Pigmented Adenomatoid Odontogenic Tumor with Areas of Calcifying Epithelial Odontogenic Tumor: a Case Report

Abstract

Adenomatoid odontogenic tumor (AOT) is a benign epithelial odontogenic tumor characterized by the presence of different-sized solid nodules of epithelial cells, forming nests, rosette-like structures, and duct-like spaces, composed of odontogenic epithelium, embedded in a mature connective tissue stroma. Microscopically, AOT is generally surrounded by a well-developed fibrous capsule and eventually shows melanin pigmentation of both tissue and stroma cells. AOT may show areas resembling calcifying epithelial odontogenic tumor (CEOT), which may be considered a histologic variant of AOT, thus misleading the final diagnosis and affecting treatment and prognosis. The aim of this study was to report the case of a patient referred to an oral and maxillofacial surgeon for facial asymmetry associated with a radiographic lytic lesion in the mandibular third molar region. After the initial surgical procedure, the histologic diagnosis was pigmented AOT with CEOT areas. The patient is under close follow-up, awaiting an enucleation surgical procedure.