Calcifying epithelial odontogenic tumours in three cats and a dog

Maxillary and Mandibular Peripheral Odontogenic Fibromas (Fibromatous Epulides of Periodontal Ligament Origin) in a Cat

Peripheral odontogenic fibroma (POF) is an uncommon finding in the mouth of cats. Few cases have been reported in the literature. The present report describes an adolescent, male-castrated domestic shorthair cat with POFs at the rostral upper and lower jaws that were treated via marginal excision including removal of underlying bone. Despite the high incidence of recurrence reported in the literature, recheck examinations up to 11 months postoperatively did not show regrowth of the gingival masses. Thus, marginal excision including removal of underlying bone appears to be a viable treatment option for POF in cats.

Diagnosis and Management of Odontogenic Myxoma in a Dog

A three-year-old Jack Russell terrier dog was presented with a large gingival mass of the right mandible extending from the fourth premolar to the first molar teeth. Radiographic examination of the expansile mass revealed moth-eaten, honeycomb-like lyses of the mandible and extended into the mandibular alveolar canal based on computed tomography. The histopathological diagnosis of the biopsy was odontogenic fibromyxoma. Mandibulectomy with resection of the associated soft tissues was performed. Surgical management was curative with no clinical signs of disease 2-years after treatment. These neoplasms are slow growing, locally destructive tumors of odontogenic origin that have been described in the jaw of only one dog. In this paper, the clinico-radiological and pathologic features, diagnostic modalities as well as the factors that might influence treatment outcome of odontogenic myxomas are discussed. These odontogenic tumors are currently excluded from the WHO classification of odontogenic tumors in domestic animals and inclusion in future classifications systems is proposed.

Oral Masses in Two Cats

Incisional biopsies from the oral cavity of 2 adult cats were submitted for histological investigation. Cat No. 1 showed a solitary well-circumscribed neoplasm in the left mandible. Cat No. 2 demonstrated a diffusely infiltrating neoplasm in the left maxilla. Both tumors consisted of medium-size epithelial cells embedded in a fibrovascular stroma. The mitotic index was 0 to 1 mitosis per high-power field. The epithelial cells showed an irregular arrangement forming nests or streams in cat No. 1, whereas a palisading growth was noted in cat No. 2. Both tumors, especially that of cat No. 1, showed multifocal accumulations of amyloid as confirmed by Congo red staining and a distinct green birefringence under polarized light, which lacked cytokeratin immunoreactivity as well as and AL and AA amyloid immunoreactivity. In addition, the amyloid in cat No. 2 was positive for the odontogenic ameloblast-associated protein, formerly termed APin. In sum, both cats suffered from an amyloid-producing odontogenic tumor, but their tumors varied with respect to morphology and type of amyloid produced.

Amyloid-producing odontogenic tumor and its immunohistochemical characterization in a Shih Tzu dog

A 10-year-old, male, Shih-Tzu dog presented with swelling of the right lower jaw caused by a mass arising from the right mandibular gingiva. Radiographic examination revealed bone lysis of the right wing of the mandible. Histopathologically, the growth was characterized by indistinctly lobulated nests, islands, and strands of proliferating odontogenic and squamous epithelial cells, intermingled in close association with large numbers of irregular extracellular deposits of amyloid and amorphous calcified substance. Immunohistochemically, both epithelial components stained strongly positive for cytokeratin (AE1/AE3); the squamous epithelial cells also reacted strongly with neuron-specific enolase (NSE) and S-100 protein, whereas the odontogenic epithelial cells displayed weak immunoreactivity to NSE and partial reactivity to S-100 protein. The amyloid deposits were AE1/AE3-negative. The growth was diagnosed as an amyloid-producing odontogenic tumor.

Amyloid-producing odontogenic tumour (calcifying epithelial odontogenic tumour) in the mandible of a Bengal tiger (Panthera tigris tigris)

A 13-year-old male tiger (Panthera tigris tigris) had a marked mandibular swelling noticed 12 months earlier and associated with progressive anorexia and weight loss. Radiological and post-mortem examination revealed a mass (13x15 cm) which was firm and poorly defined, with destruction of the adjacent bone tissue. Histologically, the mass was poorly demarcated, with infiltrative growth, and composed of nests, cords and islands of epithelial cells with characteristic basal cell features. Also observed were extensive squamous metaplasia, ghost cells, stellate reticulum, and fibroblastic connective tissue stroma containing inflammatory cells. A prominent feature of this tumour consisted of abundant nodular deposits of congophilic amyloid-like material with partial mineralization (Liesegang rings). Immunohistochemically, the neoplastic cells and the amyloid-like material were positive for pancytokeratin and negative for vimentin. The findings supported the diagnosis of an amyloid-producing odontogenic tumour (APOT), also known as calcifying epithelial odontogenic tumour in man and animals.

Amyloid-producing odontogenic tumor in a Shih-Tzu dog

A 9-month-old male Shih-Tzu dog had a right mandibular tumor composed of strands, or nest-like proliferation of epithelial cells with abundant fibrous stroma characterized by spheroid to large nodular deposition of amyloid with Congo-red stain. Globule calcification was also seen throughout the tumor tissue and the spheroid depositions often had a concentrically laminated structure (Liesegang rings). The case was diagnosed as amyloid-producing odontogenic tumor in a dog.

Radiation therapy for long-term control of odontogenic tumours and epulis in three cats

Orthovoltage radiation was used to treat odontogenic tumours in three cats following incomplete surgical resection. Cats received a total radiation dose of 48-52 Gy over a period of 26-29 days. Acute toxicities were mild, consisting of hair loss within the radiation field in all cats, and mild mucositis in one cat. All cats had long-term (>35 months) control of their tumour, and two cats are still alive without recurrence of tumour 60 and 39 months, respectively, after completing treatment. Radiation therapy should be considered to be an adjuvant to incomplete surgery in cats with odontogenic neoplasms or epulides.

Case of calcifying epithelial odontogenic tumour in a dog

A 12-year-old male shih tzu dog was diagnosed as having a calcifying epithelial odontogenic tumour. One and a half years prior to presentation, a mass was noticed on the right mandible by the owners. Radiography revealed irregular, faintly radiopaque material within the tumour. A right hemimandibulectomy was performed, based on the clinical diagnosis of osteosarcoma. Histopathological evaluation of the mandibular mass showed that it was composed of a polyhedral odontogenic epithelial cell nest, fibrous stroma, homogeneous eosinophilic material and rounded calcifying material. The eosinophilic material was visualised by staining with Congo red, and observed under green birefringence by polarisation microscopy. Although the tumour had not recurred 12 months after surgery, the dog was euthanased because of aspiratic pharyngitis. The literature on the clinical behaviour of calcifying epithelial odontogenic tumours in dogs and cats is reviewed.

Calcifying epithelial odontogenic tumours in small domesticated carnivores: histological, immunohistochemical and electron microscopical studies

Histological, immunohistochemical and electron microscopical studies revealed one feline and four canine calcifying epithelial odontogenic tumours in 115 oral tumours over a 10-year period. The tumours consisted of islands and sheets of odontogenic epithelium of varying size within a stroma of fibrous connective tissues. The tumour cells were pleomorphic with variable amounts of eosinophilic cytoplasm and large hyperchromatic, polymorphic nuclei with prominent nucleoli. Clusters of keratinized tumour cells ("shadow cells") were frequently seen within the islands and sheets. The multiple spherules of homogeneous eosinophilic material stained positively with Congo red and Dylon stains and produced an apple green birefringence under polarization microscopy, indicative of amyloid. Mineralized foci were scattered throughout the tumour masses and in the homogeneous spherules. Immunohistochemically, the tumour cells reacted with anti-human keratin antibody, but not with anti-human vimentin or anti-chicken desmin antibodies. The homogeneous spherules did not react with anti-human keratin, anti-human vimentin, anti-chicken desmin, anti-amyloid A, anti-laminin or anti-human collagen (type I, III, IV) antibodies. Ultrastructurally, the cytoplasm of tumour cells was abundant and contained a large number of electron-dense bundles of tonofilaments. The homogeneous spherules consisted of fine filaments measuring about 10-12 nm in diameter.

Epulides in the dog: a review

This article is based on a review of the literature and the study of pathology sections obtained from various veterinary pathology laboratories. Epulis is a non-specific, clinical designation for a localized, exophytic growth on the gingiva. Four reactive epulides occur in human beings, namely focal fibrous hyperplasia (fibrous epulis), pyogenic granuloma, peripheral giant cell granuloma (giant cell epulis), and peripheral ossifying fibroma (calcifying fibrous epulis). The first three also occur in dogs but only focal fibrous hyperplasia appears to be common. The peripheral ossifying fibroma has not yet been reported in dogs. Odontogenic tumors occurring on the gingiva (i.e., as epulides) are referred to as peripheral odontogenic tumors. Three types have been reported in dogs. One, the common fibromatous epulis, is equivalent to the rare peripheral odontogenic fibroma in human beings. Another, the acanthomatous epulis, appears to be a form of ameloblastoma but differs from the peripheral ameloblastoma in human beings in that it invades bone; its biological behavior is therefore that of the human intraosseous ameloblastoma. The third, a rare lesion, has been referred to in the veterinary literature as a calcifying epithelial odontogenic tumor, although it is not the canine counterpart of the human CEOT. The term, amyloid-producing odontogenic tumor, has been suggested as being appropriate for this lesion.

The so-called calcifying epithelial odontogenic tumour in dogs and cats (amyloid-producing odontogenic tumour)

This paper describes the microscopical features of a rare odontogenic tumour that occurs in dogs and cats and which has been referred to as the calcifying epithelial odontogenic tumour (CEOT), although it is not the counterpart of the human tumour of that name. We have proposed amyloid-producing odontogenic tumour (APOT) as an appropriate alternative term. The tumour is composed of irregularly shaped strands of squamous epithelium, which in some areas exhibit palisading of the basal cells, similar to that seen in ameloblastomas. Stellate reticulum occurs focally in some examples. The second prominent feature is the presence of amyloid which tends to calcify. Finally, in some examples, a collagenous matrix, which is apparently a form of dentine, is present focally, adjacent to the epithelium. These histological features are compared with those of the canine keratinizing ameloblastoma and the human CEOT. To date, to few examples have been reported to determine accurately the biological behaviour of APOTs, but some have recurred after excision; none has metastasized.

Light microscopic, ultrastructural, and immunohistochemical examinations of two calcifying epithelial odontogenic tumors (CEOT) in a dog and a cat

Two calcifying epithelial odontogenic tumors from a 10-year-old cross-breed dog and a 9-year-old cat were characterized histologically and electron microscopically. Important characteristics were plexiform to squamous epithelial structure, amyloid in the tumor tissue with partial calcification (Liesegang's rings), and a low rate of mitosis. The amyloid found in the tumors was subjected to immunohistochemical examination, using a series of antibodies (anti-AA, -AL, -AF, -ASc1, -AB, -cytokeratin, -vimentin, -desmin, -laminin). The exclusive reaction to anti-cytokeratin and anti-laminin suggests that the amyloid is of epithelial origin.

The histopathological features of canine keratinizing ameloblastoma

This paper describes the microscopical features of one variant of canine ameloblastoma. It is composed of islands and strands of odontogenic epithelium that have infiltrated through the surrounding stroma. Most of the basal cells are hyperchromatic, cuboidal and perpendicular to the basement membrane (palisading); in some areas their nuclei are located at the distal ends of the cells (reverse polarization) and their cytoplasm is vacuolated. These are the classical characteristics of the basal cell layer of ameloblastomas. The central cells of these tumours are closely-packed, spindle-shaped and exhibit cellular keratinization and calcification as prominent features. Amyloid is present between the neoplastic epithelial cells in some examples.

An orderly approach to the study of odontogenic tumours in animals

In this paper odontogenic tumours in animals are discussed with the aim of developing a sound basis for further work in this relatively poorly understood field. The following recommendations are made: (1) Odontogenic tumours should be classified according to whether they are of epithelial, mesenchymal or of mixed epithelial and mesenchymal origin, rather than based on inductive changes. (2) The clinical behaviour implied by ameloblastoma, ameloblastic fibroma and odontoma should be carefully considered before these terms are incorporated into the diagnosis of any odontogenic tumour. (3) Caution should be exercised in designating specific odontogenic tumours in animals as being the counterpart of human tumours until their histopathological features and clinical behaviour have been proved to be equivalent. (4) Only tumours that exhibit the typical features of the basal cell layer of ameloblastomas should be designated as ameloblastomas. (5) Ameloblastic epithelium should not be used when odontogenic epithelium is intended. (6) These recommendations should be substantiated by reviewing odontogenic tumours in animals, although doing so will be difficult because of their rarity.

A survey of epithelial odontogenic tumors and cysts in dogs and cats

A retrospective histologic study of 12 canine and eight feline epithelial odontogenic tumors and cysts was conducted from oral masses (n = 3,917) obtained between 1980 and 1990. No sex or breed predilection was identified. Ameloblastoma was observed in two dogs (case Nos. 1, 2) 6 and 8 months of age. Calcifying epithelial odontogenic tumors were seen in a dog (case No. 3) and in two cats (case Nos. 4, 5) between 8 and 16 years of age. Ameloblastic fibroma (or fibroameloblastoma) was observed in cats (case Nos. 6-10) only. Inductive fibroameloblastoma was observed in four cats (case Nos. 6-9) up to 1 year of age, whereas ameloblastic fibroma was seen in a 14-year-old cat (case No. 10). A single ameloblastic odontoma was identified in a 20-month-old dog (case No. 11). Two complex odontomas occurred in a 6-month-old (case No. 12) and a 4-year-old (case No. 13) dog. Odontogenic cysts were identified in five dogs (case Nos. 14-18) aged 4.5 months to 16 years and in a 1-year-old cat (case No. 19) and have not been previously reported in these species. These cysts were lined by a stratified epithelium reminiscent of the appearance of ameloblastic epithelium. An odontogenic keratocyst with prominent central parakeratotic keratinization was identified in one 9-year-old female dog (case No. 20). Almost all epithelial odontogenic tumors were circumscribed, benign tumors that warranted a good prognosis for survival, although local recurrence may have followed (or may follow) incomplete excision. Calcifying epithelial odontogenic tumors may be locally invasive. Of six odontogenic cysts (case Nos. 14-19), two (case Nos. 15, 18) gave rise to basi-squamous carcinomas. The classification and behavior of epithelial odontogenic tumors and cysts in human beings, dogs, and cats are discussed.

Epithelial odontogenic tumours in domestic animals

Epithelial odontogenic tumours are uncommon, poorly understood and often difficult to diagnose, oral neoplasms. Dental organ pre-ameloblasts and basal lamina induce development of mesenchymal cells into odontoblasts, which produce dentin and induce pre-ameloblasts to mature into secretory ameloblasts. These reciprocal sequential inductive interactions between dental epithelium and mesenchyme form the basis for classifying epithelial odontogenic tumours. There are three tumours classified as non-inductive: ameloblastoma characterized by cords and islands of stellate reticulum with peripheral palisades of polarized columnar cells, adenomatoid ameloblastoma which has acini, rosettes and ducts of polarized columnar cells and stellate reticulum and calcifying epithelial odontogenic tumour which contains foci of Congo-red-positive material surrounded by pleomorphic polygonal epithelial cells. There are five tumours in which induction of mesenchymal tissue is evident: ameloblastic fibroma with characteristics of ameloblastoma plus proliferation of closely associated pulp-like mesenchyme; dentinoma consisting of masses of dentin, often with minimal cellular component; ameloblastic odontoma which contains palisaded epithelium and stellate reticulum as in ameloblastoma, as well as foci of dentin and/or enamel; complex odontoma which is a disorderly array of dentin, enamel, ameloblastic epithelium and odontoblasts; and compound odontoma containing denticles with well-organized tooth morphology. This paper reviews the embryogenesis of teeth and describes six types of epithelial odontogenic tumours in 13 animals. The literature concerning these tumours in nearly 250 animals is reviewed. The most commonly reported tumour is ameloblastoma and the species in which all types are most commonly reported is the dog.