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Cavalcante IL, Barros CCDS, Sousa Cruz VM, Costa MB, da Silveira Santos DF, de León-Garza B, Parra-Salazar MA, Cruz-Tapia RO, Rodriguez B, Manresa C, Sánchez G, Villarroel-Dorrego M, Turatti E, Cavalcante RB, de Andrade BAB. Primordial Odontogenic Tumor: A Review of the Literature and Report of Three New Patients. Int J Surg Pathol 2024:10668969241266925. [PMID: 39106356 DOI: 10.1177/10668969241266925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2024]
Abstract
The primordial odontogenic tumor (POT) is a rare mixed odontogenic tumor composed of mesenchymal cells, columnar odontogenic epithelium, and fibromyxoid stroma affecting the posterior mandible of children and adolescents. Herein, we report 3 patients with POT and the clinicopathological features of POT previously reported in the literature. A 12-year-old, 19-year-old, and 4-year-old patient presented an asymptomatic swelling in the posterior maxilla and posterior mandible. Imaging exams revealed radiolucent lesions associated with unerupted teeth. The lesions were surgically removed, and the histopathological examination revealed spindle-to-ovoid mesenchymal cells in a fibromyxoid stroma surfaced by columnar odontogenic epithelial cells with reverse nuclear polarization. Deposition of mineralized tissue was observed. The final diagnosis was POT, and patients did not exhibit signs of recurrence. POT should be included in the differential diagnoses of intraosseous lesions in the posterior mandible in pediatric patients.
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Affiliation(s)
- Israel Leal Cavalcante
- Department of Dentistry, University of Fortaleza (UNIFOR), Fortaleza, CE, Brazil
- Department of Oral Diagnosis and Pathology, Postgraduate Program in Dentistry, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Caio César da Silva Barros
- Department of Dentistry, Postgraduate Program in Dental Sciences, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Vitória Maria Sousa Cruz
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Mariana Bispo Costa
- Traumatology and Bucomaxillofacial Surgery, General Hospital of Fortaleza, Fortaleza, CE, Brazil
| | | | | | | | | | - Brigitte Rodriguez
- Maxillofacial Surgery Service, General Hospital of the West, Dr José Gregorio Hernández, Caracas, Venezuela
| | - Carlos Manresa
- Maxillofacial Surgery Service, General Hospital of the West, Dr José Gregorio Hernández, Caracas, Venezuela
| | - Gabriela Sánchez
- Maxillofacial Surgery Service, General Hospital of the West, Dr José Gregorio Hernández, Caracas, Venezuela
| | | | - Eveline Turatti
- Department of Dentistry, University of Fortaleza (UNIFOR), Fortaleza, CE, Brazil
| | | | - Bruno Augusto Benevenuto de Andrade
- Department of Oral Diagnosis and Pathology, Postgraduate Program in Dentistry, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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Pereira Prado V, Landini G, Mosqueda Taylor A, Vargas P, Bologna Molina R. Spatial distribution of CD34 protein in primordial odontogenic tumour, ameloblastic fibroma and the tooth germ. J Oral Pathol Med 2023; 52:181-187. [PMID: 36207782 DOI: 10.1111/jop.13370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/18/2022] [Accepted: 09/15/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Primordial odontogenic tumour is a benign mixed neoplasm of recent description, which has histological similarities with other odontogenic tumours such as the ameloblastic fibroma. In this article, we investigate the architecture of the sub-epithelial layer of mesenchymal cells expressing the marker CD34 in primordial odontogenic tumour. OBJECTIVE Analyse the spatial patterns of CD34 expression in primordial odontogenic tumour and compare them with those in ameloblastic fibroma and the normal tooth germ by means of objective imaging approaches, to better characterise these lesions. METHODS Two cases of primordial odontogenic tumour, four cases of ameloblastic fibroma and two cases of tooth germ in cap and bell stages were used for morphological, structural and immunohistochemical analyses. RESULTS CD34 expression was found in vascular endothelium of primordial odontogenic tumour, ameloblastic fibroma and tooth germ. In addition, a characteristic sub-epithelial expression was observed only in primordial odontogenic tumour, corresponding to 84%-86% of the sample boundaries. Moreover, the zone expressing CD34 corresponded with a higher cellularity, which was absent in ameloblastic fibroma and tooth germ. CONCLUSION Image analysis of the primordial odontogenic tumour architecture revealed characteristics absent in other odontogenic tumours and tooth germs. This study provides additional information to support the idea that this neoplasm is a distinct entity from early stage AF or developing odontoma.
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Affiliation(s)
- Vanesa Pereira Prado
- Molecular Pathology Area, Facultad de Odontología, Universidad de la República, Montevideo, Uruguay
| | - Gabriel Landini
- School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | | | - Pablo Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Ronell Bologna Molina
- Molecular Pathology Area, Facultad de Odontología, Universidad de la República, Montevideo, Uruguay
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Recurrent Primordial Odontogenic Tumor: Epithelium-Rich Variant. Head Neck Pathol 2021; 16:550-559. [PMID: 34224080 PMCID: PMC9187781 DOI: 10.1007/s12105-021-01354-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/24/2021] [Indexed: 10/20/2022]
Abstract
Primordial odontogenic tumor (POT) is a rare, mixed odontogenic neoplasm composed of spindled and stellate-shaped cells in myxoid stroma resembling dental papilla, surfaced by cuboidal-to-columnar odontogenic epithelium. Most POTs present in the posterior mandible as a well-demarcated radiolucency associated with a developing tooth in children and adolescents. POT is treated conservatively with no recurrences documented to-date. To describe the clinicopathological features of a recurrent POT. A 19-year-old female presented with an asymptomatic swelling, and panoramic radiograph revealed a multiloculated radiolucency in the mandibular body and ramus, with buccal and lingual perforation. The tumor was composed of plump spindle and stellate cells in a delicately collagenous and myxoid stroma, surfaced by columnar epithelial cells with reverse nuclear polarization. There was extensive epithelial proliferation forming invaginations within the tumor mass and organoid/enamel organ-like structures with enameloid-like deposits, dentinoid, and dystrophic calcifications. This was similar to the POT that had been excised four years prior from the same location. The patient underwent hemi-mandibulectomy and currently is free of disease at a thirteen-month follow-up. This report describes the first recurrent POT exhibiting extensive epithelial proliferation.
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Primordial odontogenic tumor: report of 2 new cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 132:e69-e77. [PMID: 32981867 DOI: 10.1016/j.oooo.2020.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/16/2020] [Accepted: 08/02/2020] [Indexed: 12/21/2022]
Abstract
Primordial odontogenic tumor (POT) is a recently described benign odontogenic tumor, with only 16 cases reported in the literature. We present 2 new cases of POT affecting the mandible. Case 1 is that of 12-year-old girl with an asymptomatic, slow-growing mass, causing facial asymmetry. Radiography showed a well-defined unilocular radiolucency surrounding an impacted second premolar. Case 2 is that of a 13-year-old girl with a mass involving the crown of the unerupted third molar and showing similar radiographic features. Microscopically, both lesions were composed of variably cellular fibromyxoid tissue surrounded by thin ameloblastic epithelium, with stellate reticulum-like areas, but no mineralized tissue, yielding the diagnosis of POT. Immunohistochemical analysis showed diffuse expression of CK14 in epithelial cells, whereas CK19 was expressed mainly in the basal layer. Syndecan-1 (CD138) was expressed in the stellate-like regions and in the subepithelial zone. Both patients were treated surgically, with no signs of recurrence seen after 15 and 60 months, respectively.
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Azzi L, Tettamanti L, Di Francesco A, Cerati MP, Tagliabue A, Farronato D, Maurino V. Primordial odontogenic tumour: A systematic review of the common but also unusual features of this novel entity. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:408-417. [PMID: 32145435 DOI: 10.1016/j.jormas.2020.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 02/26/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Primordial odontogenic tumour (POT) is a novel entity that was described in 2014 and that is included in the group of benign mixed epithelial and mesenchymal odontogenic tumours. In recent years, several papers have added new cases with some clinical and histopathological aspects that slightly differ from those described in the original report. The aim of this systematic review is to update all available data on POT published in the literature and to identify those features of the neoplasm that require further investigation. MATERIALS AND METHODS A systematic review of literature was conducted using PubMed, Embase, Web of Science and Scopus. Additional sources were also checked. Publications reporting cases with enough clinicopathological information were included, without any time or language restrictions. Histopathological or radiological studies were considered for qualitative analysis. RESULTS A total of 30 publications were included. Seventeen papers were used for quantitative analysis while 13 papers were used only for qualitative analysis. A total of 18 cases of POT were identified. Some clinical, radiographic, histopathological and therapeutic features were common in all reported cases, while other aspects of the neoplasm were inconsistent through published cases. This inconsistency was particularly remarkable when dealing with the histopathological features of the neoplasm. DISCUSSION Some issues about POT remain unclear and deserve to be clarified by future reports. The description of the odontogenic epithelium covering the ectomesenchyme is often contradictory, while it remains debatable whether peripheral ameloblastic epithelial islands or hard dental tissue deposition can occasionally occur within the tumour.
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Affiliation(s)
- L Azzi
- Unit of Oral Medicine and Pathology, ASST dei Sette Laghi-Ospedale di Circolo, Department of Medicine and Surgery, University of Insubria, 10, via G. Piatti, 21100 Varese, Italy.
| | - L Tettamanti
- Unit of Pediatric Dentistry, ASST dei Sette Laghi-Ospedale di Circolo, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - A Di Francesco
- Unit of Pediatric Maxillofacial Surgery, ASST Lariana-Ospedale Sant'Anna, Department of Medicine and Surgery, University of Insubria, Como, Italy
| | - M P Cerati
- Unit of Pathological Anatomy, ASST dei Sette Laghi-Ospedale di Circolo, Varese, Italy
| | - A Tagliabue
- Unit of Oral Medicine and Pathology, ASST dei Sette Laghi-Ospedale di Circolo, Department of Medicine and Surgery, University of Insubria, 10, via G. Piatti, 21100 Varese, Italy
| | - D Farronato
- Unit of Oral Medicine and Pathology, ASST dei Sette Laghi-Ospedale di Circolo, Department of Medicine and Surgery, University of Insubria, 10, via G. Piatti, 21100 Varese, Italy
| | - V Maurino
- Unit of Pediatric Dentistry, ASST dei Sette Laghi-Ospedale di Circolo, Department of Medicine and Surgery, University of Insubria, Varese, Italy
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