a mesenchymal neoplasm that commonly occurs on the skin, but is not infrequently found in the oral cavity, primarily on the dorsal tongue. Diagnosis is usually straightforward with hematoxylin and eosin stained slides. Immunohistochemical studies on classic granular cell tumor shows positive immunostaining for S-100 and vimentin, while CD68 is variably positive. We report a case of otherwise unremarkable oral granular cell tumor that was immunohistochemically negative for S-100, and positive for vimentin and CD68, and discuss the differential diagnosis. The results of the immunohistochemical studies in our case are compared with those of classic S-100 positive oral granular cell tumors, as well as cutaneous and oral S-100 negative granular cell tumors. Classic S-100 positive granular cell tumors and S-100 negative granular cell tumors of the oral cavity can only be distinguished by immunohistochemical studies; however, the necessity of this distinction is unclear, as both are benign lesions in which recurrence is unlikely.

Peripheral odontogenic fibroma: an uncommonly overviewed lesion

Peripheral odontogenic fibroma is considered a gingival tumor characterized by a proliferation of relatively cellular fibrous or fibromyxomatous connective tissue which exhibits variable amounts of odontogenic epithelium and sometimes foci of calcification in the form of dentinoid, cementicles, or bone. It is considered the extraosseous counterpart of central odontogenic fibroma. This lesion usually is presented as a focal swelling in the gingiva, occurring in a wide age range, and the anterior region of the gingiva is the most frequent anatomic site. Conservative local excision is the treatment frequently adopted and its recurrence rate varies widely, and its biologic behavior is still unknown. In this study, the authors discuss 3 cases of peripheral odontogenic fibroma, and present their clinical and histopathological features and management.

Central granular cell odontogenic tumor: a systematic review

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

Odontogenic fibroma, including amyloid and ossifying variants

Sixty-five cases of odontogenic fibroma (OdonF) are herein presented having been segregated into peripheral, extra bony tumors (n = 40) and tumors arising in bone or centrally (n = 25). All cases were characterized microscopically by a fibrous proliferation that varied within and between cases in cellularity and collagen fibril diameter, with intermixed odontogenic epithelial islands and cords. All central lesions presented as well demarcated radiolucencies and resorption of contiguous tooth roots was a common finding. These intraosseous lesions were of the WHO type; the so-called nonWHO type was excluded as all lesions with this diagnosis were devoid of an epithelial component and could be reclassified as other soft tissue fibrogenic tumors. Neither the central tumors nor the peripheral lesions recurred following enucleation/curettage, with a mean follow-up of 4 and 3.4 years respectively. Three distinct microscopic variations were encountered in this series: (1) two cases of OdonF with giant cell reaction, (2) two instances of OdonF with ossifying fibroma; and (3) four instances of OdonF with odontogenic ameloblast-associated protein (ODAM), an amyloid-like protein found deposited adjacent to epithelial cords plus CD1a+/S-100+ Langerhans dendritic cells entwined around the epithelial element. A single instance of the odontogenic fibroma-like hamartoma/enamel hypoplasia syndrome has been included in this series.

Peripheral odontogenic fibroma: a clinicopathologic study of 151 cases and review of the literature with special emphasis on recurrence

OBJECTIVE

The peripheral odontogenic fibroma (POdF) is a rare benign neoplasm of odontogenic origin with limited data on recurrence. The purpose of this study was to define the clinical and histopathologic spectrum of POdF and to investigate its recurrence rate and variables associated with its recurrence.

STUDY DESIGN

A total of 151 cases of POdF were accepted for this study, which documented clinical, histopathologic, and follow-up data. Multivariate stepwise logistic regression was used to investigate the association of categorical variables and recurrence.

RESULTS

POdF should be considered a mixed odontogenic tumor because it is composed of active odontogenic epithelial and ectomesenchymal components. Of the 58 cases with follow-up, 29 recurred. Budding of the basal cell layer of the surface squamous epithelium was associated with higher recurrence (P=.0186); 27 cases with recurrence which exhibited this feature. The presence of calcification in direct apposition to epithelial rests was associated with lower recurrence (P=.0076); 13 cases that did not recur exhibited this feature.

CONCLUSIONS

POdF has a 50% recurrence rate. Budding of the surface epithelium and calcification in apposition to odontogenic epithelial rests are histologic predictors of recurrence.