Adenomatoid odontogenic tumor of the mandible: review of the literature and report of a rare case

Hybrid odontogenic lesions: A case series of a rare entity

Background

The occurrence of hybrid odontogenic lesions with two or more morphologically distinct components is a rare phenomenon and poses a diagnostic challenge. We aimed to study the clinical, radiological, and pathological features and behavior of hybrid odontogenic lesions, to enhance awareness about these rare lesions.

Method

Hematoxylin and Eosin slides of hybrid odontogenic lesions diagnosed between January 01, 2012 and December 31, 2020, were reviewed. Demographic and radiological information were obtained from the patient's medical records.

Results

8 cases were diagnosed with a mean age of 19.1 years and male to female ratio of 1:1.7. Involvement of mandible was more common (n = 5) as compared to maxilla (n = 3). All patients presented with swelling for an average of 9.75 months (3-25 months) duration. Bleeding, loose teeth, pain and facial asymmetry were reported in 5,3, 3, and 2 cases, respectively. Radiologically, 7 cases were well demarcated, 75% cases (n = 6) were radiolucent, and average radiological size was 4.8 cm. All patients were managed with surgery alone. 5 cases (62.5%) underwent enucleation and curettage, while local excision, en-block resection and segmental mandibulectomy were performed in 1 case each. Histologically, ossifying fibroma/cemento-ossifyiong fibroma were the most lesion, occurring in 5 cases (62%), followed by giant cell granuloma like lesions (GCG) i.e., central and peripheral giant cell granuloma (n = 3), Adenomatoid Odontogenic tumor (AOT) (n = 2), and DC (n = 2), ameloblastic fibroma (AF) (n = 1), Ameloblastoma (n = 1), calcifying odontogenic cyst (COC) (n = 1), and complex odontoma (n = 1). No evidence of recurrence was noted after 4-99 months of surgery (mean: 32.9) in cases with available data (n = 7). Long-term complaints included facial asymmetry (n = 2) and pain (n = 1).

Conclusion

Most hybrid odontogenic lesions affect young females in the second decade of life and commonly show COF and OF as hybrid components. A conservative approach to management appears adequate.

An Unusual Presentation of “Two-Thirds Tumor” in the Mandible – A Diagnostic Quandary with a Review of the Literature

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.

Adenomatoid Odontogenic Tumor of the Maxilla in a 13-year-old Patient: A Rare Case Report with a Review of Literature

Background

The AOT is an atypical tumor of odontogenic origin that comprises about 0.1% of jaw tumors and cysts as well as up to 3% of odontogenic tumors (OTs).

Aim and objective

This review describes the clinical, radiographical, histopathological, and immunohistochemical properties of adenomatoid odontogenic tumor (AOT) and reports an occurrence of an AOT in a boy, 13 years of age.

Case description

A male, 13 years of age, presented with a swelling with respect to the left maxilla, painless, and with obvious facial asymmetry. The orthopantomogram and computed tomography scan revealed a large unilocular radiolucency in the left maxilla with permanent lateral incisor embedded within the lesion and permanent canine pushed away from its normal position. After complete enucleation of the cyst under local anesthesia and extraction of associated impacted permanent teeth and retained deciduous teeth related to the lesion, the defect was filled with a bone graft and closed. Postoperative follow-up was uneventful.

Conclusion

An accurate diagnosis should be established through clinical, radiographical, and pathological correlations in order to be able to differentiate AOT from other conditions for early diagnosis.

Clinical significance

This report highlights the salient features of the AOT to be able to correctly diagnose and manage the lesion.

How to cite this article

Kamble A, Shimpi MR, Dash JK, et al. Adenomatoid Odontogenic Tumor of the Maxilla in a 13-year-old Patient: A Rare Case Report with a Review of Literature. Int J Clin Pediatr Dent 2021;14(4):596–600.

Trauma to Tumor: A Hunt of Adenomatoid Odontogenic Tumor-A Rare Case Report

Tumors and tumor-like growths arising from odontogenic tissues constitute a heterogeneous group of interesting lesions, as they display the various inductive interactions that normally occur among the embryologic components of the developing tooth germ. Adenomatoid odontogenic tumor is a benign tumor, most common in the maxilla, characterized by slow, progressive, painless growth of firm consistency, the size of which usually does not reach large proportions. They are of three types: extrafollicular, follicular, and peripheral. It usually develops around or overlaps adjacent teeth.

An Extrafollicular Adenomatoid Odontogenic Tumor Mimicking a Periapical Cyst

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.

Adenomatoid odontogenic tumor: What is the true nature?

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).

A retrospective review of 61 cases of adenomatoid odontogenic tumour seen in five tertiary health facilities in Nigeria

INTRODUCTION

Adenomatoid odontogenic tumor (AOT) is a benign lesion originating from the dental lamina or its remnants. It is a relatively uncommon neoplasm representing about 3% of all odontogenic tumors. The aim of this study was to examine the clinical and radiological characteristics of AOTs in five major tertiary centres in Nigeria.

METHODS

Archival hospital-based data stores of five tertiary health facilities in Nigeria were accessed. Case files and biopsy records were retrieved to obtain relevant information. Data was collected according to a proforma for standardization and entered into and analysed using SPSS for Windows (version 20.0; SPSS Inc. Chicago, IL).

RESULTS

61 (4.5%) cases of AOT were documented. The age range was 8-46 years with a mean age of 20.4±9.9 years. Male: Female ratio was 1:1.3. The anterior maxilla had 34 (55.8%) cases and the anterior mandible had 20 (32.8%) cases. 40 (65.6%) follicular cases, 20 (32.8%) extra-follicular cases and 1(1.6%) extra-osseous case were found. 31 cases (61.1%) were associated with impacted teeth and the upper canine was involved in 19 (57.6%) cases.

CONCLUSION

This study showed AOT to be more common in the maxilla, more in females, most often associated with impacted canines, however, the suggestion of AOT being a "Two third tumour" was not observed in this study.

Unusual Adenomatoid Odontogenic Tumor

The adenomatoid odontogenic tumor is a rare benign neoplasm. It can, however, have locally aggressive behavior. This is a case of an adenomatoid odontogenic tumor of unusual location and behavior in a 15-year-old female patient. A panoramic radiograph revealed a large radiolucent lesion involving the retained tooth 33. Teeth involved in this lesion were displaced and with apparent root resorption. A prototype of the mandible showed a marked expansion of cortical bone, fenestration points in the lingual cortex, and fragility of the base of the mandible. Therefore, because of the risk of postoperative pathologic fracture the placement of a 2.4-mm reconstruction plate was indicated. Total enucleation of the lesion, as well as placement of a reconstruction plate were performed. Despite the large bone destruction, with the correct surgical procedure and the use of the reconstruction plate the patient recovered without incidents and a 24-month postoperative radiography showed satisfactory bone formation.

A Rare Pathological Entity of Multiple Calcified Hyperplastic Dental Follicles

Multiple calcified hyperplastic dental follicles (MCHDF) are an extremely rare condition which has been categorized as a separate pathological entity very recently. It was initially described by Sandler et al. Gardner and Radden proposed this as a separate pathological entity. This disease is characterized by multiple unerupted teeth with abundant calcifications and rests of odontogenic epithelium in enlarged dental follicles.

A case report and short review on changing trends in the site of occurrence of adenomatoid odontogenic tumor: Unravelling the past 15 years

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.

Adenomatoid odontogenic tumor associated with an unerupted mandibular lateral incisor: a case report

Adenomatoid odontogenic tumor (AOT) is a rare, benign odontogenic tumor that predominantly appears in the second decade of life in female patients. Most AOTs occur in the anterior part of the maxilla and are usually associated with impacted anterior teeth. There are three types of AOT, follicular, extrafollicular, and peripheral, which are classified based on the location of the lesion and its association with the impacted tooth. We report a rare case of AOT associated with an impacted right mandibular lateral incisor in an 11-year-old female patient.

Maxillary adenomatoid odontogenic tumor associated with a premolar

The adenomatoid odontogenic tumor (AOT) represents 3-7% of all odontogenic tumors, and over 750 cases have been reported in the literature. This lesion was formerly considered to be a variant of the ameloblastoma and was designated as adenoameloblastoma. These lesions may infrequently produce dentinoid material and rarely enamel matrix. Consequently, the WHO (2005) classification of odontogenic lesions considered this process to represent a mixed odontogenic neoplasm. We present a case of a 12-year-old female patient with an AOT of diameter 5 cm × 5 cm located in the anterolateral region of the maxilla in association with an impacted premolar tooth. The rarity of AOT, association of this lesion with regards to maxillary premolar, the exaggerated size at presentation, the eruption of the displaced canine postoperatively and uneventful healing of the bony defect without adjunctive therapy makes this case unique.

Squamous Odontogenic Tumor: Literature Review Focusing on the Radiographic Features and Differential Diagnosis

Since its first publication in 1975, the squamous odontogenic tumor remains the rarest odontogenic lesion, with around 50 cases in the English-language literature in which the microscopic characteristics are frequently very well demonstrated. However, articles which discuss the radiographic aspects are scarce, especially with emphasis on the differential diagnosis. The present treatise proposes an assessment of jaw lesions with the same radiographic characteristics of the squamous odontogenic tumor to clarify the main findings for dental clinicians during routine diagnosis.

Amelogenin in odontogenic cysts and tumors: An immunohistochemical study

Background:

Amelogenins are the major enamel proteins that play a major role in the biomineralization and structural organization of enamel. Aberrations of enamel-related proteins are thought to be involved in oncogenesis of odontogenic epithelium. The expression of amelogenin is possibly an indicator of differentiation of epithelial cells in the odontogenic lesions.

Aims and Objectives:

The present study aimed to observe the expression of amelogenin immunohistochemically in various odontogenic lesions.

Materials and Methods:

Paraffin sections of 40 odontogenic lesions were stained immunohistochemically with amelogenin antibodies. The positivity, pattern and intensity of expression of the amelogenin antibody were assessed, graded and statistically compared between groups of odontogenic cysts and tumors.

Results:

Almost all the odontogenic lesions expressed amelogenin in the epithelial component with the exception of an ameloblastic carcinoma. Differing grades of intensity and pattern were seen between the cysts and tumors. Intensity of expression was uniformly prominent in all odontogenic lesions with hard tissue formation. Statistical analysis however did not indicate significant differences between the two groups.

Conclusion:

The expression of amelogenin antibody is ubiquitous in odontogenic tissues and can be used as a definitive marker for identification of odontogenic epithelium.

Adenomatoid odontogenic tumor in the maxillary antrum: A rare case entity

Adenomatoid odontogenic tumor (AOT) is an uncommon benign tumor of odontogenic origin. It occurs in the second decade of life. Females are more commonly affected than males. AOT has a striking tendency to occur in the anterior maxilla; however, very few cases have been reported to occur in the maxillary antrum. This is a case report of a 17-year-old male presented with a large radiolucent lesion associated with the crown of an unerupted canine located in the right maxillary antrum, which was clinically diagnosed as dentigerous cyst. The histopathological examination revealed the presence of AOT.

Multiple calcifying hyperplastic dental follicles: A case report

This report describes a 31-year-old female patient with six impacted teeth. The crowns of the impacted teeth were surrounded with cyst-like lesions with a mixed internal structure and well-defined cortical borders. Microscopic examination of the specimen obtained from the follicle of the left mandibular third molar tooth revealed loose to moderately dense collagenous connective tissue with abundant calcified material and sparse epithelial islands. A diagnosis of multiple calcifying hyperplastic dental follicles was made.

Mandibular adenomatoid odontogenic tumor: Radiographic and pathologic correlation

Adenomatoid odontogenic tumor (AOT) is a rare tumor of epithelial origin comprising 3% of all the odontogenic tumors. It is a benign, painless, noninvasive, and slow-growing lesion, with a relative frequency of 2.2-13% and often misdiagnosed as an odontogenic cyst on clinical examination. AOT affects young individuals with a female predominance, occurs mainly in the second decade, and usually surrounds the crown of unerupted teeth. This lesion is most commonly located in the anterior maxilla and rarely in the mandible. It is usually associated with an impacted canine. AOT frequently resembles lesions like dentigerous cyst or ameloblastoma. AOT has three variants, follicular, extrafollicular, and peripheral. The intraoral periapical radiograph is the best radiograph to show radiopacities in AOT as discrete foci having a flocculent pattern within radiolucency even with minimal calcified deposits. These calcified deposits are seen in approximately 78% of the lesions. Herewith, we present the report of four unusual cases of AOT located in the mandible, with an emphasis on radiographic findings and on pathologic correlation, and on reviewing the existing literature on this tumor.

A rare case of extrafollicular adenomatoid odontogenic tumour in the posterior region of the mandible: misdiagnosed as residual cyst

Adenomatoid odontogenic tumor is a relatively uncommon distinct odontogenic neoplasm. It is an uncommon tumor of odontogenic origin with varying number of ductlike structures and inductive changes in the stroma. It is a benign and slow growing epithelial tumor and represents 3% of all odontogenic tumors. Its occurrence is more common in anterior region of the maxilla than mandible. Most of the adenomatoid odontogenic tumors occur intra-osseously but few peripheral variant have been reported which are attached to the gingival structures. The intra-osseous Adenomatoid odontogenic tumor may be related to unerrupted tooth (follicular varient) or may not (extrafollicular varient) be related to unerrupted tooth. This paper is to present a rare case of an extrafollicular Adenomatoid odontogenic tumor occurring in the body of the mandible in a male patient which is distinct and secondly it was clinically and radiographically diagnosed as residual cyst. The diagnosis of Adenomatoid odontogenic tumor was confirmed by Histopathological investigation. How to cite this article: Shivali V, Khanna VD, Khanna P, Singh A, Pandey A, Ahuja T. A Rare Case of Extrafollicular Adenomatoid Odontogenic Tumour in the Posterior Region of the Mandible: Misdiagnosed as Residual Cyst. J Int Oral Health 2013; 5(5):124-8.

Adenomatoid odontogenic tumour in mandible in a 14-year-old boy

A 14-year-old boy reported with a painless swelling over the right anterior mandible with missing right canine tooth. The lesion was diagnosed as 'central follicular adenomatoid odontogenic tumour' and excised surgically under general anaesthesia. The patient was on a year-long clinical and radiographical follow-up.

Current concepts and occurrence of epithelial odontogenic tumors: I. Ameloblastoma and adenomatoid odontogenic tumor

Ameloblastomas and adenomatoid odontogenic tumors (AOTs) are common epithelial tumors of odontogenic origin. Ameloblastomas are clinico-pathologically classified into solid/multicystic, unicystic, desmoplastic, and peripheral types, and also divided into follicular, plexiform, acanthomatous, granular types, etc., based on their histological features. Craniopharyngiomas, derived from the remnants of Rathke's pouch or a misplaced enamel organ, are also comparable to the odontogenic tumors. The malignant transformation of ameloblastomas results in the formation of ameloblastic carcinomas and malignant ameloblastomas depending on cytological dysplasia and metastasis, respectively. AOTs are classified into follicular, extrafollicular, and peripheral types. Ameloblastomas are common, have an aggressive behavior and recurrent course, and are rarely metastatic, while AOTs are hamartomatous benign lesions derived from the complex system of the dental lamina or its remnants. With advances in the elucidation of molecular signaling mechanisms in cells, the cytodifferentiation of epithelial tumor cells in ameloblastomas and AOTs can be identified using different biomarkers. Therefore, it is suggested that comprehensive pathological observation including molecular genetic information can provide a more reliable differential diagnosis for the propagation and prognosis of ameloblastomas and AOTs. This study aimed to review the current concepts of ameloblastomas and AOTs and to discuss their clinico-pathological features relevant to tumorigenesis and prognosis.

An Adenomatoid Odontogenic Cyst (AOC) with an Assorted Histoarchitecture: A Unique Entity

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.

Appraisal of jaw swellings in a Nigerian tertiary healthcare facility

Introduction: The mandible and maxilla can be the site of myriads of lesions that may be categorized as neoplastic, cystic, reactive and infective or inflammatory. Literature reviewing jaw swellings in an amalgamated fashion are uncommon, probably because aetiologies for these swellings are varied. However, to appreciate their relative relationship, it is essential to evaluate the clinico-pathologic profile of jaw swellings. The aim of this appraisal is to describe the array of jaw swellings seen at our hospital from 1990 to 2011, to serve as a reference database. Material and Methods: Biopsy records of all histologically diagnosed cases of jaw swellings seen at the department of Oral Pathology, University College Hospital between January 1990 and December 2011 were retrieved, coded and inputted into SPSS version 20. Data on prevalence, age, sex, site and histological diagnosis were analysed descriptively for each category of jaw swellings. All patients below 16 years were regarded as children. Results: A total of 638 jaw swellings were recorded in the 22-year study period. The Non Odontogenic Tumours (NOT) were the commonest, accounting for 46.2% of all jaw swellings. Odontogenic Tumours (OT) formed 45% of all adult jaw swelling while it formed 25.2% in children and adolescents. Ameloblastoma was the commonest while the most common NOT was ossifying fibroma (OF). Chronic osteomyelitis of the jaws was about 6 times commoner in adult females than males and mostly involved the mandible. The most common malignant jaw swelling was Burkitts’ lymphoma (BL) that was about 7 times more in children than adults. Osteogenic sarcoma was the most common malignancy in adults. Conclusion: Jaw swellings are extensively varied in types and pattern of occurrence. This study has categorized jaw swellings in a simple but comprehensive fashion to allow for easy referencing in local and international data acquisition and epidemiological comparison.

Key words:Jaw swellings, odontogenic, Nigeria.

The interrelationship of adenomatoid odontogenic tumour and dentigerous cyst: a report of a rare case and review of the literature

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.

Immunohistological features in adenomatoid odontogenic tumor: review of the literature and first expression and mutational analysis of β-catenin in this unusual lesion of the jaws

PURPOSE

To investigate for the first time the immunohistochemical and mutational status of β-catenin in a mandibular case of adenomatoid odontogenic tumor (AOT) and to review the immunohistochemical expression data of various markers (cytokeratins, metalloproteinases, etc) in such a lesion.

MATERIALS AND METHODS

A case of follicular-type AOT in a young male patient was analyzed in regard to the immunohistochemical expression of β-catenin and mutations of the β-catenin gene (CTNNB1). Its expression is altered in some odontogenic tumors.

RESULTS

We found a strong cytoplasmic expression of β-catenin, but no molecular anomaly within the exon 3 of CTNNB1. β-catenin is considered to play a role in cell differentiation processes.

CONCLUSION

Our results were consistent with previous findings in ameloblastoma and malignant odontogenic tumors. However, β-catenin alterations had not been explored in AOT so far. Further studies are necessary to understand the specific regulation of β-catenin in the AOT pathogenesis.

Parameters predicting complications in flap surgery

OBJECTIVES

The aim of this prospective study was to determine laboratory parameters predicting complications and/or failure in flap surgery.

STUDY DESIGN

Fifty-seven patients undergoing reconstructive surgery with cutaneous free and pedicled flaps were included. Blood samples were taken 2 days before surgery and 1, 3, 5, 7, and 14 days after. Parameters associated with thrombophilia, bleeding disorders, and wound healing were determined.

RESULTS

In 45 (77%) of 57 patients no complications occurred. Bleeding (9%) and venous thrombosis of the flaps (9%) led in 18% of the cases to surgical revisions. Activated protein C resistance showed a significant (P < .05) cluster in cases with venous thrombosis, whereas it was absent in all other cases. Fibrinogen, factor VIII:C, von Willebrand factor (vWF) activity, and VWF antigen were significantly (P < .05) higher in patients with venous thrombosis compared with all other patients.

CONCLUSIONS

Laboratory parameters of thrombosis and bleeding appear to be associated with complications in flap surgery.

Critical evaluation of the radiological and clinical features of adenomatoid odontogenic tumour

OBJECTIVES

The aim of this study was to evaluate the radiological and clinical features of adenomatoid odontogenic tumours (AOTs).

METHODS

A total of 272 cases (267 from the English-language literature and 5 new cases) were analysed with special emphasis on their radiological features.

RESULTS

The patients' ages at time of diagnosis ranged from 3 years to 82 years (mean 18.4 years). The maxilla-to-mandible ratio was 1.7:1. Mandibular lesions were significantly more frequent among patients older than 16 years (p = 0.032). Expansion of the cortex was significantly more prominent among patients older than 16 years (p = 0.045). There was a positive correlation between the size of the lesion and the age of the patient at the time of diagnosis (p = 0.016). The size was also associated with increased root resorption (p < 0.001), ill-defined borders (p < 0.001), expansion (p < 0.001) and perforation of the cortex (p < 0.001). Small opacities were present in 77% of lesions and were associated with expansion of the cortex (p = 0.043). The significant radiological features in patients aged 30 years and above were root resorption (p = 0.013) and lesions crossing the midline (p = 0.019).

CONCLUSIONS

The size of an AOT is influenced by the patient's age. It is also associated with root resorption, ill-defined borders, expansion and perforation of the cortex, but it cannot be ruled out that those changes reflect a longer duration of the lesion.

A huge adenomatoid odontogenic tumor of maxilla

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.

Bilateral multifocal Warthin's tumors in upper neck lymph nodes. Report of a case and brief review of the literature

Cystadenolymphomas (Warthin's tumors) are the second most frequent lesions of the parotid gland. Due to their benign clinical behavior, the low rates of recurrence and malignant transformation they were classified as tumor-like lesions. In addition, a polyclonal growth of the epithelial components of the tumor could be detected. Warthin's tumors occur bilateral in 7-10%, whereas a multifocal appearance is extremely rare. Even if the pathogenesis is still unclear a heterotopia of salivary tissue during embryogenesis is the most likely explanation for the origin of these tumors in the upper neck and periparotideal region. Here we present a rare case of bilateral, multifocal, extraglandular Warthin's tumors in lymph nodes of the upper neck and give a brief review of the literature. If a primary malignancy can be excluded by a careful staging procedure prior to the operation an isolated excision of the lesions of the neck is the adequate treatment.

Adenomatoid odontogenic tumor: A unique report with histological diversity

Odontogenic tumors are a group of heterogeneous lesions, features of which have been catalogued for several decades. Adenomatoid odontogenic tumor (AOT) is a relatively rare and distinct odontogenic tumor that is exclusively odontogenic epithelium in origin. Although considerable number of reports is available with regard to the clinical and histological spectrum of AOT, very few have highlighted its varied histological presentations. Therefore, this article focuses on the assorted histoarchitectural patterns of AOT.

Bilateral adenomatoid odontogenic tumour of the maxilla in a 2-year-old female--the report of a rare case and review of the literature

Multifocal odontogenic lesions are uncommon and have only been observed in conditions associated with known genetic mutations. To the best of our knowledge, only two cases of multifocal adenomatoid odontogenic tumours (AOT) have previously been reported in the literature. In this study, we report the first case of a bilateral, separate AOT in the maxilla in the midline in a 2-year-old female. The patient presented with bilateral expansile masses in the maxilla on either side of the midline which had been present for 6 months. She was asymptomatic and had occasional difficulty in breathing. The tumour was diagnosed as AOT and was surgically enucleated along with the associated teeth. The patient recovered well and has been on recall for 5 years. The follow-up panoramic radiograph made a fortnight ago revealed evidence of three new radio-opaque lesions with an associated tooth in the region of the anterior mandible, the premolar region of the right maxilla and the molar region of the left maxilla. To acquire additional information about AOT, all reports regarding AOT cited in 'PubMed' from 1995 onward were reviewed and the incidence, clinical features, radiographic features and management of AOT are discussed in this study.

Adenomatoid odontogenic tumor associated with dentigerous cyst in posterior maxilla: A case report and review of literature

Adenomatoid odontogenic tumor (AOT)-a benign (hamartomatous) lesion of odontogenic origin-is an uncommon tumor which affects young individuals with a female predominance, mainly in the second decade. This lesion is most commonly located in the anterior maxilla and is usually associated with an impacted canine tooth. This is a case report of a 39-year-old female patient presented with a large AOT of the posterior maxilla associated with an impacted second molar - a very rare situation.

Extrafollicular adenomatoid odontogenic tumour

Adenomatoid odontogenic tumour (AOT) is an uncommon, benign tumour that represents 3-7% of all odontogenic tumours. It is slow growing, occurs twice as common in females and usually in the second decade of life. There are three subclinical types of this tumour with identical histology: follicular type (73%), extrafollicular variant (24%) and peripheral form (3%). Here, the authors have presented two rare cases of extrafollicular varieties of AOT in 25-year-old female patients, of which one was situated in the maxillary canine area and the other one situated in an unusual location of mandibular premolar area. Such lesions may be confused as an odontogenic cyst and should be carefully differentiated from other benign and malignant lesions arising in this region.

Central odontogenic fibroma: a case report with long-term follow-up

An osteolytic tumour of the mandible with prominent expansive growth on the alveolar ridge and displacement of the involved teeth is described in a 28-year-old man. The lesion was diagnosed as a central odontogenic fibroma, an uncommon benign neoplasm derived from dental apparatus, and was removed by curettage. The patient remains asymptomatic after thirteen years of follow-up, which supports the claimed indolent behavior of this poorly documented disease and the adequacy of a conservative surgical treatment.

Adenomatoid odontogenic tumour: tumour or a cyst, a histopathological support for the controversy

Adenomatoid odontogenic tumour (AOT) is a well-established odontogenic tumour with various clinicopathological variants. AOT quite frequently mimics an odontogenic cyst commonly a dentigerous cyst. Histologically a cystic component of AOT has been described in the literature. In the present paper we review the literature for the AOTs arising in an odontogenic cyst and add to the literature a case of cystic AOT. The present review is aimed to provide an insight to the varied demographic profile, clinical behavior and prognosis of cystic variant of AOT.

Extrafollicular adenomatoid odontogenic tumor of the mandible: report of a case

The purpose of this study was to report an extrafollicular adenomatoid odontogenic tumor in the mandibular anterior region in a patient. A 15 year-old female with a painless swelling in the mandibular anterior region was referred to our clinic. Fine needle aspiration yielded no fluid. Periapical, panoramic and computer tomography scans showed circumscribed radiolucent area with fine calcifications. The lesion was totally enucleated and the teeth 31, 32 were removed. The rarity of adenomatoid odontogenic tumor may be associated with its slowly growing pattern and symptomless behavior. Therefore, it should be distinguished from more common lesions of odontogenic origin in routine dental examinations.

An updated clinical and epidemiological profile of the adenomatoid odontogenic tumour: a collaborative retrospective study

BACKGROUND

Adenomatoid odontogenic tumour (AOT) is a benign odontogenic jaw lesion. The aim of this study was to update the biological profile of AOT.

MATERIAL AND METHODS

Cases published in the literature and cases in files of co-authors were included.

RESULTS

550 new cases were retrieved, and of a total of 1082 cases analysed, 87.2% were found in the second and third decades. The M:F ratio was 1:1.9. 70.8% were of the follicular variant (extrafollicular: 26.9%, peripheral: 2.3%). 64.3% occurred in the maxilla. 60% of follicular AOTs were associated with unerupted canines. Nineteen cases of AOT (2.8%, M:F ratio was 1:1.4) were associated with embedded third molars. Twenty-two peripheral AOTs (2.3%, M:F ratio was 1:5.3) were recorded. The relative frequency (RF) of AOT ranged between 0.6% and 38.5%, revealing a considerably wider AOT/RF range than hitherto reported (2.2-7.1%).

CONCLUSIONS

This updated review based on the largest number of AOT cases ever presented, confirms the distinctive, although not pathognomonic clinicopathological profile of the AOT, its worldwide occurrence, and its consistently benign behaviour.

Adenomatoid odontogenic tumor: a report of a rare case with recurrence

Adenomatoid odontogenic tumor (AOT) is an uncommon tumor of odontogenic origin, composed of odontogenic epithelium in a variety of histoarchitectural patterns, and characterized by slow but progressive growth. Generally, recurrences seldom, if ever, occur after surgical curettage, while here we report an extremely rare case of AOT with recurrence. The patient was a 36-year-old Chinese man who presented with a palpable bony-hard swelling in the anterior maxillary region initially at the age of 16 and the lesion recurred twice over a 20-year period. The tumor was diagnosed as AOT with well-defined unilocular radiolucency shown in X-ray graphs and solid nodule of cuboidal or columnar cells of odontogenic epithelium forming typical nests or rosette-like structures as well as characteristic duct-like spaces in histologic findings.