Bilateral Squamous Odontogenic Tumor: Presentation of 2 Cases and a Review of the Literature

Abstract

Squamous odontogenic tumor (SOT)is a rare odontogenic lesion first described in 1975. It has been classified by the WHO as an epithelial odontogenic tumor. While that classification has been widely accepted, some considered the lesion to be hamartomatous in nature. Others have disputed the diagnosis of many of the cases in the literature and claim they have been confused with other tumors with similar histologic features such as desmoplastic ameloblas- tomas, acanthomatous ameloblastoma1 and "SOT-like" islands in the walls of odontogenic cysts. SOTs are usually found in the fourth decade and are typically solitary, intraosseous lesions. However, peripheral lesions and multi- focal cases of SOT have been described. Multifocal cases differ from the more common solitary presentation in that they usually occur in younger patients and are found more commonly in African American males. As of 2017, 8 cases of multifocal SOT have been reported, only 1 of which was reported as exclusively bilateral maxillary lesions and 6 of which had bilateral lesions as well as additional foci of tumor. Here we present two additional cases of bilateral SOTs of the mandible in young adult males. CD56 staining, which has been reported to highlight the basal cell layer in ameloblastomas, was performed on one case to further differentiate the SOT from an acanthomatous ameloblastoma. Due to the nonspecific radiographic features of SOT and their ability to mimic bilateral dentigerous cysts or other neoplastic processes, clinicians should have an increased awareness of the entity and submit tissue associated with impacted teeth.