Clinico-Pathological Presentations of Cystic and Classic Adenomatoid Odontogenic Tumors.

Primali Rukmal Jayasooriya,Tommaso Lombardi,Inoka Krishanthi Rambukewella,Wanninayake Mudiyanselage Tilakaratne,Balapuwaduge Ranjit Rigobert Nihal Mendis

doi:10.3390/diagnostics10010003

Primali Rukmal Jayasooriya, Tommaso Lombardi + Show 3 more

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https://doi.org/10.3390/diagnostics10010003

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Abstract

The objective of the study is to present the clinico-pathological features of cystic and classic adenomatoid odontogenic tumors (AOTs) in order to identify the differences between the two variants of AOT. Materials and method: The study sample comprised of 41 AOTs, which were categorized into cystic and classic AOTs. Cystic AOTs are diagnosed as such when macroscopic and microscopic evidence of a cyst is present together with histopathological criteria of AOT (WHO–2017). Results: The study sample comprised of eleven cystic and thirty classic AOTs. Eight cystic AOTs were regarded as arising from dentigerous cysts as these lesions were attached to the cemento-enamel junction of the impacted teeth. Though not statistically significant, in contrast to classic AOTs which showed female predilection, cystic AOTs were more prevalent in males. Cystic AOTs tend to present as significantly larger lesions compared to classic AOTs (p < 0.02). In both cystic and classic AOTs, duct-like structures and epithelial whorls were the two most prominent histopathological features present in the majority of tumors. Two AOTs with massive amounts of dentinoid occurred in the mandible and presented as large lesions that eroded cortical bone. None of the 12 patients with follow-up information presented with recurrences. Conclusion: Except for the size of the lesion, no significant clinico-pathological differences were observed between cystic and classic AOTs. Therefore the cystic AOTs can be considered as a variant of AOT with enucleation, simple excision, or radical excision as the treatment of choice depending on the extent of the lesion, similar to classic AOTs.

Highlights

Adenomatoid odontogenic tumor (AOT) is defined as a lesion composed of odontogenic epithelium arranged into a variety of histo-architectural patterns and embedded in mature connective tissue [1]. the 2005 WHO blue book on “Pathology and Genetics of Head and Neck Tumours” [1]classifies adenomatoid odontogenic tumors (AOTs) under the first category containing “tumors composed of odontogenic epithelium only”, the prior WHO classification [2] included the lesion in the second category of “tumors containing both odontogenic epithelium as well as ectomesenchyme with or without dental hard tissues”
AOT [2], detailed analyses of these lesions did not take place until recently [5,6]. Another supported by the fact that cystic presentation has been mentioned in the previous WHO definitions reason for the current interest in the AOT is due to the recent publications that deal with cystic of AOT [2], detailed analyses of these lesions did not take place until recently [5,6]
Method study and sample comprised 41 AOTs diagnosed over a 14 year period from 1999–2013 at the Dept

Summary

Introduction

Adenomatoid odontogenic tumor (AOT) is defined as a lesion composed of odontogenic epithelium arranged into a variety of histo-architectural patterns and embedded in mature connective tissue [1]. the 2005 WHO blue book on “Pathology and Genetics of Head and Neck Tumours” [1]classifies AOT under the first category containing “tumors composed of odontogenic epithelium only”, the prior WHO classification [2] included the lesion in the second category of “tumors containing both odontogenic epithelium as well as ectomesenchyme with or without dental hard tissues”. Dental matrix material in the form of enameloid and dentinoid present in some AOTs was considered to be a metaplastic change and not true inductive change [1,3]. 2 ofa inductive change [3], and discussions took place to shift AOTs with inductive changes to the second. Though in the field consider thecategory, secretoryno activity the AOT to enameloid category leaving the experts remaining lesions in the first such of change hasleading been made in the most and dentinoid formation as a true inductive change [3], and discussions took place to shift. AOT the early years change has been made in the most recent edition of the WHO classification released in 2017 [4].

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