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Carvalho LDJ, Guimarães DM, Souza ATP, Balbinot KM, Kataoka MSDS, Alves Junior SDM, Nunes FD, da Silva MJCN, Pinheiro JDJV. Immunohistochemical Evaluation of p300, H2AacK5 and H3AcK27 in Odontogenic Cysts and Tumors. Oral Dis 2024. [PMID: 39435631 DOI: 10.1111/odi.15164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 09/10/2024] [Accepted: 10/07/2024] [Indexed: 10/23/2024]
Abstract
The acetylation of histones H2A on lysine 5 (H2AacK5) and H3 on lysine 27 (H3AcK27) modulate several cellular mechanisms through the p300 enzyme in pathological lesions; however, their role in odontogenic lesions has not been addressed. This study aims to evaluate the immunoexpression of p300, H2AacK5, and H3AcK27 in samples of ameloblastoma (AMB) (n = 30), odontogenic keratocyst (OK) (n = 15), adenomatoid odontogenic tumor (AOT) (n = 10), odontogenic fibroma (OF) (n = 8), calcifying odontogenic cyst (COC) (n = 8), odontogenic myxoma (MIX) (n = 10), and ameloblastic fibroma (AF) (n = 06). The percentage of p300-positive cells was higher in AOT and decreased in COC, OK, AMB, AF, OF, and MIX. H2AacK5-positive cells were higher in AF and decreased in AOT, COC, OK, OF, AMB, and MIX, whereas H3acK27-positive cells were higher in AOT and decreased in COC, OK, AF, OF, AMB, and MIX. The expression of these proteins was higher in nonaggressive lesions in comparison to aggressive lesions. There was a positive correlation between p300 and H2AacK5, and H3acK27 in AMB, MIX, and OF, whereas there was a positive correlation between p300 and H2AacK5 in AOT and COC. The histone acetylation may be involved in the biological behavior of these lesions, which could be used to improve their diagnosis and treatment.
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Affiliation(s)
- Luciane De Jesus Carvalho
- Laboratory of Pathological Anatomy and Immunohistochemistry, School of Dentistry, Federal University of Pará, Belém, Brazil
| | | | | | - Karolyny Martins Balbinot
- Laboratory of Pathological Anatomy and Immunohistochemistry, School of Dentistry, Federal University of Pará, Belém, Brazil
| | | | - Sérgio de Melo Alves Junior
- Laboratory of Pathological Anatomy and Immunohistochemistry, School of Dentistry, Federal University of Pará, Belém, Brazil
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Dudde F, Barbarewicz F, Bergmann W, Knyphausen AZ, Henkel KO. Large Complex Odontoma in the Angulus Mandibulae - Intraoral Enucleation as an Alternative to Mandibular Continuity Resection. In Vivo 2024; 38:2535-2539. [PMID: 39187347 PMCID: PMC11363799 DOI: 10.21873/invivo.13726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 05/30/2024] [Accepted: 05/31/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Odontomas are among the most common odontogenic tumors and are generally considered as hamartomatous odontogenic lesions. These tumors can be histopathologically divided into complex odontomas and compound odontomas based on their composition. Odontomas show a slow growing behavior and typically lack characteristic symptoms. The standard surgical treatment for large odontogenic tumors is a mandibular (continuity) resection followed by primary or secondary plastic reconstruction. CASE REPORT A 22-year-old male presented to the Department of maxillofacial surgery with an increasing feeling of pressure in the left mandible. An orthopantomogram revealed a large complex odontoma rg 038. Instead of mandible continuity resection an alternative minimally invasive technique/approach (intraoral) with a trapezoidal bone flap for the enucleation of an odontoma of the mandibular angle with subsequent flap reimplantation and osteosynthesis was performed. CONCLUSION Surgical enucleation of large mandibular odontoma with a continuity resection through an extraoral approach represents the surgical standard treatment of this entity. The present case report describes an alternative minimally invasive technique/approach. This technique may reduce surgical risks of the continuity resection through an extraoral approach (nerve damage, scarring) and can improve the long-term stability of the mandible by bone preservation.
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Affiliation(s)
- Florian Dudde
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Hamburg, Germany;
| | - Filip Barbarewicz
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Hamburg, Germany
| | - Wilken Bergmann
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Hamburg, Germany
| | | | - Kai-Olaf Henkel
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Hamburg, Germany
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Escobar E, Gómez-Valenzuela F, Peñafiel C, Ortega-Pinto A. Odontogenic tumours in a Chilean population: a retrospective study of 544 cases based on 2022 WHO classification. Med Oral Patol Oral Cir Bucal 2023; 28:e596-e606. [PMID: 37823289 PMCID: PMC10635623 DOI: 10.4317/medoral.26008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 09/18/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Odontogenic tumours are infrequent lesions. Studies on the frequency of odontogenic tumours from Latin America are scarce. This work aimed to determine the relative frequency of odontogenic tumours in a Chilean population using the 2022 World Health Organization classification. MATERIAL AND METHODS This is a case series retrospective study. We reviewed 35,530 samples from 1975 to 2022 from the Oral Pathology Referral Institute and the Pathological Anatomy Service, Faculty of Dentistry, University of Chile. We utilized the 2022 World Health Organization classification for histological typification. RESULTS According to 2022 World Health Organization classification, 544 odontogenic tumours were confirmed. The most frequent odontogenic tumours were: odontoma (n=241; 44.3%), ameloblastoma (n=109; 20.0%) and cemento-ossifying fibroma (n=71; 13.1%). Benign odontogenic tumours corresponded to 538 cases (98.9%) and malignant tumours were only six cases (1.1%). CONCLUSIONS In our population, odontoma was the most frequent odontogenic tumour followed by ameloblastoma and cemento-ossifying fibroma. Malignant odontogenic tumours were very rare. The results of this study are similar to reports from America, but there are some differences concerning the data from Africa and Asia.
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Affiliation(s)
- E Escobar
- Department of Oral Pathology and Medicine Faculty of Dentistry, University of Chile Olivos 943, Independencia, Santiago Postal Code: 8380544, Chile
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Pereira T, Shetty SJ, Punjabi V, Vidhale RG, Gotmare SS, Kamath P. Immunohistochemical expression of SOX2 in OKC and ameloblastoma: A comparative study. J Oral Maxillofac Pathol 2023; 27:685-692. [PMID: 38304494 PMCID: PMC10829463 DOI: 10.4103/jomfp.jomfp_265_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/28/2023] [Accepted: 09/01/2023] [Indexed: 02/03/2024] Open
Abstract
Introduction Odontogenic, non-inflammatory maxillofacial cysts and tumours vary greatly in their ability to grow and cause local tissue destruction. Despite their common embryologic origin, the biologic mechanisms responsible for this diverse array of clinical behaviour are largely unknown. Unfortunately, even with accurate tissue diagnosis and appropriate surgical management, these tumours have relatively high recurrence rates. While this may be related to surgical technique, it may also be due to intrinsic tumour biology. SOX2 is differentially expressed in odontogenic cysts and tumours, which has an impact over patient prognosis. This could be related to their diverse cells of origin or stages of histogenesis. SOX2 is expressed in OKC and ameloblastoma, and in this study, we look forward to find altered levels and intensity of SOX2 in the above-mentioned lesions. Aim and Objectives To profile the expression of SOX2 in odontogenic keratocyst (OKC) and ameloblastomaTo compare the intensity of these lesions, analyse their intrinsic feature and predict their recurrence. Material and Methods Histopathologically diagnosed cases of OKC and ameloblastoma will be selected (n = 40). Paraffin-embedded, formalin-fixed sections of these lesions will be stained for SOX2 marker using a standard immunohistochemical technique. Positive control will be taken as oral squamous cell carcinoma and negative control will be taken as normal oral mucosa. Results A comparison between the stained cell types in odontogenic keratocyst and ameloblastoma revealed statistically significant differences. The immunoreactivity scores of SOX2 were analysed in both groups. The results indicated that 45% of OKC cases exhibited strongly positive reactivity, while 65% of ameloblastoma cases were negative. Statistical analysis demonstrated highly significant differences in the frequency of SOX2 expression between the two groups, with a higher frequency of negative expression in ameloblastoma. Conclusion Stem cell markers have been observed in these lesions, suggesting the acquisition of stem-like properties by tumour cells, which can affect patient prognosis. Specifically, the marker SOX2 shows differential expression in odontogenic cysts and tumours. High expression of SOX2 in OKC indicates the presence of stem cells with significant self-renewal and proliferative properties, potentially signifying neoplastic behaviour. In contrast, weak or absent expression of SOX2 in ameloblastoma suggests different molecular pathways involved in its neoplastic behaviour.
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Affiliation(s)
- Treville Pereira
- Department of Oral and Maxillofacial Pathology, D.Y. Patil University, School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Subraj J. Shetty
- Department of Oral and Maxillofacial Pathology, D.Y. Patil University, School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Vishal Punjabi
- Department of Oral and Maxillofacial Pathology, D.Y. Patil University, School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Rutuja G. Vidhale
- Department of Oral and Maxillofacial Pathology, D.Y. Patil University, School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Swati S. Gotmare
- Department of Oral and Maxillofacial Pathology, D.Y. Patil University, School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Pooja Kamath
- Department of Oral and Maxillofacial Pathology, D.Y. Patil University, School of Dentistry, Navi Mumbai, Maharashtra, India
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Nguyen DK, Van Huynh D. Clinical and radiological characteristics of odontomas: A retrospective study of 90 cases. Imaging Sci Dent 2023; 53:117-126. [PMID: 37405206 PMCID: PMC10315233 DOI: 10.5624/isd.20220184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/25/2023] [Accepted: 01/28/2023] [Indexed: 11/25/2023] Open
Abstract
PURPOSE Odontomas represent a common clinical entity among odontogenic tumors, but are not well-addressed in the Vietnamese population. The present study aimed to determine the clinical and preclinical characteristics of odontomas and associated factors in the Vietnamese population. MATERIALS AND METHODS This retrospective study retrieved data from histopathological diagnoses from 2 central hospitals of Odonto-Stomatology in Ho Chi Minh City, Vietnam during 2004-2017. The odontomas were classified as complex (CxOD) or compound (CpOD) subtypes. The epidemiological, clinical, and radiological characteristics of the odontomas, stratified by subtype and sex, were obtained and analyzed. RESULTS Ninety cases, consisting of 46 CxODs and 44 CpODs, were included. The average age of patients was 32.4 (±20.2) years. The patients with CxOD were older than those with CpOD (P<0.05). Clinically, 67% of patients showed an intraoral bone expansion. Approximately 60% of patients with CxOD exhibited a painful symptom, about 3-fold more than those with CpOD (P<0.05), whereas almost all patients with CpOD exhibited perturbations of dentition, unlike those with CxOD (P<0.05). Radiologically, CxOD was characterized by a larger dimension than CpOD in both sexes (P<0.05), and CpOD induced complications in adjacent teeth more often than CxOD (P<0.05). The development of odontoma with advancing age differed significantly in odontoma subtypes related to their pathological origins, and between the sexes, resulting from different physiological states. CONCLUSION The findings of this study highlight the value of clinical and radiological features of odontomas and their associated factors for the early diagnosis and adequate treatment of younger patients.
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Affiliation(s)
- Dung Kim Nguyen
- U1059 INSERM - SAINBIOSE (SAnté INgéniérie BIOlogie St-Etienne), Campus Santé Innovation, Université Jean Monnet, Saint-Priest-en-Jarez, France
| | - Duong Van Huynh
- Department of Maxillofacial Surgery, National Hospital of Odonto-Stomatology, Ho Chi Minh, Vietnam
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Agrawal R, Chandra A, Singh J, Khairnar MR, Jain T, Raja D, Tumpuri S, Naveen Kumar PG. Patterns of Oral and Maxillofacial Lesions in Eastern Uttar Pradesh Region: A Retrospective Study. J Maxillofac Oral Surg 2022. [DOI: 10.1007/s12663-022-01736-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Ismail A, Boujguenna I, Hattab K, Mansouri N, El Ganouni NCI, Idrissi MO, Hazmiri FE, Rais H. A cartilage-forming tumor of the mandibular angle: a case report. J Med Case Rep 2022; 16:176. [PMID: 35484609 PMCID: PMC9047383 DOI: 10.1186/s13256-022-03359-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mandible can be the site of benign or malignant lesions of different origins, including odontogenic and non-odontogenic lesions. Cartilage-forming tumors have been rarely reported at this site. Chondrosarcoma is a rare malignant cartilage-producing neoplasm that is extremely rare in the mandible. The rarity of cartilage-forming tumor occurrence in the mandible can make diagnosis difficult for pathologists, as they do not expect this type of tumor at this anatomical site. Here we report a case of chondrosarcoma of mandibular angle. CASE PRESENTATION A 70-year-old Moroccan male patient consulted a dentist for wisdom tooth pain. Wisdom tooth extraction was conducted. After 6 months, the patient reported the recurrence of pain associated with swelling in the mandibular area and paresthesia along the path of the mandibular nerve. A panoramic radiograph demonstrated a mixed radiolucent-opaque lesion involving the mandibular angle. Computed tomography showed a large osteolytic spontaneously hypointense and multilobulated lesion. A biopsy was done. Histopathological examination revealed sheets and irregular lobules of atypical cells presenting cartilaginous differentiation. Tumor cells showed severe nuclear atypia and were located within a hyaline cartilage matrix. Some foci of necrosis were noted. Osteoid deposits were not found. The patient was diagnosed with grade III chondrosarcoma and underwent a right segmental mandibulectomy with submandibular lymph node dissection. Macroscopically, the tumor was localized in the mandibular angle with extension in the mandibular body. Histopathology confirmed the previous diagnosis of grade III chondrosarcoma and did not show any lymph node metastasis. CONCLUSIONS Owing to many histological similarities, grade III chondrosarcoma must be distinguished from chondroblastic osteosarcoma and metastatic lesions. In addition, chondroblastic osteosarcoma of the jawbones has a worse prognosis than chondrosarcoma, making the distinction between these two malignant tumors the most important concern of the pathologist when dealing with a cartilage-forming tumor at this site. Surgery with wide excision margins remains the best therapeutic approach, while the role of radiotherapy is controversial. The management of mandibular chondrosarcoma requires a multidisciplinary approach involving maxillofacial surgeons, radiologists, pathologists, and oncologists.
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Affiliation(s)
- Ayman Ismail
- Department of Pathology and Biopathology Unit, Clinical Research Center, MOHAMMED VI University Hospital of Marrakech, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University of Marrakech, Marrakech, Morocco.
| | - Imane Boujguenna
- Department of Pathology and Biopathology Unit, Clinical Research Center, MOHAMMED VI University Hospital of Marrakech, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University of Marrakech, Marrakech, Morocco
| | - Koussay Hattab
- Department of Oral and Maxillofacial surgery, MOHAMMED VI University Hospital of Marrakech, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University of Marrakech, Marrakech, Morocco
| | - Nadia Mansouri
- Department of Oral and Maxillofacial surgery, MOHAMMED VI University Hospital of Marrakech, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University of Marrakech, Marrakech, Morocco
| | - Najat Cherif Idrissi El Ganouni
- Department of Radiology, MOHAMMED VI University Hospital of Marrakech, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University of Marrakech, Marrakech, Morocco
| | - Mariem Ouali Idrissi
- Department of Radiology, MOHAMMED VI University Hospital of Marrakech, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University of Marrakech, Marrakech, Morocco
| | - Fatima Ezzahra Hazmiri
- Laboratory of Histology and Embryology, Department of Preclinical Science, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University of Marrakech, Marrakech, Morocco
| | - Hanane Rais
- Department of Pathology and Biopathology Unit, Clinical Research Center, MOHAMMED VI University Hospital of Marrakech, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University of Marrakech, Marrakech, Morocco
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Farshbaf A, Zare R, Mohajertehran F, Mohtasham N. New diagnostic molecular markers and biomarkers in odontogenic tumors. Mol Biol Rep 2021; 48:3617-3628. [PMID: 33822294 PMCID: PMC8021934 DOI: 10.1007/s11033-021-06286-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 03/11/2021] [Indexed: 10/26/2022]
Abstract
Odontogenic tumors comprised of complex heterogeneous lesions that diverse from harmatomas to malignant tumors with different behavior and histology. The etiology of odontogenic tumors is not exactly determined and pathologists deal with challenges in diagnosis of odontogenic tumors because they are rare and obtained experiences are difficult to evaluate. In this study, we describe immunohistochemical and molecular markers in diagnosis of odontogenic tumors besides advanced diagnostic technique. Immunohistochemical features of odontogenic tumors beside the clinical features and radiological finding can help us to determine the correct diagnosis. Although these markers are neither specific nor sensitive enough, but analysis of gene expression provides definitive confirmation of diagnosis. In addition, "-omics" technology detected specific molecular alternation associated with etiology such as genomics, epigenomics, transcriptomics, proteomics and metabolomics. The post transcriptional events such as DNA methylation and chromatin remodeling by histone modification affect the changes in epigenome. Furthermore, non-coding RNAs like micro-RNAs, long noncoding RNA (lncRNA) and small non-coding RNA (snoRNA) play regulatory role and impact odontogenesis. Molecular marker propose their potential role in etiopathogenesis of odontogenic tumors and suitable candidate in diagnostic, prognostic and therapeutic approaches in addition to patient management. For future evaluations, organoid represents in vitro tumor model-study for tumor behavior, metastasis and invasion, drug screening, immunotherapy, clinical trial, hallmarks association with prognosis and evolution of personalized anti-cancer therapy. Moreover, organoid biobank help us to check genetic profile. We think more investigation and studies are needed to gain these knowledges that can shift therapeutic approaches to target therapy.
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Affiliation(s)
- Alieh Farshbaf
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Oral and Maxillofacial Pathology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Zare
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farnaz Mohajertehran
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Oral and Maxillofacial Pathology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.,Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nooshin Mohtasham
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Sathasivam HP, Saw CL, Lau SH. Clinico-pathological study of malignant odontogenic tumours from a national referral centre. BMC Oral Health 2021; 21:129. [PMID: 33736630 PMCID: PMC7977582 DOI: 10.1186/s12903-020-01365-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 12/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malignant odontogenic tumours are extremely rare tumours occurring within the jaws. Our study was performed to determine the demographic and clinico-pathological features of malignant odontogenic tumours amongst a multi-ethnic Asian population. METHODS This was a retrospective cross-sectional study of malignant odontogenic tumours diagnosed at the Institute for Medical Research, Malaysia, from 2009 to 2019. All cases were independently reviewed and reclassified following the criteria set out in the latest edition of the World Health Organization 2017 reference text. Demographic and clinico-pathological data were recorded for each case. RESULTS Twenty-four cases of malignant odontogenic tumours were identified. The patients' age ranged from 16 to 79 years with the mean age at diagnosis being 50.8 years (SD = 16.18). There was a male predominance (66.7%) in this cohort of patients. The ethnic distribution appeared to reflect the Malaysian population with most cases seen amongst the Malay ethnic group (66.7%). Ameloblastic carcinoma was the most frequently diagnosed malignant odontogenic tumour (45.8%) and was also predominantly seen in males (90.9%). All patients with clear cell odontogenic carcinoma were females. There was no obvious sex predilection in primary odontogenic carcinoma not otherwise specified (NOS). The mandible (79.2%) was more frequently involved compared to the maxilla. CONCLUSIONS Diagnosis and management of malignant odontogenic tumours are challenging due to the rarity of these tumours. Our study has elucidated the clinico-pathological features of malignant odontogenic tumours seen in a multi-ethnic Asian population.
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Affiliation(s)
- Hans Prakash Sathasivam
- Cancer Research Centre, Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Setia Alam, Malaysia.
| | - Chee Lynn Saw
- Penang Health Services, Ministry of Health Malaysia, Georgetown, Malaysia
| | - Shin Hin Lau
- Cancer Research Centre, Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Setia Alam, Malaysia
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Odontogenic Myxoma: A 23-Year Retrospective Series of 38 Cases. Head Neck Pathol 2020; 14:1021-1027. [PMID: 32506377 PMCID: PMC7669973 DOI: 10.1007/s12105-020-01191-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 01/11/2023]
Abstract
Odontogenic myxoma (OM) is an uncommon benign odontogenic tumor arising in the jaw. Though it has slight histologic overlap with other entities, definitive diagnosis is imperative considering the tumor's aggressive nature, high recurrence rate, and necessity of radical surgical intervention in large-sized lesions. With IRB approval, a retrospective search of the University of Florida College of Dentistry Oral Pathology Biopsy Service archives from 1994 to 2017 for diagnosis of OM of the jaw was performed. Biopsy reports and original slides for each case were assessed and reviewed along with any accompanying radiographs to confirm the diagnosis. Immunohistochemical staining was utilized to exclude entities with histologic overlaps, such as intraosseous myxoid neurofibroma. A total of 38 cases were included. The patients' age ranged from 6 to 84 years, with a mean age of 37.47 years. Females comprised two-thirds of the cases (n = 25) versus males (n = 13). The mandible was the most affected at 60.5% (n = 23), followed by maxilla 39.4% (n = 15). Posterior jaw involvement was higher than anterior in both the mandible (n = 20 versus n = 3) and the maxilla (n = 11 versus n = 4). Most lesions presented clinically as expansile masses with variable radiographic appearance. The clinical impression from submitting providers included "gelatinous masses", abscesses, odontogenic lesions, fibro-osseous lesions, soft tissue or bone neoplasms, and reactive gingival lesions. A consensus of odontogenic myxoma as a diagnosis was rendered for 30 cases (79%), while in 8 cases (21%) that exhibited a more fibrous stroma was identified as fibromyxoma. OM may exhibit a varied demographic and clinical profile with a wide spectrum of histologic presentations. Pathologists should be sentient of this variability in order to arrive at an accurate diagnosis and correctly manage these patients.
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Flores Orozco EI, Abu Hasna A, Teotonio de Santos Junior M, Flores Orozco EI, Falchete Do Prado R, Rocha Campos G, Carneiro Valera M. Case Report: Interdisciplinary management of a complex odontoma with a periapical involvement of superior anterior teeth. F1000Res 2019; 8:1531. [PMID: 31824665 PMCID: PMC6880268 DOI: 10.12688/f1000research.20337.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2019] [Indexed: 11/20/2022] Open
Abstract
This case report aims to describe the management of a complex odontoma with endodontic involvement of surrounding teeth utilizing a new bioceramic cement consisting of five mineral oxides (5MO) as a retro-filling material. The patient presented for routine consultation with slight dental mobility in the antero-superior region. Upon clinical and computed tomography examination, bone rarefaction was observed in the apical region of teeth 11 and 12, external root resorption in the involved teeth and necrotic pulp of tooth 12. Root canal treatment was performed in teeth 11 and 12. Later, local surgical excision of the lesion was carried out, finding a mass with clinical features of complex odontoma, with histopathological examination of the mass confirming this diagnosis. Retro-filling of tooth 12 with 5MO was carried out. No signs and symptoms were observed over twelve-months of follow-up, with bone neoformation observed in the region. Therefore, 5MO appears to be an effective bioceramic cement that has reparative features.
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Affiliation(s)
- Esteban Isaí Flores Orozco
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245-000, Brazil
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245-000, Brazil
| | - Moacir Teotonio de Santos Junior
- Department of Science and Technology Applied to Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245-000, Brazil
| | - Elan Ignacio Flores Orozco
- Department of Prosthodontics, Faculty of Dentistry, Autonomous University of Nayarit, Tepic, Nayarit, 63155, Mexico
| | - Renata Falchete Do Prado
- Department of Social Dentistry and Children's Clinic, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245-000, Brazil
| | - Gabriel Rocha Campos
- Faculty of Medicine and Dentistry, São Leopoldo Mandic, São Paulo, 01332-000, Brazil
| | - Marcia Carneiro Valera
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245-000, Brazil
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Surgical management of a large calcifying epithelial odontogenic tumor in the maxilla: A case report. Int J Surg Case Rep 2019; 57:197-200. [PMID: 30981981 PMCID: PMC6463812 DOI: 10.1016/j.ijscr.2019.03.055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/23/2019] [Accepted: 03/25/2019] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The calcifying epithelial odontogenic tumor (CEOT), also known as Pindborg tumor, is a locally invasive benign neoplasm. Histogenesis is controversial. PRESENTATION OF CASE A 26-year-old male presented asymptomatic swelling on the right side of the face, with approximately six months of evolution. At intraoral examination, a hard nodule localized in the right posterior region of the maxilla, measuring approximately 5.0 x 3.0 cm was observed. The computed tomography images showed hypodense lesion with points of calcification associated with two non-erupted teeth. We suspect of odontogenic lesions. The final diagnosis of CEOT was established based on the histopathological aspects. DISCUSSION This tumor is more frequent in adult men, usually develops in the posterior region of the mandible and may present clinical-pathological similarities with others odontogenic lesions. The radiological aspects observed in the CEOT are variable and depend on the time of evolution of the tumor. The histopathological examination is mandatory to establish the final diagnosis. CONCLUSION Our case was treated with simple enucleation without signs of recurrence in five years of follow-up. Further studies are needed to understand the aetiology and the biological behaviour of this tumor.
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