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Starr BW, Lax EA, Leto Barone AA, Ulma RM, Pan BS, Elhadi Babiker HM. Pindborg tumor in early childhood: a rare tumor in the youngest patient reported to date. CASE REPORTS IN PLASTIC SURGERY AND HAND SURGERY 2022; 9:61-65. [PMID: 35141358 PMCID: PMC8820786 DOI: 10.1080/23320885.2022.2031201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Brian W. Starr
- Division of Plastic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Elizabeth A. Lax
- Division of Plastic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Angelo A. Leto Barone
- Division of Plastic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Raquel M. Ulma
- Division of Plastic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Brian S. Pan
- Division of Plastic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Li YY, Xu ZM, Zhang SC, Tao BQ, Xiang DW, Liu WW. Mandibular Reconstruction Using Free Fibular Flap Graft Following Excision of Calcifying Epithelial Odontogenic Tumor. J Craniofac Surg 2021; 32:e167-e171. [PMID: 33705062 DOI: 10.1097/scs.0000000000006955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT The calcifying epithelial odontogenic tumor (CEOT) is a rare benign odontogenic tumor, which usually presents with distension of affected tissues. Radiologically, the lesions are often associated with an unerupted tooth and may have spot calcification shadows. The authors report a case of a CEOT in a 48-year-old male involving the right mandibular jaw bone and mentum soft tissues. The authors performed hemimandibulectomy and enucleation followed by reconstruction of the mandible using a vascularized free fibular flap through a digital surgical technique in order to restore the patient's facial symmetry and prepare the area for functional restorations. The case illustrates who the free fibular flap graft can be used for satisfactory mandibular reconstruction and restoration of the morphology and functions.
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Affiliation(s)
- Yu-Yang Li
- Department of Dental Implantology.,Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun, China
| | - Zhi-Min Xu
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University
| | - Shi-Chen Zhang
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University.,Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun, China
| | - Bo-Qiang Tao
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University.,Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun, China
| | - Dan-Wei Xiang
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University.,Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun, China
| | - Wei-Wei Liu
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Jilin University
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Malignant transformation of calcifying epithelial odontogenic tumour with solitary pulmonary metastasis. Int J Oral Maxillofac Surg 2021; 50:1540-1545. [PMID: 33744097 DOI: 10.1016/j.ijom.2021.02.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 01/09/2021] [Accepted: 02/26/2021] [Indexed: 11/20/2022]
Abstract
This report describes the management of a case of calcifying epithelial odontogenic tumour (CEOT) that underwent malignant transformation and metastasized to the lung. The solitary pulmonary metastasis was discovered incidentally on computed tomography (CT) imaging of the neck. It appears that only one previous case with proven pulmonary metastasis has been reported in the literature, which involved multiple pulmonary deposits managed with platinum chemotherapy. The long-term prognosis of metastatic CEOT is therefore unknown. In the case presented here, the patient was managed successfully with surgery alone. There is often diagnostic uncertainty because histological features of benign, recurrent, and malignant CEOT are not dissimilar. Ki-67 immunohistochemistry is helpful, as higher levels are more indicative of malignancy. We consider that in cases of suspected recurrent and malignant CEOT, CT imaging of the thorax and abdomen as part of follow-up may identify metastases early, resulting in earlier treatment, an improved prognosis, and reduced morbidity and mortality.
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Breik O, Higginson J, Al-Ajami AK, Mohamed A, Martin T, Amel-Kashipaz R. Clear Cell Odontogenic Carcinoma: First Report of Novel EWSR1-CREM Fusion Gene in Case of Long-Term Misdiagnosis. Head Neck Pathol 2021; 15:1391-1398. [PMID: 33616852 PMCID: PMC8633255 DOI: 10.1007/s12105-021-01302-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 02/05/2021] [Indexed: 01/11/2023]
Abstract
Clear Cell odontogenic Carcinomas (CCOC) are rare, aggressive malignant odontogenic tumours which are often misdiagnosed as benign odontogenic tumours due to the non-specific histologic appearance, and benign early clinical presentation. However, due to their propensity to metastasize, the best outcomes are experienced with they are diagnosed early and treated aggressively. In this paper, we present a case of a CCOC misdiagnosed as a clear cell calcifying epithelial odontogenic tumour which was only found to be a CCOC after cervical node metastasis. The original diagnosis was questioned and confirmed to be a CCOC by identification of the chromosomal translocation EWSR1 on fluorescence in situ hybridization. This has recently been described in CCOC and a wide variety of other mesenchymal and epithelial neoplasms. Previous reports have demonstrated EWSR1-ATF1 and EWSR1-CREB1 fusions in CCOC. Next generation sequencing of this case demonstrated the EWSR1-CREM fusion gene which has not been previously reported for CCOC. CREM fusion proteins have only recently been found in several tumour types including the closely associated hyalinizing clear cell carcinoma of salivary glands. This is discussed in this paper, and the role of the discovery of the CREM fusion protein in CCOC adds to your understating of the role of CREM in oncogenesis, and the possible link between CCOCs and hyalinizing clear cell carcinomas.
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Affiliation(s)
- Omar Breik
- Head and Neck Surgeon, Oral and Maxillofacial Surgery Unit, Queen Elizabeth Hospital, Birmingham, UK
| | - James Higginson
- Oral and Maxillofacial Surgery Unit, Queen Elizabeth Hospital, Birmingham, UK
| | - Abdulla K. Al-Ajami
- Oral and Maxillofacial Surgery Unit, Queen Elizabeth Hospital, Birmingham, UK
| | - Abubakar Mohamed
- Biomedical Science, Molecular Pathology, Queen Elizabeth Hospital, Birmingham, UK
| | - Tim Martin
- Head and Neck Surgeon, Oral and Maxillofacial Surgery Unit, Queen Elizabeth Hospital, Birmingham, UK
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Urzúa B, Ahumada-Ossandón R, Casa-Weisser D, Franco-Martínez ME, Ortega-Pinto A. Amelogenin in calcified matrices of odontogenic cysts and odontogenic tumors: An immunohistochemical study. J Dent Sci 2020; 16:7-14. [PMID: 33384773 PMCID: PMC7770315 DOI: 10.1016/j.jds.2020.05.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/29/2020] [Indexed: 11/06/2022] Open
Abstract
Background/purpose There are few studies comparing the expression of enamel proteins, such as amelogenin, and cytokeratins in cyst and odontogenic tumors like in ameloblastoma and odontogenic keratocyst, indicating that amelogenin could be a potential biomarker for the aggressiveness in the odontogenic tumors. The aim of this study was to evaluate if the expression of amelogenin, cytokeratin AE1/AE3 (CKAE1/AE3) and cytokeratin 14 (CK14) in cysts and odontogenic tumors with calcified matrices such as calcifying odontogenic cyst (COC), compound (CdO) and complex (CxO) odontomas, adenomatoid odontogenic tumor (AOT) and calcifying epithelial odontogenic tumor (CEOT) as an aggressiveness indicator. Materials and methods Three COC, eight CxO, three CdO, twelve AOT, two CEOT and three dental germs were submitted to an immunohistochemistry panel of antibodies composed of amelogenin, CKAE1/AE3 and CK14. Results CKAE1/AE3 and CK14 was present in all odontogenic epithelia. The amelogenin protein was detected in prismatic and amorphous calcified matrices of epithelial origin belonging to CxO, CdO, AOT, COC and the tooth germs used as controls. On the other hand, the CEOT was the only tumor or cyst studied that did not present immunostaining for amelogenin in calcified matrices. Conclusion Amelogenin was detected in pathologies with a low or absent recurrence rate and excellent prognosis. CEOT was the lesion of greater clinical aggressiveness which did not express amelogenin. The presence of amelogenin in calcified matrices of odontogenic arise could be an indicator of low aggressiveness.
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Affiliation(s)
- Blanca Urzúa
- Oral Biology and Biochemistry Laboratory, Faculty of Dentistry, University of Chile, Chile
| | | | - Daniel Casa-Weisser
- Departament of Pathology and Oral Medicine, Faculty of Dentistry, University of Chile, Chile
| | | | - Ana Ortega-Pinto
- Departament of Pathology and Oral Medicine, Faculty of Dentistry, University of Chile, Chile
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CEOT Variants or Entities: Time for a Rethink? A Case Series with Review of the Literature. Head Neck Pathol 2020; 15:186-201. [PMID: 32642935 PMCID: PMC8010033 DOI: 10.1007/s12105-020-01200-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/01/2020] [Indexed: 10/27/2022]
Abstract
The first detailed description of calcifying epithelial odontogenic tumor (CEOT) are ascribed to Jens Pindborg, but this tumor was described some years previously. Subsequently, CEOT was included in the 1971 WHO classification of odontogenic tumors and a since then number of variants have been described, which have added confusion to the diagnostic criteria. We aimed to survey the literature on the variants of CEOT, in parallel with a review of our single institution experience of CEOTs. Cases identified were collated, including available clinical, radiological and histological information and then reviewed, taking into account changes in the understanding and classifications of odontogenic tumors since initial diagnosis. We identified 26 cases from 1975 to 2017 for which histological material was available. Of these, only 13 (50%) showed the "classic" histological appearance, whilst two cases were identified as recognized variants. In 11 cases, other diagnoses or a differential diagnosis were preferred, with no agreed diagnosis in four of these. The proliferation fraction (Ki67) in the 10 cases tested was 2.1% ± 0.18. These findings illustrate the diagnostic challenges in this group of tumors and highlight the gaps in knowledge. Techniques, such as EWSR1 gene cytogenetic analysis, may be helpful in cases with clear cells. However, in other areas of controversy, including the non-calcifying and Langerhans cell rich variants, further investigation, perhaps utilizing sequencing technologies may be needed to refine the classification. Owing to the relative rarity of these lesions it would be beneficial if future work could be pursued as an international collaboration.
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de Arruda JAA, Arantes DAC, Schuch LF, Mosconi C, Abreu LG, de Andrade BAB, Romañach MJ, Mesquita RA, Silva TA, Batista AC, Mendonça EF. A Rare Case of an Aggressive Clear Cell Variant of Calcifying Epithelial Odontogenic Tumor in the Posterior Maxilla. Int J Surg Pathol 2020; 28:526-535. [PMID: 31986944 DOI: 10.1177/1066896920901755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
A clear cell variant of calcifying epithelial odontogenic tumor is a rare benign odontogenic neoplasm, accounting for 33 cases described in the literature. In this article, we report a challenging example of clear cell variant of calcifying epithelial odontogenic tumor of the posterior maxilla in a 45-year-old female patient showing locally aggressive growth and recurrence. Microscopically, islands of polyhedral cells containing abundant cytoplasm, well-developed intercellular bridges blended with clear cells were observed. The nuclei were frequently pleomorphic and permeated by hyaline calcified material. Immunohistochemistry revealed positivity for pan-cytokeratin (AE1/AE3), cytokeratins (CK-14 and CK-19), Bcl-2, p53, and p63. The Ki-67 proliferative index was ~10%. As odontogenic tumors are rare, when a significant clear cell component is observed, the differential diagnosis with other lesions of the jaws with similar morphology, including other odontogenic tumors with prominent clear cell component, clear cell odontogenic carcinomas, and metastatic tumors, is difficult.
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Affiliation(s)
| | | | | | - Carla Mosconi
- Universidade Federal de Goiás, Goiânia, Goiás, Brazil
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Ibituruna ACH, Costa ARGF, Paulo LFBD, Faria PRD, Cardoso SV, Loyola AM. Multiple calcifying epithelial odontogenic tumor: case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:268-272. [DOI: 10.1016/j.oooo.2019.03.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 03/06/2019] [Accepted: 03/19/2019] [Indexed: 12/18/2022]
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9
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Fazeli SR, Giglou KR, Soliman ML, Ezzat WH, Salama A, Zhao Q. Calcifying Epithelial Odontogenic (Pindborg) Tumor in a Child: A Case Report and Literature Review. Head Neck Pathol 2019; 13:580-586. [PMID: 30771214 PMCID: PMC6853849 DOI: 10.1007/s12105-019-01009-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 01/06/2019] [Indexed: 12/01/2022]
Abstract
Calcifying epithelial odontogenic tumor (CEOT) is a rare neoplasm, which accounts for < 1% of all odontogenic tumors. CEOT occurs more frequently in adults with a peak incidence in the 5th decade of life and is extremely rare in the pediatric population. We present a case of a 13-year-old girl who was found to have a mandibular CEOT. We summarize the radiological features, pathological findings, clinical management and literature review focusing on this entity in children.
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Affiliation(s)
- Shoreh R. Fazeli
- Department of Pathology, Boston University, Boston Medical Center, Boston, MA USA
| | - Kamyar R. Giglou
- Department of Oral and Maxillofacial Surgery, Boston University, School of Dental Medicine, Boston, MA USA
| | - Mahmoud L. Soliman
- Department of Pathology, Boston University, Boston Medical Center, Boston, MA USA
| | - Waleed H. Ezzat
- Department of Otolaryngology-Head and Neck, Boston University, Boston Medical Center, Boston, MA USA
| | - Andrew Salama
- Department of Oral and Maxillofacial Surgery, Boston University, School of Dental Medicine, Boston, MA USA
| | - Qing Zhao
- Department of Pathology, Boston University, Boston Medical Center, Boston, MA USA
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A clinicopathologic study on central odontogenic fibroma: with special reference to amyloid variant. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:513-520. [DOI: 10.1016/j.oooo.2018.08.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 08/25/2018] [Accepted: 08/26/2018] [Indexed: 11/18/2022]
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11
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Arruda JAA, Abreu LG, Silva LVDO, Schuch LF, Monteiro JLGC, Arantes DAC, da Costa AAS, Nóbrega KHS, Vasconcelos ACU, Andrade BAB, Romañach MJ, Sobral APV, Rivero ERC, Silva TA, Batista AC, Mesquita RA. Calcifying epithelial odontogenic tumours: Collaborative study of 32 cases and review of literature. Oral Dis 2018; 25:192-205. [DOI: 10.1111/odi.12958] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 08/10/2018] [Accepted: 08/13/2018] [Indexed: 01/08/2023]
Affiliation(s)
- José Alcides A. Arruda
- Department of Oral Surgery and Pathology, School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte MG Brazil
| | - Lucas G. Abreu
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte MG Brazil
| | - Leni Verônica de O. Silva
- Department of Oral Surgery and Pathology, School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte MG Brazil
| | - Lauren F. Schuch
- Department of Oral Surgery and Pathology, School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte MG Brazil
| | - João Luiz G. C. Monteiro
- Department of Oral and Maxillofacial Surgery and Pathology, School of Dentistry Universidade de Pernambuco Camaragibe PE Brazil
| | - Diego Antônio C. Arantes
- Department of Stomatology (Oral Pathology), School of Dentistry Universidade Federal de Goiás Goiânia GO Brazil
| | - Adriana Aparecida S. da Costa
- Department of Oral Surgery and Pathology, School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte MG Brazil
| | - Kaio Heide S. Nóbrega
- Diagnostic Centre for Oral Diseases, School of Dentistry Universidade Federal de Pelotas Pelotas RS Brazil
| | | | - Bruno Augusto B. Andrade
- Department of Oral Diagnosis and Pathology, School of Dentistry Universidade Federal do Rio de Janeiro Rio de Janeiro RJ Brazil
| | - Mario José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry Universidade Federal do Rio de Janeiro Rio de Janeiro RJ Brazil
| | - Ana Paula V. Sobral
- Department of Oral and Maxillofacial Surgery and Pathology, School of Dentistry Universidade de Pernambuco Camaragibe PE Brazil
| | - Elena R. C. Rivero
- Department of Pathology, Health Sciences Centre Universidade Federal de Santa Catarina Florianópolis SC Brazil
| | - Tarcília Aparecida Silva
- Department of Oral Surgery and Pathology, School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte MG Brazil
| | - Aline C. Batista
- Department of Stomatology (Oral Pathology), School of Dentistry Universidade Federal de Goiás Goiânia GO Brazil
| | - Ricardo A. Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte MG Brazil
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Munteanu C, Pirici D, Stepan AE, Camen A, Margaritescu C. Maxillary calcifying epithelial odontogenic tumor with sinus and buccal vestibule extension: a case report and immunohistochemical study. Diagn Pathol 2016; 11:134. [PMID: 27871286 PMCID: PMC5117498 DOI: 10.1186/s13000-016-0582-3] [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] [Received: 08/02/2016] [Accepted: 11/08/2016] [Indexed: 11/28/2022] Open
Abstract
Background Calcifying epithelial odontogenic tumor (CEOT) is a rare benign neoplasia, locally aggressive, that tends to invade bone and adjacent soft tissues. This case report describes the thirteenth known case of CEOT with maxillary sinus extension and the second one that also involves the buccal vestibule mucosa with peculiar histopathological and immunohistochemical data. Case presentation Here we report the case of a 45-year-old female with a CEOT diagnosed and treated at the Oral & Maxillofacial Surgery Department, County Clinical Emergency Hospital of Craiova, Romania. The clinical and imaging investigation revealed an intraosseous tumor developed from the left posterior maxilla with maxillary sinus and buccal vestibule mucosa extension. Histopathology found an epithelium-rich CEOT variant, but with scattered S100 positive clear cells, focal small rounded cementum-like deposits and areas with some degree of nuclear pleomorphism. The immunohistochemical investigations emphasised its local aggressiveness behavior with involvement of multiple molecular mechanisms that underlie tumor invasiveness. A subtotal maxillectomy was performed followed by defect reconstruction. Conclusions We discuss the relevant clinicopathological features of an aggressive rare case of CEOT with maxillary sinus extension and buccal vestibule mucosa involvement. The immunohistochemical study suggests its utility in attempting to assess the degree of local tumor aggressiveness and thus in adopting the most efficient therapeutic attitude.
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Affiliation(s)
- Cristina Munteanu
- Department of Oral & Maxillofacial Surgery, University of Medicine and Pharmacy Craiova, Petru Rares 2, Craiova, 200349, Romania
| | - Daniel Pirici
- Department of Research Methodology, University of Medicine and Pharmacy Craiova, Petru Rares 2, Craiova, 200349, Romania.
| | - Alex Emilian Stepan
- Department of Pathology, University of Medicine and Pharmacy Craiova, Petru Rares 2, Craiova, 200349, Romania
| | - Adrian Camen
- Department of Oral & Maxillofacial Surgery, University of Medicine and Pharmacy Craiova, Petru Rares 2, Craiova, 200349, Romania
| | - Claudiu Margaritescu
- Department of Pathology, University of Medicine and Pharmacy Craiova, Petru Rares 2, Craiova, 200349, Romania
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Dev DA, Pattamparambath M, Michael MJ, Akhilesh AV, Das B. Calcifying Epithelial Odontogenic Tumour of the Mandible: An Unusually Aggressive Presentation of an Indolent Tumour. J Clin Diagn Res 2016; 10:ZD03-ZD05. [PMID: 27790590 DOI: 10.7860/jcdr/2016/21310.8475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 07/15/2016] [Indexed: 11/24/2022]
Abstract
Calcifying Epithelial Odontogenic Tumour (CEOT) or Pindborg tumour is a rare odontogenic tumour of epithelial origin. They constitute less than 1% of odontogenic tumours. Intra-ossseous variant of CEOT are more common compared to extra-osseous variant. Although benign, these can exhibit deceptively aggressive presentation. Here we report a rare case of CEOT in a 36-year-old female patient who presented with aggressive intra-osseous lesion with cortical breach and exuberant soft tissue proliferation. The lesion was treated with resection and reconstructed with titanium reconstruction plate.
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Affiliation(s)
- Dp Arul Dev
- Junior Resident, Department of Oral and Maxillofacial Surgery, Government Dental College , Calicut, Kerala, India
| | - Manjusha Pattamparambath
- Senior Resident, Department of Oral Pathology and Microbiology, Government Dental College , Calicut, Kerala, India
| | - Manoj Joseph Michael
- Associate Professor, Department of Oral and Maxillofacial Surgery, Government Dental College , Calicut, Kerala, India
| | - A V Akhilesh
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Government Dental College , Calicut, Kerala, India
| | - Bindu Das
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Government Dental College , Calicut, Kerala, India
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Crivelini MM, Oliveira DT, de Mesquita RA, de Sousa SCOM, Loyola AM. Kallikrein 4 and matrix metalloproteinase-20 immunoexpression in malignant, benign and infiltrative odontogenic tumors. J Oral Maxillofac Pathol 2016; 20:246-51. [PMID: 27601817 PMCID: PMC4989555 DOI: 10.4103/0973-029x.185927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
CONTEXT Matrix metalloproteinase-20 (MMP20) (enamelysin) and kallikrein 4 (KLK4) are enzymes secreted by ameloblasts that play an important role in enamel matrix degradation during amelogenesis. However, studies have shown that neoplastic cells can produce such enzymes, which may affect the tumor infiltrative and metastatic behaviors. AIMS The aim of this study is to assess the biological role of MMP20 and KLK4 in odontogenic tumors. MATERIALS AND METHODS The enzymes were analyzed immunohistochemically in ameloblastoma, adenomatoid odontogenic tumor (AOT), calcifying epithelial odontogenic tumor, keratocystic odontogenic tumor with or without recurrence and odontogenic carcinoma. STATISTICAL ANALYSIS USED Clinicopathological parameters were statistically correlated with protein expression using the Fisher's exact test. Kruskal-Wallis and Wilcoxon-independent methods were used to evaluate the differences in median values. RESULTS Positive Immunoexpression was detected in all benign lesions, with a prevalence of 75-100% immunolabeled cells. Patients were predominantly young, Caucasian, female, with slow-growing tumors located in the mandible causing asymptomatic swelling. No KLK4 expression was seen in carcinomas, and the amount of MMP20-positive cells varied between 20% and 80%. Rapid evolution, recurrence and age >60 years characterized the malignant nature of these lesions. CONCLUSIONS Data showed that KLK4 and MMP20 enzymes may not be crucial to tumoral infiltrative capacity, especially in malignant tumors, considering the diversity and peculiarity of these lesions. The significant immunoexpression in benign lesions, remarkably in AOT, is likely associated with differentiated tumor cells that can produce and degrade enamel matrix-like substances. This would be expected since the histogenesis of odontogenic tumors commonly comes from epithelium that recently performed a secretory activity in tooth formation.
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Affiliation(s)
- Marcelo Macedo Crivelini
- Department of Pathology and Clinical Propedeutics, Araçatuba School of Dentistry, Universidade Estadual Paulista, Araçatuba, Brazil
| | - Denise Tostes Oliveira
- Department of Stomatology, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ricardo Alves de Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Adriano Motta Loyola
- Department of Pathology, Laboratory of Oral and Maxillofacial Pathology, School of Dentistry, Federal University of Uberlandia, Minas Gerais, Brazil
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15
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Lin HP, Kuo YS, Wu YC, Wang YP, Chang JYF, Chiang CP. Non-calcifying and Langerhans cell-rich variant of calcifying epithelial odontogenic tumor. J Dent Sci 2016; 11:117-122. [PMID: 30894958 PMCID: PMC6395191 DOI: 10.1016/j.jds.2016.02.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Indexed: 11/29/2022] Open
Abstract
This study reported the clinicopathological features, treatment and prognosis of nine cases of noncalcifying and Langerhans cell (LC)-rich calcifying epithelial odontogenic tumor (CEOT) collected from the English literature. Of the nine cases, seven were intraosseous and two were extraosseous. All nine tumors were found in Asian patients. The age of the nine patients ranged from 20 years to 58 years with a mean age of 41 years. There were five female and four male patients. The seven intraosseous cases included six in the anterior and premolar region of the maxilla and one in the posterior region and ascending ramus of the mandible. The two extraosseous cases were located at the upper lateral incisor and premolar gingivae, respectively. Of the seven intraosseous cases, five showed unilocular and two multilocular radiolucency without foci of calcification. Six of the seven intraosseous cases showed resorption of the tooth roots in the tumor-involved region. Histologically, noncalcifying and LC-rich CEOTs were composed of small nests and thin strands of tumor epithelial cells with a relatively high number of LCs among them. This was the reason why we classed these nine cases as noncalcifying and LC-rich CEOTs. Two extraosseous cases received total excision of the gingival mass. For the seven intraosseous cases, four accepted partial maxillectomy or mandibulectomy, two received total excision or enucleation, and one underwent curettage. The six cases with the follow-up information available showed no tumor recurrence after a follow-up period of 6 months to 10 years.
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Affiliation(s)
- Hung-Pin Lin
- Department of Dentistry, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Ying-Shiung Kuo
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Yang-Che Wu
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yi-Ping Wang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Julia Yu-Fong Chang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Chun-Pin Chiang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
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Abstract
This article presents various odontogenic cysts and tumors, including periapical cysts, dentigerous cysts, odontogenic keratocysts, orthokeratinized odontogenic cysts, lateral periodontal cysts, glandular odontogenic cysts, ameloblastomas, clear cell odontogenic carcinomas, adenomatoid odontogenic tumors, calcifying epithelial odontogenic tumors, squamous odontogenic tumors, ameloblastic fibromas, ameloblastic fibro-odontomas, odontomas, calcifying cystic odontogenic tumors, and odontogenic myxomas. The authors provide an overview of these cysts and tumors, with microsopic features, gross features, differential diagnosis, prognosis, and potential diagnostic pitfalls.
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Affiliation(s)
- Angela C Chi
- Division of Oral Pathology, Department of Stomatology, College of Dental Medicine, Medical University of South Carolina, MSC 507, 173 Ashley Avenue, Charleston, SC 29425, USA
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Kaili W, Guangning Z, Li L, Laiqing X, Wenhao G. [Calcifying epithelial odontogenic tumor: two cases report]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2016; 34:104-107. [PMID: 27266209 PMCID: PMC7030786 DOI: 10.7518/hxkq.2016.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 07/18/2015] [Indexed: 06/06/2023]
Abstract
Calcifying epithelial odontogenic tumor (CEOT) is a rare benign epithelial tumor of odontogenic origin. CEOT is a benign but a locally infiltrative tumor. CEOT has two clinical variants: intraosseous (central) CEOT and extraosseous (peripheral) CEOT. The peripheral type is rare. In this paper, we report two cases of CEOT. The diagnoses of the cases were verified by histopathology. This study aims to explore the clinical and imaging appearances of CEOT and improve the understanding of the disease.
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18
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Stojanov IJ, Woo SB. Rapidly expanding mass of the maxilla and paranasal sinuses. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 122:117-23. [PMID: 26712683 DOI: 10.1016/j.oooo.2015.10.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 09/30/2015] [Accepted: 10/20/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Ivan J Stojanov
- Resident, Oral and Maxillofacial Pathology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
| | - Sook-Bin Woo
- Associate Professor of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA; Co-director, Center for Oral Pathology, StrataDx Inc., Lexington, MA, USA
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19
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Clinicopathologic correlation: a mixed radio-opaque and radiolucent lesion of the posterior maxilla. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:387-91. [DOI: 10.1016/j.oooo.2014.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 02/04/2014] [Accepted: 03/09/2014] [Indexed: 11/21/2022]
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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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Lin J, Bianchi M, Popnikolov NK, Abaza NA. Calcifying epithelial odontogenic tumor: case report with immunohistochemical and ultrastructural study and review of the literature. J Oral Maxillofac Surg 2012; 71:278-89. [PMID: 22868029 DOI: 10.1016/j.joms.2012.06.171] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 06/14/2012] [Accepted: 06/14/2012] [Indexed: 11/25/2022]
Affiliation(s)
- Jeffrey Lin
- Department of Surgery, Division of Oral and Maxillofacial Surgery, Drexel University College of Medicine/Hahnemann University Hospital, Philadelphia, PA 19102-1192, USA
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22
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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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Gomes CC, Gomez RS. PTCH1 gene inactivation is not a Keratocystic odontogenic tumour exclusive alteration. Oral Oncol 2011; 47:226-7. [DOI: 10.1016/j.oraloncology.2010.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Accepted: 12/13/2010] [Indexed: 11/26/2022]
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