Computerized tomography observation of a calcifying cystic odontogenic tumor with an odontoma: case report

Compound odontoma associated with a calcifying odontogenic cyst. Case report and systematic review

The objectives of the present study were to comprehensively evaluate all the published cases on compound odontoma associated with calcifying odontogenic cyst (COaCOC) in the English literature and to describe the clinical, imaging and therapeutic variables for this condition. In August 2020, an electronic search of the PubMed / MEDLINE, Web of Science, ScienceDirect, Springer, and Scopus databases was carried out. The eligibility criteria included publications with enough information to confirm the diagnosis. Furthermore, we present a clinical case of a 16-year-old male patient with OCCaC, who was treated with enucleation, obtaining favorable and functional results. A total of 32 cases reported in the literature that met the inclusion and exclusion criteria, including ours, were analyzed and discussed. The mayority of the patients were women (n = 17) with an average age of 14.4 years, the maxilla was the most affected bone (n = 22) and the maxillary anterior region was the area with the highest number of cases (n = 18), the main clinical presentations were the volume increase (n = 14) and asymptomatic (n = 14). The choice treatment was enucleation (n = 26) and, in most cases, no recurrence was reported (n = 20). This study allows to update the characteristics of the OCCaC, giving an effective vision of how to treat this rare pathological association made up of two conditions that are completely different from each other.

Dentigerous cyst accompanied by a calcifying epithelial odontogenic tumor: a case report

Introduction: Calcifying epithelial odontogenic tumor (CEOT) is a rare benign, but locally infiltrating neoplasm which accounts for less than 1% of all other odontogenic tumors. The tumor is often associated with impacted teeth and is twice as prevalent in the mandible. Dentigerous cysts are developmental odontogenic cysts, commonly manifesting in the second and third decades of life. A greater incidence in men than in women with a ratio of 1.6:1 and 61.4% associated with impacted or unerupted teeth. Observation: A 17-year-old Indian male reported to the hospital with an asymptomatic lesion associated to an impacted lower first molar with the presence of radiopaque entity inside. The radiological differential diagnosis was calcifying odontogenic tumor, adenomatoid odontogenic tumor and dentigerous cyst. The lesion was completely enucleated under general anesthesia and was sent for histopathologic examination. Discussion: Calcifying epithelial odontogenic tumor (CEOT) is a rare benign odontogenic neoplasm derived from epithelial tissue, forming 0.4–3.0% of all intraosseous odontogenic tumors. A dentigerous (follicular) cyst is a developmental odontogenic cyst usually attached to the crown of an unerupted tooth lined by reduced enamel epithelium. Conclusion: The patient is still under follow-up and has not shown any signs of recurrence in past 8 months after surgery.

Calcifying Epithelial Odontogenic Cyst of Maxilla: Report of A Case and Review and Discussion on the Terminology and Classification

A cyst is defined as a pathological cavity which may or may not have an epithelial lining and which has a fluid, semi-fluid, or gaseous contents and is not formed by accumulation of pus. The calcifying epithelial odontogenic cyst (CEOC) was first reported by Gorlin et al. in 1962. At that time, it was classified as a cyst related to the odontogenic apparatus. It was later renamed as calcifying cystic odontogenic tumor (CCOT) in the World Health Organization classification devised in 2005 due to its histological complexity, morphological diversity, and aggressive proliferation. CCOT was later recognized by numerous names including Gorlin cyst, calcifying ghost cell odontogenic cyst, and/or dentinogenic ghost cell tumor. It has a peak incidence during the second and third decades of life and does not demonstrate any gender predilection. Radiographically, CEOC may appear as a unilocular or multilocular radiolucent lesion with either well-circumscribed or poorly-defined margins and may also be observed in association with unerupted teeth. Calcification is an important radiographic feature for the interpretation of CEOC/CCOT. The typical histopathological features of CEOC include a fibrous wall and lining of odontogenic epithelium with either columnar or cuboidal basal cells resembling ameloblasts. The treatment of choice for CEOC is conservative surgical enucleation, however, recurrence is also not found to be uncommon. Herein, we are reporting a case of the same in a 21-year-old female which was a great dilemma during the diagnostic work-up.

Calcifying cystic odontogenic tumor accompanied by a dentigerous cyst: A case report

A calcifying cystic odontogenic tumor (CCOT) is a proliferation of odontogenic epithelium and scattered nests of ghost cells and calcifications that may form the lining of a cyst, or present as a solid mass. It was previously described by Gorlin et al in 1962 as a calcifying odontogenic cyst. Dentigerous cysts are developmental odontogenic jaw cysts, commonly manifesting in the second and third decades of life. The present study reports an asymptomatic case in a 13-year-old boy who was referred to the outpatient clinic of the Osaka Dental University Hospital (Osaka, Japan) for additional investigation of an area of radiolucency in the lower right jaw. X-ray demonstrated a unilocular, well-circumscribed, radiolucent lesion in the mandible, which measured 30×20 mm, with radiopaque structures within it. Enucleation of the lesion with tooth extraction was performed, which histopathologically revealed features of a CCOT and a cyst. To the best of our knowledge, the occurrence of such a lesion has not been previously identified. The present study examined the significance of the case with a brief review of the literature.

A rare presentation of hybrid odontogenic tumor involving calcifying cystic odontogenic tumor and plexiform ameloblastoma

A hybrid odontogenic tumor comprising two distinct lesions is extremely rare. We presented a hybrid odontogenic tumor composed of a calcifying cystic odontogenic tumor (CCOT) and a plexiform ameloblastoma. This tumor was observed in the anterior area of the mandible of a 17-year-old Indian male. Masses of ghost epithelial cells with the characteristics of CCOT were seen in the lining of the cyst. The odontogenic epithelia with the features of plexiform ameloblastoma were also observed.

Calcifying cystic odontogenic tumor and adenomatoid odontogenic tumor: radiographic evaluation

OBJECTIVES

The aim of this study was to describe the radiographic features of calcifying cystic odontogenic tumors (CCOTs) and adenomatoid odontogenic tumors (AOTs) and to compare the radiographic findings for these 2 lesions.

STUDY DESIGN

We retrospectively reviewed radiographs of CCOTs and AOTs. Location, border, relationship of the lesion with the impacted tooth, calcification patterns, tooth displacement, and root resorption were evaluated.

RESULTS

Nine CCOTs and 8 AOTs were reviewed. Most CCOTs and AOTs had smooth borders. Three CCOTs and 7 AOTs enclosed impacted teeth. Of these cases, the radiolucencies of 3 CCOTs and 1 AOT were attached to the impacted teeth at the cementoenamel junctions. Three AOTs enclosed more portions of the roots, and the other 3 AOTs enclosed the entire teeth. Calcification in CCOTs appeared as a thin radiopaque line (2 cases) and discrete radiopaque foci (1 case), whereas AOTs had numerous dispersed or clustered radiopaque foci (4 cases).

CONCLUSIONS

Radiolucency with numerous radiopaque foci (particularly when the radiolucency surrounds a portion of the root or entire tooth) is suggestive of an AOT rather than a CCOT.

Distintas manifestações do tumor odontogênico cístico calcificante

O tumor odontogênico cístico calcificante normalmente se manifesta como uma massa indolor, de crescimento lento, que acomete tanto a maxila como a mandíbula, tendo predileção pelo segmento anterior (área dos incisivos e caninos). Geralmente, ocorre em adultos jovens, na terceira a quarta década de vida, sem preferência por gênero. Imagens de tomografia computadorizada revelaram características importantes não detectadas na radiografia panorâmica, tais como fenestração, calcificação e estruturas dentiformes. A característica microscópica típica dessa lesão é a presença de células epiteliais aberrantes anucleadas, em quantidades variáveis, denominadas "células fantasmas". Também se pode encontrar dentina displásica e, ocasionalmente, os cistos estão associados a tecido dentário duro, semelhante ao odontoma. O tratamento do tumor odontogênico cístico calcificante incluiu simples enucleação e curetagem. O objetivo deste trabalho foi mostrar duas manifestações diferentes do tumor odontogênico cístico calcificante, em que a tomografia computadorizada, associada às características clínicas, foi ferramenta importante para o diagnóstico, o planejamento cirúrgico e o acompanhamento dos pacientes.

Odontoma associated with calcifying cystic odontogenic tumor in deciduous dentition: case report

BACKGROUND

Initially described by Gorlin et al. in 1962, the calcifying cystic odontogenic tumor (CCOT) may be associated with unerupted teeth, ameloblastomas, adenomatoid odontogenic tumors, and, in many cases, with odontomas. It is rare in patients in the first decade of life, particularly involving deciduous teeth. Surgery is the treatment of choice, with low recurrence rates.

CASE REPORT

We present a clinical case of CCOT associated with odontoma and a missing deciduous tooth in a 3-year-old female patient. The lesion was removed under general anesthesia. The patient has been followed up for 1 year, and no recurrence was found. This appears to be the first report in such a young age.

Calcifying cystic odontogenic tumour: CT imaging

OBJECTIVES

Calcifying cystic odontogenic tumour (CCOT) is a rare disorder of the jaw. A comparison between conventional radiographs and CT images in CCOTs has not been reported. The purposes of this study were to analyse conventional radiographs and CT images of CCOTs, establish CT images of CCOTs and assess the utility of CT in the diagnosis of CCOTs.

METHODS

Nine patients with a histopathologically confirmed CCOT who had both conventional radiographs and CT images were enrolled.

RESULTS

CT was superior to conventional radiographs in detecting buccolingual expansion, odontomas and radio-opaque bodies.

CONCLUSION

The characteristic CT appearances of CCOT were that radio-opaque bodies were typically located in the periphery of the lesion and the shape of radio-opaque bodies was linear and/or spotted. CT was useful in diagnosing a CCOT.