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Indu S, Sood A, Mishra D. Hybrid odontogenic tumor masquerading as a salivary gland lesion: A diagnostic predicament. J Oral Maxillofac Pathol 2021; 25:S32-S36. [PMID: 34083967 PMCID: PMC8123243 DOI: 10.4103/jomfp.jomfp_51_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: 02/05/2020] [Revised: 01/20/2021] [Accepted: 01/29/2021] [Indexed: 11/29/2022] Open
Abstract
Hybrid odontogenic tumors are sporadic, where the distinctive areas of more than one odontogenic tumor tissue type have been reported. The occurrence of adenomatoid odontogenic tumor (AOT) with calcifying epithelial odontogenic tumor (CEOT) like areas histologically simulating salivary gland pathology is an unusual finding that has not been previously reported in the literature. We report the case of a 32-year-old female presenting with slow-growing firm swelling, radiographically as a pear-shaped radiolucent lesion in the interdental region of maxillary incisors. Histologically, the tissue showed nests and anastomosing strands of the bland cuboidal to squamoid epithelial cells showing nuclear pleomorphism, hyperchromatism, and abundant cytoplasm with prominent intercellular bridges focally. Multiple basophilic calcifications, amyloid-like material, duct-like formation, and mucinous spillage are seen. Tumor cells showed immunopositivity for CK 7, CK 19, CK 8/18 and low Ki67, p63, and immunonegativity for S100 suggesting of a hybrid lesion of CEOT with AOT.
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Affiliation(s)
- Sudip Indu
- Army Dental Centre (R and R), New Delhi, India
| | - Anubhuti Sood
- Department of Oral Pathology and Microbiology, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Deepika Mishra
- Department of Oral Pathology and Microbiology, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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Zhang A, Chaw SY, Talacko AA, Besly WJ, Savage NW, Monsour PA. Central calcifying epithelial odontogenic tumour in the posterior maxilla: a case report. Aust Dent J 2016; 61:381-5. [DOI: 10.1111/adj.12384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2015] [Indexed: 11/26/2022]
Affiliation(s)
- A Zhang
- School of Dentistry; The University of Queensland; Herston Queensland Australia
| | - SY Chaw
- School of Dentistry; The University of Queensland; Herston Queensland Australia
| | - AA Talacko
- Specialist Private Practice; Melbourne Victoria Australia
| | - WJ Besly
- Oral and Maxillofacial Surgery Unit; Monash Health; Melbourne Victoria Australia
| | - NW Savage
- School of Dentistry; The University of Queensland; Herston Queensland Australia
| | - PA Monsour
- School of Dentistry; The University of Queensland; Herston Queensland Australia
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Lakshmi CR, Bhavana SM, Nallamilli SM, Prabhat MPV, Sarat G, Anuradha C. Hybrid Ameloblastoma of the Maxilla: A Puzzling Pathology. IRANIAN JOURNAL OF MEDICAL SCIENCES 2016; 41:340-4. [PMID: 27365557 PMCID: PMC4912654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Ameloblastomas are slow growing, locally invasive, benign odontogenic tumors of an epithelial origin, accounting for approximately 1% of all oral tumors. A 40-year-old man presented with a chief complaint of a swelling over the left side of his face of 4 years' duration. On examination, gross facial asymmetry was detected, and a well-defined swelling was noted intraorally involving the left maxilla medially from the mid palatal raphe and obliterating the buccal vestibule laterally. The swelling was non-tender and exhibited dual consistencies: firm in the palate and cystic in the vestibular region. Computed tomography revealed a multilocular radiolucency, which involved the left maxilla, encroached into the left maxillary sinus and the nasal complex, and caused bony erosion. Early diagnosis and treatment are the key tools in managing ameloblastomas, failure of which may lead to a significant deterioration of the prognosis and an increased recurrence rate. Uncommon variants of ameloblastomas have been gaining interest recently. To date, 25 cases of hybrid ameloblastomas have been documented in the scientific literature. We present an extremely rare hybrid type of the ameloblastoma with combined follicular, cystic, acanthomatous, and desmoplastic variants, which render it the first of its kind to have ever been reported.
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Affiliation(s)
- Chintamaneni Raja Lakshmi
- Department of Oral Medicine and Radiology, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannavaram Mandal, Krishna District, Andhra Pradesh, India,Correspondence: Chintamaneni Raja Lakshmi, MDS; Department of Oral Medicine and Radiology, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannavaram Mandal, Krishna District-521286, Andhra Pradesh, India Tel: +91 9490658002, +91 866 2471504
| | - Sujana Mulk Bhavana
- Department of Oral Medicine and Radiology, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannavaram Mandal, Krishna District, Andhra Pradesh, India
| | - Sai Madhavi Nallamilli
- Department of Oral Medicine and Radiology, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannavaram Mandal, Krishna District, Andhra Pradesh, India
| | - Meka Poorna Venkata Prabhat
- Department of Oral Medicine and Radiology, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannavaram Mandal, Krishna District, Andhra Pradesh, India
| | - Gummadapu Sarat
- Department of Oral Medicine and Radiology, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannavaram Mandal, Krishna District, Andhra Pradesh, India
| | - Chennupati Anuradha
- Department of Oral Medicine and Radiology, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannavaram Mandal, Krishna District, Andhra Pradesh, India
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Wadhwan V, Sharma P, Bansal V. A rare case of hybrid odontogenic tumor: Calcifying epithelial odontogenic tumor combined with ameloblastoma. J Oral Maxillofac Pathol 2015; 19:268. [PMID: 26604514 PMCID: PMC4611946 DOI: 10.4103/0973-029x.164560] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 07/27/2015] [Indexed: 11/04/2022] Open
Abstract
A hybrid odontogenic tumor comprising two distinct lesions is extremely rare. Nevertheless, such tumors have been reported in the literature for academic and research interest. However, it is still obscure whether they behave as a new entity or they solely present separate histopathologic patterns. Here, we present a true hybrid neoplasm of combined ameloblastoma and calcifying epithelial odontogenic tumor showing intermixed histopathologic patterns of both the tumors.
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Affiliation(s)
- Vijay Wadhwan
- Department of Oral Pathology and Microbiology, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Preeti Sharma
- Department of Oral Pathology and Microbiology, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Vishal Bansal
- Department of Oral and Maxillofacial Surgery, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
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Report of Two Cases of Combined Odontogenic Tumors: Ameloblastoma with Odontogenic Keratocyst and Ameloblastic Fibroma with Calcifying Odontogenic Cyst. Head Neck Pathol 2015; 9:417-20. [PMID: 25552434 PMCID: PMC4542788 DOI: 10.1007/s12105-014-0601-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 12/21/2014] [Indexed: 10/24/2022]
Abstract
Combined odontogenic neoplasms have rarely been documented. Such tumors have also been described by other researchers as "hybrid" lesions. The histologic features are often identical to other individually well-established odontogenic neoplasms such as ameloblastoma, adenomatoid odontogenic tumor, ameloblastic fibroma (AF), and ameloblastic fibro-odontoma. Their clinical presentation is variable, ranging from cysts to neoplasms showing varying degrees of aggressive behavior. Most combined tumors contain features of one of the odontogenic tumors in combination with either a calcifying odontogenic cyst (COC) or a calcifying epithelial odontogenic tumor. We present two new cases of combined odontogenic tumors: an ameloblastoma with an odontogenic keratocyst and an AF with COC. Predicting clinical outcome is challenging when a combination tumor is encountered due to the paucity of such lesions. One must understand salient features of these entities and differentiate them from the more common conventional neoplasms to expand classification and provide prognostic criteria.
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Choudhari SK, Gadbail AR. Hybrid odontogenic tumors: a controversy. Pathol Oncol Res 2014; 21:501-2. [PMID: 25319138 DOI: 10.1007/s12253-014-9844-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 09/18/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Sheetal Korde Choudhari
- Department of Oral Pathology & Microbiology, Yerala Dental College and Hospital, B-15, Mandovi, Chheda Nagar, Chembur(W), Mumbai, 4400089, Maharashtra, India,
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Yamazaki M, Maruyama S, Abé T, Babkair H, Fujita H, Takagi R, Koyama JI, Hayashi T, Cheng J, Saku T. Hybrid ameloblastoma and adenomatoid odontogenic tumor: report of a case and review of hybrid variations in the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:e12-8. [DOI: 10.1016/j.oooo.2013.08.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 08/23/2013] [Accepted: 08/29/2013] [Indexed: 10/26/2022]
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Chen Y, Wang TT, Gao Y, Li TJ. A clinicopathologic study on calcifying epithelial odontogenic tumor: with special reference to Langerhans cell variant. Diagn Pathol 2014; 9:37. [PMID: 24555881 PMCID: PMC3932507 DOI: 10.1186/1746-1596-9-37] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 01/05/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Calcifying epithelial odontogenic tumour (CEOT) is a rare benign odontogenic tumour, and its Langerhans cell variant is even rarer. Due to the limited number of recorded cases, the biological behaviour and histogenesis of the Langerhans cell variant of CEOT are not yet fully understood. Thus, the correlation between conventional CEOT and the Langerhans cell variant remains to be clarified. MATERIAL (CASES) Eight cases of CEOT including 2 cases of Langerhans cell variant were clinicopathologically studied and the English language literature was reviewed. Langerhans cells were detected in 2 cases of conventional CEOT and in 2 cases of Langerhans cell variant by immunohistochemistry. RESULTS AND FINDINGS In the 6 cases of conventional CEOT, 5 tumours involved the premolar and molar region and the anterior portion of the mandible was affected in 1 case. Four patients were followed for 2-7 years and did not show any sign of recurrence. A review of the English language literature revealed 5 cases; combined with the present 2 new cases, a total of 7 cases of Langerhans cell variant of CEOT were collected. The patients were all Asian. Six tumours occurred in the maxilla and 1 in mandible; all mainly involved the anterior region of the jaws. Five patients were followed for 2-10 years and did not show any evidence of recurrence. Langerhans cells can be seen in both the conventional and the Langerhans cell variant of CEOT; however, increased numbers of Langerhans cells are seen in the latter. CONCLUSIONS Although the Langerhans cell variant of CEOT is a rare entity and behaves similarly to the conventional type, it could show unique clinical and histologic features that may pose problems for differential diagnosis. VIRTUAL SLIDES http://www.diagnosticpathology.diagnomx.eu/vs/1979090740113894.
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Affiliation(s)
- Yan Chen
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Ting-Ting Wang
- Department of Oral Medicine, Hebei United University, School and Hospital of Stomatology, Tangshan, Hebei, China
| | - Yan Gao
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Tie-Jun Li
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, China
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
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Kestler DP, Foster JS, Macy SD, Murphy CL, Weiss DT, Solomon A. Expression of odontogenic ameloblast-associated protein (ODAM) in dental and other epithelial neoplasms. Mol Med 2008; 14:318-26. [PMID: 18472969 DOI: 10.2119/2008-00010.kestler] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Accepted: 03/17/2008] [Indexed: 01/09/2023] Open
Abstract
We previously have communicated our discovery that the amyloid associated with calcifying epithelial odontogenic tumors is composed of N-terminal fragments of the structurally novel odontogenic ameloblast-associated protein designated ODAM. Subsequently, it was shown by other investigators that ODAM is expressed in rodent enamel organ and is likely involved in dental development. We now report that this molecule also is found in certain human tissues, principally the salivary gland and trachea, as evidenced by RNA array analysis and immunohistochemistry-utilizing antibodies prepared against synthetic ODAM-related peptides and recombinant protein. Notably, these reagents immunostained normal and malignant ameloblasts and other types of human neoplastic cells, including those of gastric, lung, and breast origin where the presence in the latter was confirmed by in situ hybridization using gene-specific molecular probes. Moreover, significant titers of anti-ODAM IgG antibodies were detected in the sera of patients with these malignancies. Our studies have provided the first evidence in humans for the cellular expression of ODAM in normal and diseased states. Based on our findings, we posit that ODAM is a developmental antigen that has an essential role in tooth maturation and in the pathogenesis of certain odontogenic and other epithelial neoplasms; further, we suggest that ODAM may serve as a novel prognostic biomarker, as well as a potential diagnostic and therapeutic target for patients with breast and other epithelial forms of cancer.
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Affiliation(s)
- Daniel P Kestler
- Human Immunology and Cancer Program, Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee 37920, United States of America
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Murphy CL, Kestler DP, Foster JS, Wang S, Macy SD, Kennel SJ, Carlson ER, Hudson J, Weiss DT, Solomon A. Odontogenic ameloblast-associated protein nature of the amyloid found in calcifying epithelial odontogenic tumors and unerupted tooth follicles. Amyloid 2008; 15:89-95. [PMID: 18484335 DOI: 10.1080/13506120802005965] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We have previously reported that the amyloid found in three patients with calcifying epithelial odontogenic tumors (CEOT) was composed of N-terminal fragments of a putative 153-residue protein specified by a gene designated FLJ20513 now known to represent exons 5 through 10 of the odontogenic ameloblast-associated protein (ODAM) locus that encodes a 279-residue polypeptide. Confirmation of the amyloidogenic potential of ODAM has resulted from analyses of four other cases where we found, in addition, a 74-residue segment specified by exon 4. Through preparation of ODAM-related synthetic peptides, it was possible to localize the fibril-forming region of this molecule, as well as generate a monoclonal antibody that reacted specifically with the amyloid associated with CEOT. Notably, we also detected green birefringent congophilic material in unerupted tooth follicles - a precursor of CEOT - and demonstrated through immunologic and chemical analyses the ODAM nature of the deposits. Our studies have provided further evidence for this unique form of odontogenic amyloid that we provisionally designate "AODAM".
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Affiliation(s)
- Charles L Murphy
- Human Immunology and Cancer Program, Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee 37920, USA
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Poomsawat S, Punyasingh J. Calcifying epithelial odontogenic tumor: an immunohistochemical case study. J Mol Histol 2007; 38:103-9. [PMID: 17318341 DOI: 10.1007/s10735-007-9082-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2006] [Accepted: 02/02/2007] [Indexed: 10/23/2022]
Abstract
Calcifying epithelial odontogenic tumor (CEOT) is a rare benign odontogenic tumor. A case of CEOT in a 25-year-old female is presented here. Histologically, the case showed sheets of polyhedral epithelial cells with deep eosinophilic cytoplasm and prominent nuclei. Nuclear pleomorphism and hyperchromatism were evident. Globules of amyloid-like material among the tumor cells were prominent. Also found was a small area demonstrating a cribriform pattern. Immunohistochemical studies with antibodies against basement membrane proteins (laminins 1 and 5, collagen type IV and fibronectin), pan-cytokeratins AE1/AE3, vimentin, S-100 protein and CD 1a were performed. Tumor cells expressed laminins 1 and 5, fibronectin, cytokeratins and vimentin. The amyloid-like material was not reactive to all antibodies examined. A number of dendritic cells among sheets of tumor cells were revealed with strong staining for S-100 protein and CD 1a. These dendritic cells are likely to be Langerhans cells. Hence, immunohistochemistry is a useful method to study the variant of CEOT.
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Affiliation(s)
- Sopee Poomsawat
- Department of Oral Pathology, Faculty of Dentistry, Mahidol University, Yothi Street, Bangkok 10400, Thailand.
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