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

A giant adenomatoid odontogenic tumor of the mandible: A case report and literature review

INTRODUCTION AND IMPORTANCE

An adenomatoid odontogenic tumor is a rare medical condition. Large tumor (or several) often appears in the maxillae. In a minority of cases, the tumor(s) appear in the mandible.

CASE PRESENTATION

We report on a case of a 24-year-old female diagnosed with a mandibular adenomatoid odontogenic tumor, a giant tumor measuring approximately 22 × 25 × 17 cm. The tumor was located on the side of the mandible, causing facial deformity, malnutrition, and hemorrhaging. We assessed the patient's overall condition, carried out a resection of the tumor and mandible from the right condyle to the left mandibular angle, and reconstructed the mandibular defect with a fibula free flap. After the treatment, the patient was followed up for 1 year, with no recurrence detected over this period.

CLINICAL DISCUSSION

Because adenomatoid odontogenic tumors are benign odontogenic lesions, which are painless and slow-growing, most are surgically removed or treated conservatively. However, the above treatment measures cannot be applied in the case of a giant tumor that causes facial deformity, destroys the entire jawbone, and has complications such as hemorrhaging and malnutrition. After the tumor resection, the defect is still significant. Accordingly, reconstruction using a microsurgical bone flap is an effective method instead.

CONCLUSION

Large adenomatoid odontogenic tumors in the mandible are rare, and treatment cannot follow conventional methods. Accordingly, defect reconstruction after tumor resection is essential.

Clear cell adenomatoid odontogenic tumour and dentigerous cyst: an uncommon hybrid combination - case and review

Odontogenic tumours and cysts have a characteristic presentation, histopathologically and clinically. The diagnostic criteria and nomenclature are distinct as elaborated in 2017 WHO classification. But one can occasionally and infrequently find an association between different odontogenic tumours and cysts, like calcifying epithelial odontogenic tumour (CEOT) and adenomatoid odontogenic tumour (AOT), CEOT and ghost cell tumour. Some of the odontogenic tumours and cysts share the site of occurrence, intraosseous location, teeth involved/quadrant involved and histopathology too. Hence these lesions are considered for differential diagnoses in most cases. But some instances report hybrid or associated tumours and cyst cases. Here we present a case of dentigerous cyst in association with AOT that showed variation in cell type, pattern and induction pattern.

A case of large adenomatoid odontogenic tumor in the posterior region of the mandible showing root resorption

Introduction: Adenomatoid odontogenic tumor (AOT) is a rare tumor of epithelial origin, and usually presents as a unilocular radiolucency in the maxillary anterior region in adolescent females. Observation: A 31-year-old Japanese male, having a large adenomatoid odontogenic tumor from the right molar region to the left anterior region of the mandible showing root resorption of the neighboring teeth, was presented to the hospital. The lesion was totally resected under general anesthesia. Commentary: AOT may cause displacement of the neighboring teeth. But root resorption is a very rare finding. AOTs are relatively small in size. Conclusion: The patient was under follow-up and had not shown any signs of recurrence 12 months after surgery.

Adenomatoid odontogenic tumour: A rare threat to orthodontic treatment planning

This case report aims to increase awareness of how an adenomatoid odontogenic tumour (AOT) can present in a similar fashion to a dentigerous cyst and the importance of accurate histopathological diagnosis. In this case, the AOT resulted in loss of the upper left permanent canine in a patient who already had a congenitally absent upper left second premolar, compromising the original orthodontic treatment plan.

Adenomatoid odontogenic tumor: Case series of 14 with wide range of clinical presentation

Background

To present 14 cases of adenomatoid odontogenic tumor (AOT), highlighting their clinical, radiographic, and histologic characteristics.

Material and Methods

Fourteen cases of AOT were retrieved from the archives of the Oral Pathology Biopsy Service (OPBS). Clinical, radiologic, and histologic findings are described.

Results

Fourteen AOT cases were reviewed, of which 12 were intraosseous and two were peripheral (gingiva). The cases came from eight females and six males with an age range of 11–30. Of the 12 intraosseous cases, nine were follicular (associated with impacted teeth), while three were extra-follicular (present between teeth). Six of the 12 cases were in the maxilla, and the other six were in the mandible. The two peripheral cases presented as nodules on the buccal gingiva of the anterior maxillary teeth. Radiographically, all 12 follicular and extra-follicular cases were unilocular radiolucencies; of those, only one had specks of radiopacity. Histologically, all specimens were similar in morphology, demonstrating a varied degree of duct-like structures, epithelial spheres, spindle-shaped epithelial cells, calcifications, and a thick capsule. The two peripheral cases had no capsule.

Conclusions

AOT usually affects patients under 20 years of age, with a female to male ratio close to 2:1. Presentation in the anterior maxilla is almost twice as common as in the anterior mandible. Radiographically, AOT presents as a unilocular radiolucency more commonly associated with impacted teeth, simulating a dentigerous cyst. We present 14 new cases of AOT (nine follicular, three extra-follicular, and two peripheral) with discussions of their clinical, radiographic, and histological features.

Key words:Adenomatoid, odontogenic, tumor.

Adenomatoid Odontogenic Tumor Associated with an Impacted Maxillary Lateral Incisor: A Case Report with Five-Year Follow-Up

Adenomatoid odontogenic tumor (AOT), a benign (hamartomatous) lesion of odontogenic origin, is an uncommon tumor which affects mainly females in the second decade. This lesion is most commonly associated with an impacted maxillary canine. This paper reported a case of AOT, in a 16-year-old female, associated with an impacted maxillary left lateral incisor. The evolution of this tumor was followed over 36 months and 24 months after excision.

Jaw lesions associated with impacted tooth: A radiographic diagnostic guide

This review article aimed to introduce a category of jaw lesions associated with impacted tooth. General search engines and specialized databases such as Google Scholar, PubMed, PubMed Central, MedLine Plus, Science Direct, Scopus, and well-recognized textbooks were used to find relevant studies using keywords such as "jaw lesion", "jaw disease", "impacted tooth", and "unerupted tooth". More than 250 articles were found, of which approximately 80 were broadly relevant to the topic. We ultimately included 47 articles that were closely related to the topic of interest. When the relevant data were compiled, the following 10 lesions were identified as having a relationship with impacted tooth: dentigerous cysts, calcifying odontogenic cysts, unicystic (mural) ameloblastomas, ameloblastomas, ameloblastic fibromas, adenomatoid odontogenic tumors, keratocystic odontogenic tumors, calcifying epithelial odontogenic tumors, ameloblastic fibro-odontomas, and odontomas. When clinicians encounter a lesion associated with an impacted tooth, they should first consider these entities in the differential diagnosis. This will help dental practitioners make more accurate diagnoses and develop better treatment plans based on patients' radiographs.

The adenomatoid odontogenic tumour: an update of selected issues

The aim of this update was to present the recent notable progress within remaining questions relating to the adenomatoid odontogenic tumour (AOT). Selected issues that were studied included the following: (i) AOT history and terminology, (ii) the so-called peripheral AOT, (iii) AOT and the gubernaculum dentis and (iv) the so-called adenomatoid odontogenic cyst (AOC). The earliest irrefutable European case of AOT was described in 1915 by Harbitz as 'cystic adamantoma'. Recently, Ide et al. have traced two Japanese cases with irrefutable proof described by Nakayama in 1903. The so-called peripheral (gingival) variant of AOT seems to cover a dual pathogenesis, both an 'erupted intraosseous' and an 'extraosseous' (gingival) one. In 1992, we theorized that the generally unnoticed gubernaculum dentis (cord and canal) seems to be involved in the development of AOT. Ide et al. have concluded that the dental lamina in the gubernacular cord seems to be an embryonic source of the vast majority of AOTs. The suggestion by Marx and Stern to change the nomenclature of AOT to adenomatoid odontogenic cyst (AOC) is critically discussed. The present authors agree on the background of the work of several groups of researchers and WHO/IARC classifications that the biology of the follicular variant of AOT is already fully explained and does not make room for any change in diagnostic terms. Further, there is no reason to change terminology in this case where improvements or conditions to better clinical management are not an issue.

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.

Dentigerous Cyst Associated with Adenomatoid Odontogenic Tumour

Adenomatoid odontogenic tumour (AOT), a tumour composed of odontogenic epithelium, is an uncommon tumour of odontogenic origin that accounts for only 2.2- 7.1% of all odontogenic tumours. Very few cases of AOT associated with Dentigerous cyst (DC) have been reported till date, most cases are in females and have a striking tendency to occur in the anterior maxilla. The present case is that of a 14-year-old female who revealed a large radiolucent lesion associated with the crown of an unerupted canine located in the left maxillary anterior region. The microscopic examination revealed the presence of AOT in the fibrous capsule of a DC. In this paper, we describe the importance of grossing, sectioning and complete examination of the slide to diagnose such hybrid lesions.

Adenomatoid Odontogenic Tumor (AOT) Arising from a Dentigerous Cyst: Literature Review and Report of a Case

Adenomatoid odontogenic tumor (AOT) is an uncommon benign tumor of odontogenic origin composed of odontogenic epithelium in a variety of histopathological patterns. These lesions are usually solid but are occasionally cystic. AOT has been reported to occur in association with odontogenic cysts. Very few cases have been described that arise in association with a dentigerous cyst. A systematic search of the English-language medical literature in PubMed and Medline search (keywords adenomatoid odontogenic tumor, dentigerous cyst) data bases revealed only ten such cases. The present case is very unique, exceptional and first of this kind that occurred in the posterior mandible associated with an impacted lower first premolar in a 19-year old female patient. The intraosseous follicular AOT, as this case reported here, frequently resemble dentigerous cysts. There is an uncertainty whether the lining of an associated cyst represents a true dentigerous cyst, cystic change within an AOT or may represent a distinct entity. We believe that this case represents an odontogenic cyst with neoplastic change. Hence, in such cases, the final diagnosis should be made on the basis of histological examination of extensive tissue sampling of entire excised tissue specimen. Further studies to determine whether the AOT derived from an odontogenic cyst could represent a distinct variant are to be done.

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.

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.

Adenomatoid odontogenic tumour

Adenomatoid odontogenic tumour (AOT) is a benign non-invasive odontogenic tumour, having mostly a slow and sustained growth pattern. AOT is an uncommon lesion of odontogenic origin, which affects young individuals, with a female predilection and mostly occurring in the second decade. In the literature, it has been considered as a hamartoma rather than a true neoplasm because of its limited size, minimal growth potential and the lack of recurrence. We present an extrafollicular central variant of AOT with a occurrence rate of 30%, adjacent to the incisors.

Adenomatoid odontogenic tumor with dentigerous cyst: Report of a rare case with review of literature

Adenomatoid odontogenic tumor (AOT) is a benign lesion derived from the complex system of dental lamina or its remnant. It is categorized into three variants (follicular, extrafollicular, and peripheral). We present a rare case of AOT arising from a dentigerous cyst around the unerupted canine in a 28-year-old female. We believe that this case z an odontogenic cyst with neoplastic development, containing both epithelial and mesenchymal components. As more cases accumulate, we will be able to study these rare lesions further whether the AOTs derived from an odontogenic cyst could represent a distinct “hybrid” variant separate to the three variants described thus far.

Adenomatoid Odontogenic Tumor (AOT) Arising from a Dentigerous Cyst: Literature Review and Report of a Case

Adenomatoid odontogenic tumor (AOT) is an uncommon benign tumor of odontogenic origin composed of odontogenic epithelium in a variety of histopathological patterns. These lesions are usually solid but are occasionally cystic. AOT has been reported to occur in association with odontogenic cysts. Very few cases have been described that arise in association with a dentigerous cyst. A systematic search of the English-language medical literature in PubMed and Medline search (keywords adenomatoid odontogenic tumor, dentigerous cyst) data bases revealed only ten such cases. The present case is very unique, exceptional and first of this kind that occurred in the posterior mandible associated with an impacted lower first premolar in a 19-year old female patient. The intraosseous follicular AOT, as this case reported here, frequently resemble dentigerous cysts. There is an uncertainty whether the lining of an associated cyst represents a true dentigerous cyst, cystic change within an AOT or may represent a distinct entity. We believe that this case represents an odontogenic cyst with neoplastic change. Hence, in such cases, the final diagnosis should be made on the basis of histological examination of extensive tissue sampling of entire excised tissue specimen. Further studies to determine whether the AOT derived from an odontogenic cyst could represent a distinct variant are to be done.