Squamous odontogenic tumour: report of two cases

Squamous Odontogenic Tumor: Review of the Literature and Report of a New Case

PURPOSE

Squamous odontogenic tumor (SOT) is a rare, benign, locally infiltrative odontogenic tumor of the gnathic bones. It is composed of islands of bland, well-differentiated squamous epithelium of varying shape and size. Because of histologic overlap, SOT has often been overdiagnosed as ameloblastoma and squamous cell carcinoma. It thus becomes important to understand the clinical, radiologic, histopathologic, and treatment characteristics of this tumor.

MATERIALS AND METHODS

Using the PubMed and Google Scholar databases, we searched for reported cases of SOT published in the English-language literature. We were able to retrieve 49 acceptable cases and perform a comprehensive literature review of the intraosseous SOTs, with emphasis on their clinical, radiographic, and pathologic characteristics, as well as treatment strategies. In addition, we present an additional case of SOT affecting the posterior mandible in a 44-year-old female patient.

RESULTS

The tumor in the posterior mandible in our patient was accompanied by acute pain and treated by enucleation. Histopathologic evaluation showed variably sized islands of benign squamous epithelium scattered in a fibrous stroma, consistent with the diagnosis of an SOT. Uneventful healing was noted at the 1-month postoperative appointment. However, the patient was lost to long-term follow-up. Our literature review showed that the average age at the time of diagnosis of SOT is 34.2 years. Men and women are equally affected, and the tumor does not show a predilection for either jaw bone. The most common locations are the anterior maxilla and posterior mandible. Most SOTs are treated conservatively by enucleation or curettage, whereas aggressive or recurrent tumors require radical resection.

CONCLUSIONS

Careful evaluation of the excised specimen, with immunohistochemical investigations, may prove rewarding in differentiating an SOT from other odontogenic neoplasms and thus minimize the patient's chances of undergoing an unnecessary aggressive intervention.

A squamous odontogenic tumor following an orthodontic micro-screw: A rare case report and review of the literature

We reported a very rare case of squamous odontogenic tumor(SOT) in a 23-year-old female. The tumor arose after an implanting operation of an orthodontic micro-screw, and was definitely diagnosed by the histopathological examination. Based on the case report and a review of the literature, we discussed about the general features, differential diagnosis and pathogenesis of SOT.

Surgical Management of an Aggressive Multifocal Squamous Odontogenic Tumor

Squamous odontogenic tumor is a rare benign epithelial odontogenic tumor of the jaw. Most are solitary lesions, although rare multifocal lesions have been described. Maxillary lesions have more aggressive behavior. Because of their benign character, these lesions are usually treated using a conservative surgical approach with curettage and surgical enucleation. This report describes the case of a 29-year-old woman with multifocal lesions who was initially treated with conservative surgical therapy. Early recurrence 6 months after surgery prompted more aggressive resection. This case is discussed in the context of current evidence related to the epidemiology, etiology, diagnosis, and therapy of squamous odontogenic tumors.

Multicentric Squamous Odontogenic Tumor: A Case Report and Review of the Literature

Squamous odontogenic tumor (SOT) is a rare benign epithelial odontogenic neoplasm of the jaws. Both intraosseous and peripheral SOTs have been described in the English language literature. While most intraosseous SOTs occur as solitary lesions, a multicentric variant has also been previously described. Although the radiographic and microscopic features are identical for both solitary and multicentric clinical presentations, there are three significant differences between them. More specifically, multicentric SOT presents at an earlier age (third decade of life), has a slightly higher male to female ratio than the solitary type and has a marked predilection for African-Americans. Here we document the eighth reported case of multicentric SOT, which was diagnosed in a 43-year-old African-American male. In addition, we feature focal sebaceous metaplasia, a heretofore unknown microscopic feature of SOT. Clinical, radiological, and histopathological findings are discussed. The differential diagnosis, biological behavior and management modalities for SOT are also addressed.

Recurrent squamous odontogenic tumor: A case report and review of the literature

Squamous odontogenic tumors (SOTs) are benign, locally infiltrative neoplasms that localize to the periodontium. In total, <50 cases have been reported since the first description of SOTs in 1975. Although the exact etiology of SOTs is unknown, the tumors are considered to derive from the epithelial cell rests of Malassez. SOTs are characterized by radiological and clinical signs and symptoms, including pain with increased sensitivity in the affected area, bone expansion and increased tooth mobility. The present study describes the case of a patient that experienced numerous SOT recurrences and also discusses recommendations for treatment. A locally invasive mandibular SOT was identified in a Caucasian 41-year-old female patient. The treatment involved recommended conservative surgery, including local curettage. In addition, 49 cases published in the literature were reviewed to assess the treatment strategies. The present patient experienced two recurrences of the tumor during the 6-year follow-up period. Ultimately, the vitality of the adjacent teeth was compromised. An apicoectomy with a small amount of resection of the marginal bone was necessary. In >50% of the reported cases of SOT in the literature the adjacent teeth were extracted. The present case of SOT and the associated literature were also discussed. It was concluded that the treatment of choice appears to be a conservative surgical removal, but the successful management of SOTs often requires the removal of the adjacent teeth.

Squamous Odontogenic Tumor: Literature Review Focusing on the Radiographic Features and Differential Diagnosis

Since its first publication in 1975, the squamous odontogenic tumor remains the rarest odontogenic lesion, with around 50 cases in the English-language literature in which the microscopic characteristics are frequently very well demonstrated. However, articles which discuss the radiographic aspects are scarce, especially with emphasis on the differential diagnosis. The present treatise proposes an assessment of jaw lesions with the same radiographic characteristics of the squamous odontogenic tumor to clarify the main findings for dental clinicians during routine diagnosis.

Squamous odontogenic tumor with unusual localization and appearance: a rare case report

Squamous odontogenic tumor is a rare benign neoplasm and may affect multiple sites in the mouth. SOT was first described by Pullon et al. (1975). Since then, there have been less than 50 reported cases. The tumor is often asymptomatic, although it can present with symptoms of pain and tooth mobility. We report a case of SOT occurring in a 26-year-old female in the anterior mandible with unusual localization and appearance.

Squamous odontogenic tumor: A case report and review of literature

The squamous odontogenic tumor (SOT) is a rare, benign, locally infiltrative neoplasm of the jaws that appears to originate from the rests of Malassez, gingival surface epithelium or from remnants of the dental lamina. SOT was first described by Pullon et al. (1975). Since then there has been paucity in the number of reported cases, especially in the Indian subcontinent. The tumor is often asymptomatic, although it can present with symptoms of pain and tooth mobility. The characteristic radiographic appearance is that of a triangular-shaped unilocular radiolucency associated with the roots of erupted, vital teeth and has a predilection for the anterior maxilla and the posterior mandible. Histologically, the tumor is characterized by the formation of variably sized nests and cords of uniform, benign-appearing, squamous epithelium with occasional vacuolization and keratinization. We report a case of SOT occurring in a 58-year-old male in the anterior mandible with unusual localization and appearance.

Aggressive maxillary squamous odontogenic tumour in a child: histological dilemma and adaptative surgical behaviour

A case of a maxillary osteolytic tumour is described in a 9-year-old boy. Histological analysis led to an initial diagnosis of benign squamous odontogenic tumour, although this was not straightforward due to swelling, and cellular pseudo-malignant and non-specific signs. Because of the young age of the patient, a local surgical tumourectomy was first chosen with respect to the mixed dentition. For 10 months, the evolution was satisfactory. Then, a very aggressive tumoural recurrence with lip and palate infiltration led to doubts as to the histologic nature of the tumour. Efficient collaboration between several specialized pathologist teams finally confirmed that this was a squamous odontogenic tumour but in a very aggressive form. Radical surgery was then carried out.