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Narayan B, Kumar P, Priya B, Urs AB, Augustine J. Adenomatoid odontogenic tumor: A histopathologic profile of 43 cases with evidence supporting a mixed odontogenic origin. Pathol Res Pract 2024; 257:155322. [PMID: 38688202 DOI: 10.1016/j.prp.2024.155322] [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: 03/02/2024] [Revised: 04/09/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Adenomatoid Odontogenic Tumor (AOT) accounts for 3% of all odontogenic tumors. It has been classified by WHO as an odontogenic tumor of purely epithelial origin. The current study attempts to establish the origin of the tumor along with detailed histopathological and clinicoradiographic analysis of 43 cases of AOT. MATERIAL AND METHODS Forty-three cases were reviewed from the departmental archives for demographic data, radiographic features and histological features. Further, histopathological slides were stained with Picrosirius Red (PSR) and observed under polarised light. RESULTS A majority of the cases were seen in the anterior jaws (76.7%), and were less than 3 cms (76.7%) in greatest dimension. Equal number of cases were of follicular and extra-follicular location while one was peripheral. Predominantly solid histological pattern was noted in 53.5%. Varied sub-patterns were observed with most cases exhibiting solid nodules and strands of tumor cells. Few cases showed melanin pigmentation. Over a third of cases (37.2%) showed dentigerous cyst like areas and one case each showed features of ossifying fibroma and focal cemento-osseous dysplasia. Tumor droplets, hyaline rings within duct-like structures, dentinoid material and osteodentin showed reddish yellow birefringence when observed under polarised microscopy post PSR staining. CONCLUSION This study highlights the diverse histopathological variation of AOT with evidence to reclassify it as a mixed odontogenic tumor based on the polarising microscopic findings with PSR staining.
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Affiliation(s)
- Bhaskar Narayan
- Department of Oral & Maxillofacial Pathology and Microbiology, Maulana Azad Institute of Dental Sciences, BSZ Marg, New Delhi 110002, India
| | - Priya Kumar
- Department of Oral & Maxillofacial Pathology and Microbiology, Maulana Azad Institute of Dental Sciences, BSZ Marg, New Delhi 110002, India
| | - Bhanu Priya
- Department of Oral & Maxillofacial Pathology and Microbiology, Maulana Azad Institute of Dental Sciences, BSZ Marg, New Delhi 110002, India
| | - Aadithya B Urs
- Department of Oral & Maxillofacial Pathology and Microbiology, Maulana Azad Institute of Dental Sciences, BSZ Marg, New Delhi 110002, India.
| | - Jeyaseelan Augustine
- Department of Oral & Maxillofacial Pathology and Microbiology, Maulana Azad Institute of Dental Sciences, BSZ Marg, New Delhi 110002, India
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Moles SL, Magraw CBL. Pediatric Odontogenic Cysts and Tumors. Oral Maxillofac Surg Clin North Am 2024:S1042-3699(24)00006-2. [PMID: 38462396 DOI: 10.1016/j.coms.2024.01.006] [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: 03/12/2024]
Abstract
Pediatric odontogenic cysts and tumors are rare and often associated with developing or impacted teeth. Odontogenic cysts are broadly categorized as inflammatory or developmental while odontogenic tumors are classified histologically as epithelial, mesenchymal, or mixed tumors. This article will discuss the presentation, diagnosis, and treatment of odontogenic cysts and tumors in the pediatric population.
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Affiliation(s)
- Sarah Loren Moles
- Head and Neck Surgical Oncology and Microvascular Reconstruction, Providence Cancer Institute, Portland, OR, USA
| | - Caitlin B L Magraw
- The Head and Neck Institute, Head and Neck Surgical Associates, Portland, OR, USA; Department of Oral and Maxillofacial Surgery, Oregon Health and Sciences University, Portland, OR, USA.
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3
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Diagnosis and Management of Pathological Conditions. J Oral Maxillofac Surg 2023; 81:E221-E262. [PMID: 37833025 DOI: 10.1016/j.joms.2023.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
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T J, Patil N, Keluskar V, M S, S LK, Panwar A. An Unusual Presentation of “Two-Thirds Tumor” in the Mandible – A Diagnostic Quandary with a Review of the Literature. GALICIAN MEDICAL JOURNAL 2022. [DOI: 10.21802/gmj.2022.4.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
An adenomatoid odontogenic tumor (AOT) is an uncommon benign tumor of the oral cavity commonly found in the maxillary anterior region and is associated with impacted canines in young females. It rarely occurs in the mandibular region with no impacted or missing teeth. A 21-year-old female reported to the clinic with swelling on the right side of the face for the past six months with no history of pain. Radiographic features such as unilocular radiolucency with thinning of the cortical borders and considerable buccal cortical expansion, as well as some evidence of radiopaque specks were noted. Histopathological examination revealed cells with hyperchromatic nuclei, rosette-like structures with focal areas of calcified mass, and concentric rings resembling Liesegang rings, suggestive of AOT. The tumor was treated surgically by enucleation and cauterization. Although follicular type is a common variant, the tumor presented in this case was of extrafollicular type noted in the mandibular canine and premolar regions of a young female patient with no related impacted tooth.
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Koutrakis NE, Vasilyeva D, Friedman JM. Mandibular radiolucency in an 11-year-old girl. J Am Dent Assoc 2022; 154:530-534. [PMID: 35725659 DOI: 10.1016/j.adaj.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/03/2022] [Accepted: 05/22/2022] [Indexed: 11/28/2022]
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6
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Akers JA, Johnson TM, Wagner JC, Vargas SM, Colamarino AN, Jenzer AC, Lincicum AR, Hawie JB, Lancaster DD. Dental implants at sites of focal high and mixed density osseous lesions: Clinical practice guidelines. Clin Adv Periodontics 2022. [PMID: 35108460 DOI: 10.1002/cap.10192] [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: 09/10/2021] [Accepted: 12/21/2021] [Indexed: 11/07/2022]
Abstract
FOCUSED CLINICAL QUESTION Under what circumstances may a clinician consider dental implant placement at a site exhibiting a focal high or mixed density (HMD) osseous lesion radiologically? SUMMARY Some conditions and pathologic entities exhibiting high and mixed density radiological appearance pose low risk for dental implant failure or complications following implant surgery. However, other lesions represent contraindications to implant placement, and implant surgery at such sites can result in severe morbidity. CONCLUSION Potential implant sites exhibiting focal HMD osseous lesions/conditions present varying levels of risk. In most cases, optimal management will include advanced imaging of the site, multidisciplinary consultations, and detailed informed consent to assure full understanding of procedural risks, benefits, and complications. Currently, clinical recommendations rely on case reports, opinion, and usual practice (level 3 evidence). The strength of each recommendation provided in this report is categorized as level C.
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Affiliation(s)
- Joshua A Akers
- Department of Periodontics, United States Army Dental Health Activity, Landstuhl, Germany
| | - Thomas M Johnson
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Jennah C Wagner
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Sarah M Vargas
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Aaron N Colamarino
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Andrew C Jenzer
- Department of Oral and Maxillofacial Surgery, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Adam R Lincicum
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Jennifer B Hawie
- Department of Oral Pathology, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Douglas D Lancaster
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
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Niccolò L, Daniela S, Arianna B, Andrea N, Laura M, Marco C, Dimitri R. Maxillary extrafollicular adenomatoid odontogenic tumor: root resorption and involvement of the maxillary sinus and nasal cavity. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2021. [DOI: 10.1051/mbcb/2021008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Adenomatoid odontogenic tumor (AOT) is a benign, slow-growing lesion and it is considered the fourth most common odontogenic tumor. AOT affects more frequently the young subjects with a predilection for the second and third decades of life. We present here the case of a 36-year-old man affected by large extrafollicular AOT which caused roots resorption of multiple teeth. The lesion involved the entire right maxillary bone and extended into the right maxillary sinus up to the orbital floor and the nasal cavity. Intra-oral surgical excision of the AOT and functional endoscopic sinus surgery led to complete clinical healing in absence of local recurrences.
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Manohar B, Verma N, Mannan N, Bhuvaneshwari S. Adenomatoid odontogenic tumor mimicking a lateral periodontal cyst - A rare case report in the mandible. J Indian Soc Periodontol 2020; 24:473-476. [PMID: 33144777 PMCID: PMC7592615 DOI: 10.4103/jisp.jisp_79_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/15/2020] [Accepted: 06/11/2020] [Indexed: 11/04/2022] Open
Abstract
Adenomatoid odontogenic tumor (AOT) is benign tumor of the oral cavity characterized by its slow growth accounting to 3%-7% of the odontogenic tumors. AOTs mostly occur in the maxillary anterior region and most often than not associated with impacted anterior teeth. It affects the younger age group, especially below 20 years and is commonly seen in females. It occurs as two main variants - (a) central/intraosseous which is more common and (b) peripheral which is rare. The location of the lesion, its association with the impacted tooth, is the basis for the classification of AOT. The intraosseous type may be related to unerupted tooth (follicular variant) or may not be related to unerupted tooth (extra-follicular variant). Radiologically, AOT presents predominantly as a unilocular cystic lesion enclosing the unerupted tooth. The lesion presents rarely with a cystic component. Radiopacities on the intraoral periapical radiograph are seen as discrete foci having a flocculent pattern within radiolucency even with the presence of minimal calcified deposits. AOT being benign in nature is enucleated with least chances of recurrence. Here, we present a rare case of extra-follicular variant of adenomatoid odontogenic tumor in a 19-year-old female patient.
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Affiliation(s)
- Balaji Manohar
- Department of Periodontology, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Neha Verma
- Private Practitioner, Ahmedabad, Gujarat, India
| | - Neha Mannan
- Department of Periodontology, Pacific Dental College Research Institute, Udaipur, Rajasthan, India
| | - S Bhuvaneshwari
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
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Saini N, Kadian B, Rajain T, Narang S, Namdev R. Extrafollicular Adenomatoid Odontogenic Tumor in the Maxillary Incisor Region Disguised as Gingival Swelling. Contemp Clin Dent 2020; 11:184-189. [PMID: 33110335 PMCID: PMC7583531 DOI: 10.4103/ccd.ccd_344_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/21/2020] [Accepted: 06/07/2020] [Indexed: 11/28/2022] Open
Abstract
Adenomatoid Odontogenic Tumor (AOT) is a benign, non-invasive tumor with slow but progressive growth, mainly affecting younger patients, predominantly females. It is more often located in maxilla, involving an unerupted or erupted tooth, mostly canine. There are three variants, namely follicular, extra-follicular and peripheral. Permanent cuspids account for 60% of all follicular and 89% of all extra-follicular AOT. This article discusses a unique case of extra-follicular AOT in 9 year old male patient associated with partially erupted maxillary central incisor.
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Affiliation(s)
- Natasha Saini
- Department of Pedodontics and Preventive Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Bindu Kadian
- Department of Pedodontics and Preventive Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Tanu Rajain
- Department of Pedodontics and Preventive Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Saurabh Narang
- Department of Pedodontics and Preventive Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Ritu Namdev
- Department of Pedodontics and Preventive Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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Siriwardena BSMS, Udagama MNGP, Tennakoon TMPB, Athukorala DAADW, Jayasooriya PR, Tilakaratne WM. Clinical and demographic characteristics of adenomatoid odontogenic tumors: analysis of 116 new cases from a single center. Braz J Otorhinolaryngol 2020; 88:309-315. [PMID: 32782125 PMCID: PMC9422414 DOI: 10.1016/j.bjorl.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/07/2020] [Accepted: 06/10/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction The adenomatoid odontogenic tumor is a relatively uncommon odontogenic neoplasm representing about 4.7% of all odontogenic tumors. Objective The aim of this study was to determine the demographic and clinical profile of the adenomatoid odontogenic tumors in a Sri Lankan population. Methods Data gathered from the cases received for a period of 38 years from the Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya. Request forms, biopsy reports and electronic data base of the department were used to obtain relevant information. Demographic data including age, gender and location of the tumor were included in the analysis. Results Out of 116 cases of adenomatoid odontogenic tumor, the mean age was 21.02 ± 11.24. It occurs more fre quently in the second decade of life, more prevalent in females, most often associated with the maxilla, predominantly affecting anterior jaw bones and presenting mostly in the right side of the jaw bone. The results from the present study showed the statistically significant relationship with site of occurrence (maxilla/mandible) and age (p < 0.005). Further, depending on whether it occurs in anterior/mid/posterior site also showed a significant relationship with age (p ≤ 0.001). However, side of occurrence, left or right or site of occurrence, showed no statistically significance with age (p > 0.05). Conclusion Adenomatoid odontogenic tumor occurs more frequently in the second decade of life with a significant female predominance and the commonest site is anterior maxilla. This study revealed few differences on demographic and clinical presentations of adenomatoid odontogenic tumor from some regions of the world.
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Affiliation(s)
| | | | | | | | | | - Wanninayake Mudiyanselage Tilakaratne
- University of Peradeniya, Faculty of Dental Sciences, Sri Lanka; Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Malaysia
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Roza ALOC, Carlos R, van Heerden WFP, de Andrade BAB, Mosqueda-Taylor A, Santos-Silva AR, Lopes MA, de Almeida OP, Romañach MJ, Vargas PA. An international collaborative study of 105 new cases of adenomatoid odontogenic tumors. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 132:327-338. [PMID: 32680811 DOI: 10.1016/j.oooo.2020.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/07/2020] [Accepted: 06/01/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of this study was to report the clinicopathologic features of 105 new cases of adenomatoid odontogenic tumor (AOT) from Brazil, Guatemala, Mexico, and South Africa. STUDY DESIGN Clinical and radiographic data were collected from records of 5 oral pathology laboratories, and all cases were microscopically reviewed. RESULTS This series of cases included 36 (34.2%) from South Africa; 33 (31.4%) from Brazil; 23 (21.9%) from Mexico; and 13 (12.3%) from Guatemala. Seventy-two patients (68.5%) were females and 33 patients (31.4%) were males, with an average age of 19.2 years. The tumors predominantly affected the anterior maxilla (48.5%), followed by the anterior mandible (29.5%); posterior mandible (15.2%); and posterior maxilla (6.6%). Sixty-three tumors (63.6%) were follicular, 34 (34.3%) were extrafollicular, and 2 (2%) were peripheral. In most cases, the tumors caused considerable cortical expansion (average size 3.4 cm). Microscopically, most cases showed rosette-like and duct-like structures. CONCLUSIONS This is one of the largest case series of AOTs reported in the literature and the first multicenter study involving populations from Latin America and South Africa. In a fifth of the present cases, the posterior regions of the gnathic bones were affected and the tumors demonstrated larger sizes compared with cases occurring in other populations.
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Affiliation(s)
| | - Román Carlos
- Pathology Section, Centro Clínico de Cabeza y Cuello/Hospital Herrera Llerandi, Guatemala City, Guatemala
| | - Willie F P van Heerden
- Department of Oral Pathology and Oral Biology, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | | | - Adalberto Mosqueda-Taylor
- Departamento de Atención a la Salud, Universidad Autónoma Metropolitana Xochimilco, Mexico City, Mexico
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Márcio Ajudarte Lopes
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Oslei Paes de Almeida
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Pablo Agustin Vargas
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil; Department of Oral Pathology and Oral Biology, School of Dentistry, University of Pretoria, Pretoria, South Africa.
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Chugh A, Srivastava I, Khatana S, Nalwa A, Bharti JN. Case series of adenomatoid odontogenic tumour of jaws with variations in presentation. BMJ Case Rep 2020; 13:13/1/e229358. [PMID: 31932461 DOI: 10.1136/bcr-2019-229358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Adenomatoid odontogenic tumour (AOT) is a rare tumour of odontogenic origin with distinct clinicopathological appearance but is often clinically misdiagnosed as a cyst. The most common site is the anterior maxilla in the canine region. We present here two cases, one at its commonest location in the maxillary canine while the other is at the uncommon location of the anterior mandible. Its clinical features of painless slow growing swelling, association with impacted tooth and radiographic appearance of well defined predominantly radiolucent lesion are overlapping with other oral pathologies like dentigerous cyst, radicular cyst, calcifying odontogenic cyst, calcifying epithelial odontogenic tumour, unicystic ameloblastoma etc. One must be aware and updated with the variation in appearance of AOT. Encapsulation of tumour causes less cumbersome enucleation of the tumour, a successful treatment as it reduces the chances of recurrence.
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Affiliation(s)
- Ankita Chugh
- Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Isha Srivastava
- Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Shruti Khatana
- Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Aasma Nalwa
- Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Coura BP, Bernardes VF, de Sousa SF, França JA, Pereira NB, Pontes HAR, Batista AC, da Cruz Perez DE, Albuquerque Junior RLCD, de Souza LB, Martins MD, Diniz MG, Gomez RS, Gomes CC. KRAS mutations drive adenomatoid odontogenic tumor and are independent of clinicopathological features. Mod Pathol 2019; 32:799-806. [PMID: 30643167 DOI: 10.1038/s41379-018-0194-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/22/2018] [Accepted: 11/23/2018] [Indexed: 11/09/2022]
Abstract
Adenomatoid odontogenic tumor is a benign encapsulated epithelial odontogenic tumor that shows an indolent clinical behavior. We have reported in a few adenomatoid odontogenic tumors mutations in KRAS, which is a proto-oncogene frequently mutated in cancer such as lung, pancreas, and colorectal adenocarcinomas. We aimed to assess KRAS mutations in the hotspot codons 12, 13, and 61 in a large cohort of adenomatoid odontogenic tumors and to test the association of these mutations with clinical (age, site, tumor size, follicular/extrafollicular subtypes) and histopathological parameters. Thirty eight central cases were studied. KRAS codon 12 mutations were assessed by TaqMan allele-specific qPCR (p.G12V/R) and/or Sanger sequencing, and codon 13 and 61 mutations were screened by Sanger. Histological tumor capsule thickness was evaluated by morphometric analysis. Additionally, the phosphorylated form of the MAPK downstream effector ERK1/2 was investigated. Statistical analysis was carried out to test the association of KRAS mutations with clinicopathological parameters. KRAS c.35 G >T mutation, leading to p.G12V, was detected in 15 cases. A novel mutation in adenomatoid odontogenic tumor, c.34 G >C, leading to p.G12R, was detected in 12 cases and the other 11 were wild-type. Codon 12 mutations were not associated with the clinicopathological parameters tested. RAS mutations are known to activate the MAPK pathway, and we show that adenomatoid odontogenic tumors express phosphorylated ERK1/2. In conclusion, a high proportion of adenomatoid odontogenic tumors (27/38, 71%) have KRAS codon 12 mutations, which occur independently of the clinicopathological features evaluated. Collectively, these findings indicate that KRAS mutations and MAPK pathway activation are the common features of this tumor and some cancer types. Although it is unclear why different codon 12 alleles occur in different disease contexts and the complex interactions between tumor genotype and phenotype need clarification, on the basis of our results the presence of KRAS p.G12V/R favors the adenomatoid odontogenic tumor diagnosis in challenging oral neoplasm cases.
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Affiliation(s)
- Bruna Pizziolo Coura
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Vanessa Fátima Bernardes
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Sílvia Ferreira de Sousa
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Josiane Alves França
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Núbia Braga Pereira
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Hélder Antônio Rebelo Pontes
- Service of Oral Pathology, João de Barros Barreto University Hospital, Universidade Federal do Pará (UFPA), Belém, Brazil
| | - Aline Carvalho Batista
- Department of Oral Pathology, School of Dentistry, Universidade Federal de Goiás (UFG), Goiânia, Brazil
| | - Danyel Elias da Cruz Perez
- Department of Clinical and Preventive Dentistry, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | | | - Lélia Batista de Souza
- Department of Dentistry, Service of Oral Pathology, Universidade Federal do Rio Grande do Norte (UFRN), Natal, Brazil
| | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Marina Gonçalves Diniz
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Carolina Cavalieri Gomes
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.
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Dwivedi D, Prabhakar N, Kasetty S, Ahuja R. Peripheral adenomatoid odontogenic tumor in a cloak of an epulis: report of a rare case. BMC Oral Health 2019; 19:81. [PMID: 31077195 PMCID: PMC6511215 DOI: 10.1186/s12903-019-0759-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/05/2019] [Indexed: 11/25/2022] Open
Abstract
Background Adenomatoid odontogenic tumor constitutes an uncommon benign odontogenic tumor which is well-known as “two-thirds tumor” (two-thirds of adenomatoid tumors occur in the maxilla, two-thirds occur in young females, two-thirds of the cases are associated with un-erupted teeth and two-thirds of the affected teeth are canines). Larger part of these present as intra - osseous tumors while peripheral counterparts are extremely rare. Peripheral adenomatoid odontogenic tumor is a unique entity which generally presents as a slow growing gingival swelling with minimal bone involvement. This often leads to its erroneous diagnosis as a simple gingival lesion and the real diagnosis is only revealed after its microscopic evaluation. It exhibits a marked predilection for maxillary gingiva of incisor region and most commonly affects the younger females. Case presentation We report a case of 25 years old female patient of African ethnicity who presented with a 2 × 2 cm mass attached to the left mandibular gingiva in cuspid- bicuspid region which is an unusual site for AOT. It was accompanied by slight bone loss. With the differential diagnosis of gingival epulis and peripheral ossifying fibroma; surgical excision was performed. The light microscopic examination of the specimen aided the final diagnosis of Adenomatoid odontogenic tumor with the histopathological features identical to its intra osseous counterpart. Conclusion In this case, the tumor is present on the mandibular gingiva in a 25 years old patient which is an atypical location and age for this tumor; also, the only individual case reported in an African patient. Only, a meager number of peripheral adenomatoid odontogenic tumor cases have been logged so far with majority of them occurring in maxillary gingiva. Furthermore, an ambiguity still prevails regarding its true origin and possible biological course. Hence, reporting of similar cases should be encouraged to facilitate the better understanding of its varied epidemiological details and clinical presentation.
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Affiliation(s)
- Dhara Dwivedi
- Department of Oral Pathology, Dentistry Unit, Ayder Referral Hospital- College of Health Sciences, CHS Mekelle University, Mekelle, Ethiopia.
| | - Nitin Prabhakar
- Department of Oral Maxillofacial Surgery, Ayder referral hospital- College of Health Sciences, Mekelle university, Mekelle, Ethiopia
| | - Sowmya Kasetty
- Oral Pathology Division, Oral Basic and Clinical Sciences, Qassim Private College, Buraidah, Kingdom of Saudi Arabia
| | - Rinky Ahuja
- People's College of Dental Sciences & Research Centre, Bhopal, Madhya Pradesh, Bhopal, India
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Chrcanovic BR, Gomez RS. Adenomatoid odontogenic tumor: An updated analysis of the cases reported in the literature. J Oral Pathol Med 2018; 48:10-16. [PMID: 30256456 DOI: 10.1111/jop.12783] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 09/18/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE To review the clinical and radiographic features of the available data published on adenomatoid odontogenic tumor (AOT) with special emphasis on the comparison of its variants. METHODS An electronic search was undertaken in July 2018. Eligibility criteria included publications having enough clinical/radiological/histological information to confirm the diagnosis. RESULTS A total of 436 publications reporting 1558 cases were included, of which 739 follicular, 247 extrafollicular, and 30 peripheral AOTs. Impacted canine is associated with follicular AOTs in almost 70% of the cases. AOTs were more prevalent in females, in the second decade of life, in maxillae, in anterior region of the jaws, and most are asymptomatic, with a considerable number of lesions presenting cortical bone perforation. Most of the lesions were treated by enucleation. Some cases of recurrence were reported in the literature, but only one was well documented. No difference was found when comparing the clinical/radiological features of the follicular, extrafollicular, and peripheral variants. CONCLUSIONS Adenomatoid odontogenic tumor variants do not show distinctive clinical radiological features. Recurrence of AOT is very rare, which justify its conservative management.
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Affiliation(s)
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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16
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Abstract
Adenomatoid odontogenic tumor (AOT) is a rare noninvasive odontogenic tumor that occurs mostly in the second decade of life. Based on its tooth association, AOT can be classified into three categories of follicular, extrafollicular, and peripheral types; the follicular classification is considered as the most common type of AOT. This study reported a large extrafollicular case of AOT in a 40-year-old female. She was asymptomatic and tumor was detected accidentally by her dental practitioner. Since the panoramic radiograph showed a well-defined unilocular radiolucent lesion, we observed radiopaque spots within the lesion by using cone beam computed tomography. The extrafollicular type can mimic a periapical radiolucent lesion.
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17
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Devakalavar KN, Bali A, Singh Chawla JP, Pandher PK. An atypical adenomatoid odontogenic tumour in the mandible. ANNALS OF PEDIATRIC SURGERY 2018. [DOI: 10.1097/01.xps.0000496989.88283.73] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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18
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Wright JM, Soluk Tekkesin M. Odontogenic tumors: where are we in 2017 ? J Istanb Univ Fac Dent 2017; 51:S10-S30. [PMID: 29354306 PMCID: PMC5750825 DOI: 10.17096/jiufd.52886] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 08/04/2017] [Indexed: 11/30/2022] Open
Abstract
Odontogenic tumors are a heterogeneous group of
lesions of diverse clinical behavior and histopathologic
types, ranging from hamartomatous lesions to malignancy.
Because odontogenic tumors arise from the tissues which
make our teeth, they are unique to the jaws, and by extension
almost unique to dentistry. Odontogenic tumors, as in normal
odontogenesis, are capable of inductive interactions between
odontogenic ectomesenchyme and epithelium, and the
classification of odontogenic tumors is essentially based
on this interaction. The last update of these tumors was
published in early 2017. According to this classification,
benign odontogenic tumors are classified as follows:
Epithelial, mesenchymal (ectomesenchymal), or mixed
depending on which component of the tooth germ gives
rise to the neoplasm. Malignant odontogenic tumors are
quite rare and named similarly according to whether the
epithelial or mesenchymal or both components is malignant.
The goal of this review is to discuss the updated changes to
odontogenic tumors and to review the more common types
with clinical and radiological illustrations.
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Affiliation(s)
- John M Wright
- Department of Diagnostic Sciences, School of Dentistry, Texas A&M University, Dallas, TX USA
| | - Merva Soluk Tekkesin
- Department of Tumor Pathology, Institute of Oncology, Istanbul University, Istanbul Turkey
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Siwach P, Joy T, Tupkari J, Thakur A. Controversies in Odontogenic Tumours: Review. Sultan Qaboos Univ Med J 2017; 17:e268-e276. [PMID: 29062548 DOI: 10.18295/squmj.2017.17.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 03/15/2017] [Accepted: 05/25/2017] [Indexed: 11/16/2022] Open
Abstract
Odontogenic tumours are lesions that occur solely within the oral cavity and are so named because of their origin from the odontogenic (i.e. tooth-forming) apparatus. Odontogenic tumours comprise a variety of lesions ranging from non-neoplastic tissue proliferations to benign or malignant neoplasms. However, controversies exist regarding the pathogenesis, categorisation and clinical and histological variations of these tumours. The recent 2017 World Health Organization classification of odontogenic tumours included new entities such as primordial odontogenic tumours, sclerosing odontogenic carcinomas and odontogenic carcinosarcomas, while eliminating several previously included entities like keratocystic odontogenic tumours and calcifying cystic odonogenic tumours. The aim of the present review article was to discuss controversies and recent concepts regarding odontogenic tumours so as to increase understanding of these lesions.
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Affiliation(s)
- Pooja Siwach
- Department of Oral Pathology & Microbiology, Government Dental College & Hospital, Mumbai, Maharashtra, India
| | - Tabita Joy
- Department of Oral Pathology & Microbiology, Government Dental College & Hospital, Mumbai, Maharashtra, India
| | - Jagdish Tupkari
- Department of Oral Pathology & Microbiology, Government Dental College & Hospital, Mumbai, Maharashtra, India
| | - Arush Thakur
- Department of Oral Pathology & Microbiology, Government Dental College & Hospital, Mumbai, Maharashtra, India
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20
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McCoy JM, Oreadi D. Diagnosis and Management of Pathological Conditions. J Oral Maxillofac Surg 2017; 75:e224-e263. [DOI: 10.1016/j.joms.2017.04.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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21
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Ide F, Kikuchi K, Kusama K. Adenomatoid odontogenic tumor revisited. Med Hypotheses 2017; 104:35. [PMID: 28673585 DOI: 10.1016/j.mehy.2017.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 05/21/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Fumio Ide
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan.
| | - Kentaro Kikuchi
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
| | - Kaoru Kusama
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
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Ide F, Kikuchi K, Kusama K, Muramatsu T. Adenomatoid odontogenic tumor: An outdated report. Am J Orthod Dentofacial Orthop 2016; 150:906-907. [DOI: 10.1016/j.ajodo.2016.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 07/12/2016] [Accepted: 08/31/2016] [Indexed: 11/25/2022]
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23
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Erdur EA, Dolanmaz D, Ileri Z. Authors’ response. Am J Orthod Dentofacial Orthop 2016; 150:907-908. [DOI: 10.1016/j.ajodo.2016.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 08/23/2016] [Accepted: 08/31/2016] [Indexed: 11/25/2022]
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24
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Rosa ACG, Soares AB, Furuse C, Lima SRR, de Araújo VC, Passador-Santos F. A Combined Epithelial Odontogenic Tumor? A 7-Year Follow-Up Case. Head Neck Pathol 2016; 11:519-524. [PMID: 27817004 PMCID: PMC5677059 DOI: 10.1007/s12105-016-0767-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 10/31/2016] [Indexed: 11/29/2022]
Abstract
Adenomatoid odontogenic tumor (AOT) is a benign epithelial odontogenic tumor characterized by slow and progressive growth. When central lesions are associated with an unerupted permanent tooth, they are also known as the follicular type. Histological variants of AOT may complicate diagnosis with possible adverse effects on treatment and prognosis. The aim of this study is to report a case of a follicular AOT with extensive calcifying epithelial odontogenic tumor (CEOT)-like histopathological areas in the anterior region of the mandible that was treated by enucleation. The teeth displaced by the tumor were repositioned with orthodontic treatment, and after 7 years of follow-up, the bone trabeculae were normal with no evidence of recurrence. The clinical, radiographic and histopathologic aspects of these tumors are discussed and the debate surrounding whether these cases are true combined lesions or histologic variants of the primary tumor is raised.
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Affiliation(s)
- Ana Cláudia Garcia Rosa
- Department of Oral Pathology, Lutheran University of Palmas, Palmas, Tocantins Brazil ,Department of Health Sciences, Federal University of Tocantins, Palmas, Tocantins Brazil ,Faculdade de Odontologia, Centro Universitário Luterano de Palmas—CEULP/ULBRA, Av. Teotônio Segurado, 1501 Sul, PO Box no 85, Palmas, Tocantins 77019900 Brazil
| | - Andresa Borges Soares
- Department of Oral Pathology, São Leopoldo Mandic Institute and Research Center, Campinas, São Paulo Brazil
| | - Cristiane Furuse
- Department of Oral Pathology, São Paulo State University, Araçatuba, São Paulo Brazil
| | | | - Vera Cavalcanti de Araújo
- Department of Oral Pathology, São Leopoldo Mandic Institute and Research Center, Campinas, São Paulo Brazil
| | - Fabricio Passador-Santos
- Department of Oral Pathology, São Leopoldo Mandic Institute and Research Center, Campinas, São Paulo Brazil
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25
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Thakur A, Tupkari JV, Joy T, Hanchate AV. Adenomatoid odontogenic tumor: What is the true nature? Med Hypotheses 2016; 97:90-93. [PMID: 27876138 DOI: 10.1016/j.mehy.2016.10.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 10/24/2016] [Accepted: 10/25/2016] [Indexed: 11/24/2022]
Abstract
The Adenomatoid odontogenic tumor (AOT) is one of the most controversial benign odontogenic tumor, which has been known to the pathologists for the past 100 years. Since then the history, histogenesis and histopathologic designation of AOT remains a matter of debate. Some authors consider it as a true benign neoplasm while others consider it as a hamartoma and still others as an odontogenic cyst. Here we propose that the AOT should not be considered as a cyst because its true cystic nature remains questionable. We hypothesize that when the AOT arises from a change in REE covering of the impacted tooth, then it appears as cystic in nature & certainly not a true cyst by origin. Further studies on the histogenesis are required to change the nomenclature of AOT to adenomatoid odontogenic cyst (AOC).
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Affiliation(s)
- Arush Thakur
- Department of Oral Pathology and Microbiology, Government Dental College and Hospital, Mumbai, Maharashtra, India.
| | - Jagdish Vishnu Tupkari
- Department of Oral Pathology and Microbiology, Government Dental College and Hospital, Mumbai, Maharashtra, India.
| | - Tabita Joy
- Department of Oral Pathology and Microbiology, Government Dental College and Hospital, Mumbai, Maharashtra, India.
| | - Amrut V Hanchate
- Department of Oral Pathology and Microbiology, Government Dental College and Hospital, Mumbai, Maharashtra, India.
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26
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Adenomatoid odontogenic tumor with peripheral cemento-osseous reactive proliferation: report of 2 cases and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:e86-92. [DOI: 10.1016/j.oooo.2015.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 11/30/2015] [Accepted: 12/02/2015] [Indexed: 11/24/2022]
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27
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Belgaumi UI, Parkar MI, Malik NA, Suresh KV, Havewala AM, Bhalinge PM. Follicular Adenomatoid Odontogenic Tumor in Mandible: A Rare Case Report. Ann Med Health Sci Res 2016; 5:469-72. [PMID: 27057389 PMCID: PMC4804662 DOI: 10.4103/2141-9248.177976] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Adenomatoid odontogenic tumor (AOT) is a relatively rare, benign, hamartomatous, and cystic odontogenic neoplasm that was first described more than a century ago. The lesion still continues to intrigue experts with its varied histomorphology and controversies regarding its development. The present article describes a case of cystic AOT with an unusual histomorphology associated with an impacted 44 in a 21-year-old male.
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Affiliation(s)
- U I Belgaumi
- Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - M I Parkar
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - N A Malik
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - K V Suresh
- Department of Oral Medicine and Radiology, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - A M Havewala
- Department of Oral Pathology and Microbiology, Institute of Dental Sciences, S.O.A.S University, Bhubaneswar, Odisha, India
| | - P M Bhalinge
- Department of Oral Pathology and Microbiology, M.A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
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28
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Philipsen HP, Khongkhunthiang P, Reichart PA. The adenomatoid odontogenic tumour: an update of selected issues. J Oral Pathol Med 2016; 45:394-8. [PMID: 26865435 DOI: 10.1111/jop.12418] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2015] [Indexed: 11/28/2022]
Abstract
The aim of this update was to present the recent notable progress within remaining questions relating to the adenomatoid odontogenic tumour (AOT). Selected issues that were studied included the following: (i) AOT history and terminology, (ii) the so-called peripheral AOT, (iii) AOT and the gubernaculum dentis and (iv) the so-called adenomatoid odontogenic cyst (AOC). The earliest irrefutable European case of AOT was described in 1915 by Harbitz as 'cystic adamantoma'. Recently, Ide et al. have traced two Japanese cases with irrefutable proof described by Nakayama in 1903. The so-called peripheral (gingival) variant of AOT seems to cover a dual pathogenesis, both an 'erupted intraosseous' and an 'extraosseous' (gingival) one. In 1992, we theorized that the generally unnoticed gubernaculum dentis (cord and canal) seems to be involved in the development of AOT. Ide et al. have concluded that the dental lamina in the gubernacular cord seems to be an embryonic source of the vast majority of AOTs. The suggestion by Marx and Stern to change the nomenclature of AOT to adenomatoid odontogenic cyst (AOC) is critically discussed. The present authors agree on the background of the work of several groups of researchers and WHO/IARC classifications that the biology of the follicular variant of AOT is already fully explained and does not make room for any change in diagnostic terms. Further, there is no reason to change terminology in this case where improvements or conditions to better clinical management are not an issue.
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Affiliation(s)
| | - Pathawee Khongkhunthiang
- Center of Excellence for Dental Implantology, Faculty of Dentistry, Chiangmai University, Chiangmai, Thailand
| | - Peter A Reichart
- Department of Oral Medicine, Dental Radiology and Oral Surgery, CC3, Charité, Berlin, Germany
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29
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30
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Sethi S, Kumar M, Aggarwal P, Indra Kumar HS, Sugandhi CD, Singh S. A case report and short review on changing trends in the site of occurrence of adenomatoid odontogenic tumor: Unravelling the past 15 years. Dent Res J (Isfahan) 2016; 13:462-471. [PMID: 27857774 PMCID: PMC5091007 DOI: 10.4103/1735-3327.192312] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Adenomatoid odontogenic tumor (AOT) is an uncommon benign odontogenic lesion, with debatable histogenesis and variable histopathology. A systematic and diverse insight into the evolution, clinical presentation, histology, and immunohistochemical findings of this lesion is reviewed and presented. We reviewed the data published from 2000 to 2014 of approximately 255 cases that revealed a significant change in the incidence of predominant site involved, in contrast to the findings published by Reichart. We have also included the chronological order of events leading to the coining of the term AOT, which shows the curiosity that has been dedicated to understanding the lesion. Immunohistochemistry is considered to be a hallmark in pathology for learning the molecular pathogenesis and giving a correct final diagnosis. Several markers have been used to investigate and understand this lesion, and a compilation of the findings has been tabulated.
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Affiliation(s)
- Sneha Sethi
- Department of Oral and Maxillofacial Pathology, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India
| | - Manish Kumar
- Department of Oral and Maxillofacial Pathology, Tatyasaheb Kore Dental College and Research Centre, Kohlapur, Maharashtra, India
| | - Pratul Aggarwal
- Department of Conservative Dentistry and Endodontics, DJ Dental College, Modinagar, Uttar Pradesh, India
| | - H S Indra Kumar
- Department of Prosthodontics, Tatyasaheb Kore Dental College and Research Centre, Kohlapur, Maharashtra, India
| | - Chetan D Sugandhi
- Department of Periodontics, Tatyasaheb Kore Dental College and Research Centre, Kohlapur, Maharashtra, India
| | - Silvie Singh
- Department of Oral Pathology, Tatyasaheb Kore Dental College and Research Centre, Kohlapur, Maharashtra, India
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31
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Abstract
Adenomatoid Odontogenic Tumor (AOT) is a well-established benign epithelial lesion of odontogenic origin. Rightfully called "the master of disguise," this lesion has been known for its varied clinical and histoarchitectural patterns. Not only does AOT predominantly present radiologically as a unilocular cystic lesion enclosing the unerupted tooth (which is commonly mistaken as a dentigerous cyst) but the lesion also presents rarely with a cystic component histopathologically. We present one such unusual case of cystic AOT associated with an impacted canine, mimicking a dentigerous cyst. The present case aims to highlight the difference between cystic AOT and dentigerous cyst radiographically. The exact histogenesis of AOT and its variants still remains obscure. An attempt has been made to hypothesize the new school of thought regarding the origin of AOT.
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32
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Rezvani G, Donoghue M, Reichart PA, Pazuhi N. Case Presentation of Concomitant and Contiguous Adenomatoid Odontogenic Tumor and Focal Cemento-Ossifying Dysplasia. Open Dent J 2015; 9:340-5. [PMID: 26464605 PMCID: PMC4598389 DOI: 10.2174/1874210601509010340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 03/19/2015] [Accepted: 05/25/2015] [Indexed: 12/02/2022] Open
Abstract
A 24 year-old male was presented for the diagnosis of an asymptomatic bony expansion in relation to the right maxillary canine and first premolar. The unilocular radiolucent lesion with central foci of calcification had caused divergence of canine and first premolar roots without any resorption. This case report details a diagnosis of two distinct disease processes of different cellular origin namely, focal cemento-ossifying dysplasia and adenomatoid odontogenic tumor in a previously unreported concomitant and contiguous relationship. The diagnosis was determined by a combination of clinical, radiographic, histopathological and surgical evidence. This case highlights two points, first the need to examine all mixed radiolucent-radiopaque lesions with advanced imaging techniques to assess the number and extent of the lesions prior to treatment planning. Second a likely role of periodontal ligament as the tissue source for odontogenic epithelial cells and mesenchymal stem cells required for the development of odontogenic tumors and cemento-osseous dysplasias.
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Affiliation(s)
- Gita Rezvani
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Shahed University, Tehran, Iran
| | | | - Peter A Reichart
- University Professor emeritus, Charité, Department of Oral Medicine, Dental Radiology and Oral Surgery (Prof A.M. Schmidt- Westhausen) CC3, Assmannshauser str. 4-6, 14197, Berlin, Germany
| | - Neda Pazuhi
- Department of Conservative Dentistry, Faculty of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Adenoid ameloblastoma: clinicopathologic description of five cases and systematic review of the current knowledge. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:368-77. [PMID: 26297394 DOI: 10.1016/j.oooo.2015.05.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 05/16/2015] [Accepted: 05/21/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe the clinicopathologic and immunohistochemical features of five cases of adenoid ameloblastoma. STUDY DESIGN Clinicopathologic data were gathered from medical records and compared with those compiled from a systematic review. Slides were also immunohistochemically stained for Ki-67, p16, p53, and cytokeratins (7, 8, 14, 18, and 19). RESULTS There were 3 males (60%) and 2 (40%) females. The mean age was 44 ± 10 years. Of the five adenoid ameloblastomas, 4 (80%) occurred in the posterior maxilla. Patients typically complained of asymptomatic swelling. All patients received surgical resection as primary therapy; 1 (20%) patient also received adjuvant radiotherapy. Recurrence was diagnosed in all patients. Immunohistochemically, the tumors stained focally positive for CK7, 8, 14, and 18 and diffusely positive for CK-19, p16, and p53. The mean Ki-67-positive cells were 72.4 ± 24.9 positive cells per high-power field (range 53-111). CONCLUSIONS To our knowledge, this is the largest series of adenoid ameloblastoma reported in the literature. Our data suggest that this entity demonstrates aggressive behavior characterized by a high likelihood of recurrence.
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Adenomatoid Odontogenic Tumor (AOT) Arising from a Dentigerous Cyst: Literature Review and Report of a Case. J Maxillofac Oral Surg 2015. [PMID: 26028864 DOI: 10.1007/s12663-012-0369-3.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022] Open
Abstract
Adenomatoid odontogenic tumor (AOT) is an uncommon benign tumor of odontogenic origin composed of odontogenic epithelium in a variety of histopathological patterns. These lesions are usually solid but are occasionally cystic. AOT has been reported to occur in association with odontogenic cysts. Very few cases have been described that arise in association with a dentigerous cyst. A systematic search of the English-language medical literature in PubMed and Medline search (keywords adenomatoid odontogenic tumor, dentigerous cyst) data bases revealed only ten such cases. The present case is very unique, exceptional and first of this kind that occurred in the posterior mandible associated with an impacted lower first premolar in a 19-year old female patient. The intraosseous follicular AOT, as this case reported here, frequently resemble dentigerous cysts. There is an uncertainty whether the lining of an associated cyst represents a true dentigerous cyst, cystic change within an AOT or may represent a distinct entity. We believe that this case represents an odontogenic cyst with neoplastic change. Hence, in such cases, the final diagnosis should be made on the basis of histological examination of extensive tissue sampling of entire excised tissue specimen. Further studies to determine whether the AOT derived from an odontogenic cyst could represent a distinct variant are to be done.
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35
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Jindwani K, Paharia YK, Kushwah APS. Surgical management of peripheral variant of adenomatoid odontogenic tumor: A rare case report with review. Contemp Clin Dent 2015; 6:128-30. [PMID: 25684929 PMCID: PMC4319333 DOI: 10.4103/0976-237x.149309] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The adenomatoid odontogenic tumour (AOT) is a relatively uncommon lesion constituting around 3% of all odontogenic tumours and often misdiagnosed as an odontogenic cyst. It manifests as a beningn growth which affects young individuals, with a female predeliction usually in the second decade of life, exhibiting more often in the anterior region of maxilla. The current article enumerates the clinical, radiographic and histopathological features of a rare case of extraosseous AOT with its therapeutic consideration
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Affiliation(s)
- Karuna Jindwani
- Department of Dentistry, G. R. Medical College, Gwalior, Madhya Pradesh, India
| | - Y K Paharia
- Department of Dentistry, G. R. Medical College, Gwalior, Madhya Pradesh, India
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36
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Adenomatoid odontogenic tumor of the mandible with a large calcified mass: Report of a rare case. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2015. [DOI: 10.1016/j.ajoms.2013.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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37
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Jiang M, You M, Wang H, Xu L. Characteristic features of the adenomatoid odontogenic tumour on cone beam CT. Dentomaxillofac Radiol 2014; 43:20140016. [PMID: 24940808 DOI: 10.1259/dmfr.20140016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To illustrate characteristic features of adenomatoid odontogenic tumour (AOT) on CBCT. METHODS The archived CBCT and panoramic radiographs of eight patients histopathologically diagnosed as AOT were analysed. The radiographic features displayed on both radiographic images were carefully described and compared. RESULTS All eight AOT cases presented as unilocular and well-demarcated lesions on both CBCT and panoramic images. CBCT images displayed three-dimensional interpretation of AOT lesions, especially the detailed intralesional radiopacities. Numerous discrete radiopaque foci scattered in the lesion with evident contrast to the radiolucent background could be considered as one of the characteristic features of AOT on CBCT. CONCLUSIONS Compared with panoramic radiography, CBCT seems to possess better potential in diagnosing AOT.
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Affiliation(s)
- M Jiang
- 1 State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Hybrid Odontogenic Lesion of the Mandible: A Rare Case Report with Literature Review. ACTA ACUST UNITED AC 2014. [DOI: 10.5466/ijoms.12.245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ide F, Muramatsu T, Ito Y, Kikuchi K, Miyazaki Y, Saito I, Kusama K. An expanded and revised early history of the adenomatoid odontogenic tumor. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:646-51. [PMID: 23601219 DOI: 10.1016/j.oooo.2013.01.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 01/18/2013] [Accepted: 01/23/2013] [Indexed: 10/26/2022]
Abstract
Adenomatoid odontogenic tumor (AOT) is not a new entity and has long been a subject of fascination after a century of recorded observation because of its unique biological profile. Hundreds of publications have covered a variety of aspects, ranging from demographic data to clinicopathologic features to treatment modalities. It is widely acknowledged that the first detailed reports of AOT were initially published in 1915 by Harbitz in Norway and later in 1916 by Wohl in the United States. However, it is very likely that earlier textbook and journal descriptions of AOT exist. This prompted us to review the extensive world literature on AOT dating back to the early part of the 19th century. Here we present a revised historical perspective of AOT, with a view to closing gaps in earlier knowledge about this entity and also encouraging further research.
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Affiliation(s)
- Fumio Ide
- Department of Diagnostic Pathology, Tsurumi University School of Dental Medicine, Yokohama, Japan.
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Kurra S, Gunupati S, Prasad PR, Raju Y S, Reddy BVR. An Adenomatoid Odontogenic Cyst (AOC) with an Assorted Histoarchitecture: A Unique Entity. J Clin Diagn Res 2013; 7:1232-5. [PMID: 23905148 DOI: 10.7860/jcdr/2013/5771.3089] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 03/03/2013] [Indexed: 11/24/2022]
Abstract
AOC - a relatively uncommon lesion of odontogenic origin, that is non-invasive, slow growing and composed of odontogenic epithelium, shows varied clinical and histoarchitectural patterns. It has been regarded as a benign odontogenic tumour for more than a century, sharing its clinical and radiographic features with that of dentigerous cysts. Few cases which have shown the association of this lesion with dentigerous cysts have also been reported. Some authors have reported a distinct hybrid variety of this lesion which was derived from dentigerous cysts. An attempt has been made in this article, in describing this lesion as a "hamartomatous odontogenic cyst" rather than a tumour. Although this lesion has been known to the oral pathologists for a long time, its histogenesis still remains obscure. The present case highlights a new school of thought regarding the origin of this lesion.
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Affiliation(s)
- Saritha Kurra
- Senior Lecturer, Department of Oral & Maxillofacial Pathology, Sri Sai College of Dental Surgery , Kothrepally, Vikarabad-501101, Andhra Pradesh, India
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Abstract
The calcifying odontogenic cyst (COC) was first delineated in 1962. It is a rare developmental odontogenic cyst with notable presence of histopathological features which include a cystic lining demonstrating characteristic “Ghost” epithelial cells with a propensity to calcify. In addition, the COC may be associated with other recognized odontogenic tumors. This gives rise to a spectrum of variants of COC according to clinical, histopathological, and radiological characteristics. Very few reports have actually captured the actual transformation while most reported cases are documents of co-existing lesions. This article presents one such entity, where the asymptomatic presentation misled the diagnosis and on histopathological examination revealed the COC with areas suggestive of adenomatoid odontogenic tumor.
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Affiliation(s)
- S M Balaji
- Balaji Dental and Craniofacial Hospital, Teynampet, Chennai, India
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The interrelationship of adenomatoid odontogenic tumour and dentigerous cyst: a report of a rare case and review of the literature. Case Rep Pathol 2013; 2012:358609. [PMID: 23304598 PMCID: PMC3530763 DOI: 10.1155/2012/358609] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 11/20/2012] [Indexed: 11/28/2022] Open
Abstract
The adenomatoid odontogenic tumor (AOT) is a relatively uncommon lesion which mainly affects females in their second decade of life, exhibiting predilection for the anterior region of the maxilla. The lesion is usually associated with the crown of an enclosed tooth, most commonly the maxillary canine. In this paper we present a case of adenomatoid odontogenic tumor associated with a dentigerous cyst affecting the left maxilla in a 15-year-old female. We also discuss clinical, radiographic, histopathologic, and therapeutic features of the case.
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Carlson ER, Ghali GE, Herb-Brower KE. Diagnosis and management of pathological conditions. J Oral Maxillofac Surg 2012; 70:e232-71. [PMID: 23128003 DOI: 10.1016/j.joms.2012.07.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Vasudevan K, Kumar S, Vijayasamundeeswari, Vigneswari S. Adenomatoid odontogenic tumor, an uncommon tumor. Contemp Clin Dent 2012; 3:245-7. [PMID: 22919236 PMCID: PMC3425119 DOI: 10.4103/0976-237x.96837] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Here we report a case of adenomatoid odontogenic tumor (AOT) in the maxilla in a young girl aged 14 years and its surgical management. We also review the literature and variations in the nomenclature and classifications of this interesting tumor. The review of literature gives an interesting picture regarding terminologies in the past and dilemma in classifying this tumor. The introduction of the name adenomatoid odontogenic tumour has resulted in the simpler and fruitful surgical management like enucleation and curettage with no reports of recurrences. In the past, similar lesion with the terminology like adeno ameloblastoma has resulted in unnecessary mutilating surgery. The conflicting views whether the lesion is being neoplasm or an anomalous hamartomatous growth is also being discussed.
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Affiliation(s)
- K Vasudevan
- Department of Oral and Maxillofacial Surgery Thai Moogambigai Dental College and Hospital, Golden George Nagar, Mugapair, Chennai 600 107, India
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Adenomatoid odontogenic tumor: retrospective study of 15 cases with emphasis on histopathologic features. Head Neck Pathol 2012; 6:430-7. [PMID: 22869356 PMCID: PMC3500904 DOI: 10.1007/s12105-012-0388-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Accepted: 07/21/2012] [Indexed: 10/28/2022]
Abstract
Adenomatoid odontogenic tumor (AOT) is an uncommon benign epithelial lesion of odontogenic origin and, thus far, only few studies regarding the frequency of its many histopathologic features have been published in the literature. Thus, the aim of this study was to perform a retrospective analysis in a case series of AOT, with emphasis on the histopathological features. Fifteen cases of AOT were studied considering their clinical, radiographic and histopathologic aspects. Twelve cases affected females and the mean age was 16.2 years. The anterior maxilla was the most common site (66.6 %) and radiographically most cases showed a unilocular radiolucency with well-defined borders (57.1 %). Histologically, most cases exhibited predominantly a solid growth pattern (46.7 %) or a similar proportion of solid and cribriform patterns (46.7 %). Eosinophilic amorphous material ("tumor droplets") was found in all cases (100 %). Most tumors showed duct-like spaces (93.3 %) and convoluted structures (60.0 %) whereas a minor proportion of cases presented calcifying epithelial odontogenic tumor (CEOT)-like areas (26.7 %). Variable amounts of calcified material were found in most AOTs (80.0 %) whereas osteodentin and perivascular hyalinization were seen only rarely (6.7 % each one). Five (33.3 %) cases had areas mimicking a dentigerous cyst and most of these were diagnosed in females (80.0 %). Regarding the histopathologic features, our results suggest that AOTs usually show predominance of solid pattern or a similar proportion of solid and cribriform patterns while osteodentin and perivascular hyalinization are rarely seen in these tumors. In addition, areas mimicking a dentigerous cyst and CEOT-like areas are relatively infrequent findings in AOTs.
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A huge adenomatoid odontogenic tumor of maxilla. Case Rep Med 2012; 2012:317341. [PMID: 22481948 PMCID: PMC3312265 DOI: 10.1155/2012/317341] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2011] [Revised: 10/12/2011] [Accepted: 12/12/2011] [Indexed: 11/17/2022] Open
Abstract
The adenomatoid odontogenic tumor (AOT) is a benign, nonneoplastic (hamartomatous) lesion with a slow progressing growth. It occurs in both intraosseous and peripheral forms. This paper reports the case of a female aged 16 years who presented with a swelling in anterior maxilla; canine was missing, and a supernumerary tooth was present in the mid line. Radiology revealed a well-defined radiolucent area associated with impacted canine and root resorption of adjacent teeth, which was diagnosed histopathologically as AOT. The patient was treated surgically and later rehabilitated with fixed prosthesis.
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Manjunatha BS, Mahajan A, Mody BM, Shah V. Adenomatoid Odontogenic Tumor (AOT) Arising from a Dentigerous Cyst: Literature Review and Report of a Case. J Maxillofac Oral Surg 2012; 14:393-7. [PMID: 26028864 DOI: 10.1007/s12663-012-0369-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 03/05/2012] [Indexed: 11/30/2022] Open
Abstract
Adenomatoid odontogenic tumor (AOT) is an uncommon benign tumor of odontogenic origin composed of odontogenic epithelium in a variety of histopathological patterns. These lesions are usually solid but are occasionally cystic. AOT has been reported to occur in association with odontogenic cysts. Very few cases have been described that arise in association with a dentigerous cyst. A systematic search of the English-language medical literature in PubMed and Medline search (keywords adenomatoid odontogenic tumor, dentigerous cyst) data bases revealed only ten such cases. The present case is very unique, exceptional and first of this kind that occurred in the posterior mandible associated with an impacted lower first premolar in a 19-year old female patient. The intraosseous follicular AOT, as this case reported here, frequently resemble dentigerous cysts. There is an uncertainty whether the lining of an associated cyst represents a true dentigerous cyst, cystic change within an AOT or may represent a distinct entity. We believe that this case represents an odontogenic cyst with neoplastic change. Hence, in such cases, the final diagnosis should be made on the basis of histological examination of extensive tissue sampling of entire excised tissue specimen. Further studies to determine whether the AOT derived from an odontogenic cyst could represent a distinct variant are to be done.
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Affiliation(s)
- B S Manjunatha
- Department of Oral Pathology and Microbiology, KM Shah Dental College and Hospital, Sumandeep Vidyapeeth, Piparia, Vadodara, 391760 India
| | - Amit Mahajan
- Department of Oral and Maxillofacial Surgery, KM Shah Dental College and Hospital, Sumandeep Vidyapeeth, Piparia, Vadodara, 391760 India
| | - Bharat M Mody
- Department of Oral Medicine, Radiology and Diagnosis, KM Shah Dental College and Hospital, Sumandeep Vidyapeeth, Piparia, Vadodara, 391760 India
| | - Vandana Shah
- Department of Oral Pathology and Microbiology, KM Shah Dental College and Hospital, Sumandeep Vidyapeeth, Piparia, Vadodara, 391760 India
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Sharma N, Passi S, Kumar VV. Adenomatoid odontogenic tumor: As an unusual mandibular manifestation. Contemp Clin Dent 2012; 3:S29-32. [PMID: 22629062 PMCID: PMC3354808 DOI: 10.4103/0976-237x.95100] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Adenomatoid odontogenic tumor (AOT) is a rare odontogenic tumor which is often misdiagnosed as odontogenic cyst and accounts for about 1% until 9% of all odontogenic tumors. It is predominantly found in young and female patients, located more often in the maxilla in most cases associated with an unerupted permanent tooth. It is a benign (hamartomatous), noninvasive lesion with slow but progressive growth. There are three variants of AOT: follicular, extrafollicular, and peripheral. We report a rare case of follicular-type AOT in the mandible of a 14-year-old male patient who presented with right -sided jaw swelling.
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Affiliation(s)
- Neeraj Sharma
- Department of Oral Medicine and Radiology, Dr. HSJ Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Sidhi Passi
- Department of Pediatric and Preventive Dentistry, Dr. HSJ Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Vinay V. Kumar
- Department of Oral Medicine and Radiology, Swami Devi Dyal Hospital And Dental College, Barwala, Haryana, India
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Woo SB. Odontogenic Tumors. ORAL PATHOLOGY 2012:340-381. [DOI: 10.1016/b978-1-4377-2226-0.00015-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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50
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Bowers L, Cohen D, Fetner A, Bhattacharyya I. The peripheral adenomatoid odontogenic tumour: a case report. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1752-248x.2011.01146.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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