Ameloblastomatous Calcifying Odontogenic Cyst: A Rare Entity

Unusual Association of Calcifying Cystic Odontogenic Tumor with Compound Odontoma and Ameloblastoma: Case Report and Review of the Literature

Calcifying cystic odontogenic tumor (CCOT) is a rare odontogenic cyst accounts for <2% of all odontogenic cysts. Simple unicystic CCOT is commonly encountered accounts for 65%, whereas other forms of CCOT are <3%. CCOT is associated with two or more odontogenic tumors, it is called combined odontogenic lesions or hybrid lesions. The aim of the present article is to report a rare case of CCOT and highlighting the clinical feature and treatment aspects of combined lesions. A 25-year-old female complained of pain and swelling in the left maxilla for 6 months. Examination revealed diffuse swelling in the maxilla, firm in consistency, and tender on palpation. Panoramic radiograph showed impacted canine with multiple radiopaque structures and well-defined lesion in the maxillary sinus. The lesion was surgically removed and histopathologically diagnosed as CCOT with compound odontoma and ameloblastoma. Pub Med database search from 1978 to June 2020 revealed only three case reports of combined odontogenic tumors associated with CCOT.

Ameloblastomatous calcifying cystic odontogenic tumour involving the mandibular anterior region: An unusual case report

Ameloblastomatous calcifying odontogenic cyst (COC) is a very rare histopathological variant of COC, which is an odontogenic cyst of the jaw. The term "calcifying odontogenic cyst" is not covered in the World Health Organisation (WHO) Classification of Tumors 2005 and was re-named as calcifying cystic odontogenic tumour (CCOT). There are only a few reports containing details on CCOT being associated with ameloblastoma. This variant has been classified as ameloblastomatous CCOT (type 3) as per the WHO 2005 classification. In this article, we reported an exceptional case of ameloblastomatous CCOT in a 15-year-old boy involving the mandibular anterior region, which is a rare combination for age and site of the lesion, along with an impacted tooth which is again an uncommon association.

Perfil clínico e histopatológico do cisto odontogênico calcificante: relato de caso

O cisto odontogênico calcificante (COC) foi primeiramente descrito em 1962, considerado como condição patológica benigna de ocorrência rara em maxila e mandíbula, caracterizado por revestimento cístico de células epiteliais odontogênicas contendo células fantasmas com propensão a regiões de calcificação.  Neste artigo, descreveu-se a configuração clínica e histopatológica do COC por meio de relato de caso submetido a tratamento cirúrgico e acompanhamento pós-operatório. Uma paciente de 11 anos apresentou um aumento de volume em região maxilar a esquerda próxima ao sulco nasolabial sem sintomatologia dolorosa. Os exames radiográficos indicaram lesão radiolúcida, bem circunscrita e expansiva em maxila, que foi submetida a enucleação associada a ostectomia marginal das paredes corticais ósseas. O quadro histopatológico foi caracterizado por revestimento cístico com epitélio odontogênico ameloblástico, ninhos espalhados de células fantasmas e regiões eosinofílicas de material compatível com dentinóide. O relato de caso apresentou perfil clínico de COC, que pode ser confundido com outras lesões císticas ou tumorais, sendo essencial diagnóstico por meio de análise histopatológica. A abordagem cirúrgica proporcionou diagnóstico e tratamento. Após acompanhamento clínico e radiográfico, não houve recorrência do COC.