Adenomatoid Odontogenic Tumor Research Articles

Immunohistochemical Evaluation of p300, H2AacK5 and H3AcK27 in Odontogenic Cysts and Tumors.

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.

A Rare Case: Adenomatoid Odontogenic Tumor Mimicking Follicular Cyst in a Young Patient

The objective of this study is to present an uncommon case of adenomatoid odontogenic tumor (AOT) with an impacted maxillary canine, initially mimicking a follicular cyst. AOT is a rare odontogenic tumor, accounting for approximately 1% to 9% of all odontogenic tumors. It primarily occurs in the maxilla and is often associated with an unerupted permanent tooth. Follicular cysts, also known as dentigerous cysts, are benign odontogenic cysts that encase the crown of an unerupted or impacted tooth. We describe a case of AOT occurring in a 14-year-old male. Both the follicular cyst and adenomatoid odontogenic tumor (AOT) can exhibit similar clinical and radiographic presentations. It is crucial to accurately differentiate between the two to ensure appropriate treatment and prognosis.

Extrafollicular adenomatoid odontogenic tumor of mandible: A case with an unusual histology

Extrafollicular adenomatoid odontogenic tumor of mandible: A case with an unusual histology

Conservative enucleation for physiologic space closure in adenomatoid odontogenic tumor.

Adenomatoid odontogenic tumor (AOT) is a rare, asymptomatic, slow-growing benign tumor that can be divided into three variants: follicular, extrafollicular, and peripheral. By treating AOT using an enucleation and curettage approach, recurrence can be avoided. We report a case of a 24-year-old female who presented with a lump in the right mandibular premolar area along with diastema between displaced teeth #43 and #44 and was diagnosed with extrafollicular AOT. The patient was managed with enucleation-curettage surgery without additional bone graft procedure along with routine follow-up. A successful outcome without recurrence was achieved, and diastema closure with repositioning of the displaced teeth did not require orthodontic treatment. AOT should be managed via enucleation and curettage to obtain successful outcomes without recurrence. Spontaneous bone regeneration following enucleation can be achieved without guided bone regeneration. Also, diastema closure and repositioning of displaced teeth can occur without orthodontic interventions through physiologic drift.

Expression of Fascin and SALL4 in odontogenic cysts and tumors: an immunohistochemical appraisal.

Background Various stemness markers (SOX2, OCT4, and NANOG) have been studied in odontogenic cysts and tumors. However, studies on SALL4 having similar properties of stemness has not been documented. Additionally, insight into fascin as a migratory molecule is less explored. In this study, the expression of SALL4 and fascin were evaluated in ameloblastoma, adenomatoid odontogenic tumor (AOT), odontogenic keratocyst (OKC), dentigerous cyst (DC), radicular cyst (RC), and calcifying odontogenic cyst (COC). Methods Semi-quantitative analysis of fascin and SALL4 immuno-positive cells was done in a total of 40 cases of ameloblastoma (11 plexiform, 12 follicular, 12 unicystic, and 5 desmoplastic) variants, 6 cases of AOT, 15 each of OKC, DC, RC and 5 of COC. Chi-square test was applied to evaluate the association between SALL4 and fascin expression in odontogenic cysts and tumors. Results Fascin immunopositivity was observed in peripheral ameloblast-like cells, and the expression was weak or absent in stellate reticulum-like cells. A moderate to weak immune-reactivity to SALL4 was observed in the cytoplasm of ameloblastoma, epithelial cells of dentigerous and radicular cysts, having a marked inflammatory infiltrate, which was an interesting observation. COC and AOT had negative to weak expressions. No recurrence has been reported. Conclusions Expression of fascin in ameloblastomas elucidate their role in motility and localized invasion. Its expression in less aggressive lesions like DC, COC, AOT will incite to explore the other functional properties of fascin. SALL4 expression in the cytoplasm of odontogenic cysts and tumors may represent inactive or mutant forms which requires further validation.

The evolving molecular characterisation, histological criteria and nomenclature of adenoid ameloblastoma as a World Health Organisation tumour type

Adenoid ameloblastoma (AA) was recently recognised as a separate tumour type in the most recent World Health Organisation (WHO) classification of head and neck tumours. This decision has been considered controversial by several groups, who have described AA as a subtype of ameloblastoma, a hybrid odontogenic tumour or to fall within the spectrum of other recognised odontogenic tumours, including dentinogenic ghost cell tumour and adenomatoid odontogenic tumour. Here we review the reasons for the WHO decision to classify AA as a separate tumour type. We also critique molecular and histological findings from recent reports published since the WHO classification. While acknowledging that the classification of tumours is constantly evolving, the balance of current evidence suggests that AA should remain a distinct tumour type, and not a subtype of ameloblastoma, pending further molecular characterisation.

Recurrent Adenomatoid Odontogenic Tumour in the Mandible: Report of a Case

Recurrent Adenomatoid Odontogenic Tumour in the Mandible: Report of a Case

Expression of Fascin and SALL4 in odontogenic cysts and tumors: an immunohistochemical appraisal.

Background Various stemness markers (SOX2, OCT4, and NANOG) have been studied in odontogenic cysts and tumors. However, studies on SALL4 having similar properties of stemness has not been documented. Additionally, insight into fascin as a migratory molecule is less explored. In this study, the expression of SALL4 and fascin were evaluated in ameloblastoma, adenomatoid odontogenic tumor (AOT), odontogenic keratocyst (OKC), dentigerous cyst (DC), radicular cyst (RC), and calcifying odontogenic cyst (COC). Methods Semi-quantitative analysis of fascin and SALL4 immuno-positive cells was done in a total of 40 cases of ameloblastoma (11 plexiform, 12 follicular, 12 unicystic, and 5 desmoplastic) variants, 6 cases of AOT, 15 each of OKC, DC, RC and 5 of COC. Chi-square test was applied to evaluate the association between SALL4 and fascin expression in odontogenic cysts and tumors. Results Fascin immunopositivity was observed in peripheral ameloblast-like cells, and the expression was weak or absent in stellate reticulum-like cells. A moderate to weak immune-reactivity to SALL4 was observed in the cytoplasm of ameloblastoma, epithelial cells of dentigerous and radicular cysts, having a marked inflammatory infiltrate, which was an interesting observation. COC and AOT had negative to weak expressions. No recurrence has been reported. Conclusions Expression of fascin in ameloblastomas elucidate their role in motility and localized invasion. Its expression in less aggressive lesions like DC, COC, AOT will incite to explore the other functional properties of fascin. SALL4 expression in the cytoplasm of odontogenic cysts and tumors may represent inactive or mutant forms which requires further validation.

CLIC4 Function in the Epithelial-Mesenchymal Transition of Epithelial Odontogenic Lesions.

Odontogenic lesions constitute a heterogeneous group of lesions. CLIC4 protein regulates different cellular processes, including epithelial-mesenchymal transition and fibroblast-myofibroblast transdifferentiation. This study analyzed CLIC4, E-cadherin, Vimentin, and α-SMA immunoexpression in epithelial odontogenic lesions that exhibit different biological behavior. It analyzed the immunoexpression of CLIC4, E-cadherin, and Vimentin in the epithelial cells, as well as CLIC4 and α-SMA in the mesenchymal cells, of ameloblastoma (AM) (n = 16), odontogenic keratocyst (OKC) (n = 20), and adenomatoid odontogenic tumor (AOT) (n = 8). Immunoexpressions were categorized as score 0 (0% positive cells), 1 (< 25%), 2 (≥ 25% - < 50%), 3 (≥ 50% - < 75%), or 4 (≥ 75%). Cytoplasmic CLIC4 immunoexpression was higher in AM and AOT (p < 0.001) epithelial cells. Nuclear-cytoplasmic CLIC4 was higher in OKC's epithelial lining (p < 0.001). Membrane (p = 0.012) and membrane-cytoplasmic (p < 0.001) E-cadherin immunoexpression were higher in OKC, while cytoplasmic E-cadherin expression was higher in AM and AOT (p < 0.001). Vimentin immunoexpression was higher in AM and AOT (p < 0.001). Stromal CLIC4 was higher in AM and OKC (p = 0.008). Similarly, α-SMA immunoexpression was higher in AM and OKC (p = 0.037). Correlations in these proteins' immunoexpression were observed in AM and OKC (p < 0.05). CLIC4 seems to regulate the epithelial-mesenchymal transition, modifying E-cadherin and Vimentin expression. In mesenchymal cells, CLIC4 may play a role in fibroblast-myofibroblast transdifferentiation. CLIC4 may be associated with epithelial odontogenic lesions with aggressive biological behavior.

Adenomatoid odontogenic tumor: A histopathologic profile of 43 cases with evidence supporting a mixed odontogenic origin

BackgroundAdenomatoid Odontogenic Tumor (AOT) accounts for 3% of all odontogenic tumors. It has been classified by WHO as an odontogenic tumor of purely epithelial origin. The current study attempts to establish the origin of the tumor along with detailed histopathological and clinicoradiographic analysis of 43 cases of AOT. Material and methodsForty-three cases were reviewed from the departmental archives for demographic data, radiographic features and histological features. Further, histopathological slides were stained with Picrosirius Red (PSR) and observed under polarised light. ResultsA majority of the cases were seen in the anterior jaws (76.7%), and were less than 3 cms (76.7%) in greatest dimension. Equal number of cases were of follicular and extra-follicular location while one was peripheral. Predominantly solid histological pattern was noted in 53.5%. Varied sub-patterns were observed with most cases exhibiting solid nodules and strands of tumor cells. Few cases showed melanin pigmentation. Over a third of cases (37.2%) showed dentigerous cyst like areas and one case each showed features of ossifying fibroma and focal cemento-osseous dysplasia. Tumor droplets, hyaline rings within duct-like structures, dentinoid material and osteodentin showed reddish yellow birefringence when observed under polarised microscopy post PSR staining. ConclusionThis study highlights the diverse histopathological variation of AOT with evidence to reclassify it as a mixed odontogenic tumor based on the polarising microscopic findings with PSR staining.

Large adenomatoid odontogenic tumor: Case report

The adenomatoid odontogenic tumor (AOT) is an uncommon, benign neoplasm of odontogenic epithelial origin, believed to have originated from two remnants of the dental lamina or enamel organ, representing 2-7% of all odontogenic tumors. Clinically, they are slow growing, asymptomatic and rarely exceed 3.0 cm in diameter. TOA presented three different clinicopathological variants without relevant clinical and radiographic differences: intraosseous follicular (associated with dental impaction, generally comprising 70% of the two cases); extra-follicular intraosseous (present between erupted teeth, representing 25% of the two cases); and peripheral (extra-osseous, 5% two cases). The aim of this paper is to report a case of a large and aggressive adenomatoid odontogenic tumor. Patient, male, 13 years old, undergoing direct increase in maxillary volume with evolution of 01 month. Upon physical examination, an increase in volume in the middle third of the face was observed, directly causing facial asymmetry. normal appearance, absence of unit, tooth 13, stable dental occlusion, poor mouth opening, poor oral hygiene. On imaging (face tomography) there was a hypodense image in the maxillary region directly, osteolytic, well circumscribed, with a radiopaque halo, causing expansion of the cortical bones without breaking them, associated with the impacted and included dental unit 13. Enucleation and complete healing of the lesion and associated extraction of unit 13 were performed, with a lesion presenting a fibrous capsule in the non-transoperative period. The patient is being followed up by a team, weeks of recurrence at the moment. In this way, a rapid and aggressive evolution appears, being clinically perceptible and confused with the behavior of an amelolastoma, however, the histopathological diagnosis of TOA was confirmed, although the lesion responded to a conservative surgical technique through enucleation and dressing, presenting a excellent result.

Immunohistochemical analysis of p53 and p63 in selected odontogenic cysts and tumours.

It is a well-recognized fact that abnormal cell proliferation plays a crucial role in the development of odontogenic lesions. p53 is a tumour-suppressor gene which assists in cell cycle regulation and p63 is a homolog of p53 responsible for ectodermal differentiation and maintenance of stratified epithelial progenitor-cell. Analysing the tissue expression of p53 and p63 in odontogenic lesions may provide us with an insight into their potential role in the development of these lesions. The objective is to study the expression of p53 and p63 in selected odontogenic lesions using immunohistochemistry. Formalin-fixed paraffin-embedded tissues of 15 ameloblastomas, 10 adenomatoid odontogenic tumours (AOT), 15 odontogenic keratocysts (OKCs), 10 dentigerous cysts (DCs) along with 10 cases of normal mucosa were retrieved from the departmental archives. These specimens were then subjected to immunohistochemical staining using p53 and p63 oncoproteins. p53 and p63 immune-expression showed mainly intranuclear localization. The mean positivity of p53 in ameloblastoma (59.45%) and OKC (26.38%) was significantly higher than AOT (6.77%) and DC (4%). In contrast, there was no significant difference in the positivity of p63 in between ameloblastoma (77.55%), AOT (69.50%), OKC (76.47%), and DC (50.69%). p53 expression can be correlated with the clinical behaviour of the odontogenic lesions and it can be used as a prognostic marker in odontogenic cysts and tumours. In contrast, p63 expression does not corelate with the biological behaviour of odontogenic lesions.

Imaging Characteristics of Embedded Tooth-Associated Cemento-Osseous Dysplasia by Retrospective Study.

Since there are many differential diagnoses for cemento-osseous dysplasia (COD), it is very difficult for dentists to avoid misdiagnosis. In particular, if COD is related to an embedded tooth, differential diagnosis is difficult. However, there have been no reports on the characteristics of the imaging findings of COD associated with embedded teeth. The aim of the present study was to investigate the occurrence and imaging characteristics of cemento-osseous dysplasia (COD) associated with embedded teeth, in order to appropriately diagnose COD with embedded teeth. The radiographs with or without histological findings of 225 patients with COD were retrospectively analyzed. A retrospective search through the picture archiving and communication system (PACS) of the Division of Oral and Maxillofacial Radiology of Kyushu Dental University Hospital was performed to identify patients with COD between 2011 and 2022. Fifteen COD-associated embedded mandibular third molars were identified in 13 patients. All 13 patients were asymptomatic. On imaging, COD associated with embedded mandibular third molars appeared as masses that included calcifications around the apex of the tooth. On panoramic tomography, COD showed inconspicuous internal calcification similar to that of odontogenic cysts or simple bone cysts, especially in patients with COD only around the mandibular third molar region. Those with prominent calcification resembled cemento-ossifying fibroma, calcifying epithelial odontogenic tumor, calcifying odontogenic cyst, adenomatoid odontogenic tumor, and so on, as categories of masses that include calcifications on panoramic tomography and computed tomography. The current investigation is the first to report and analyze the imaging characteristics of COD associated with embedded teeth. It is important to consider the differences between COD and other cystic lesions on panoramic tomography, and the differences between COD and masses that include calcifications on CT.

Adenomatoid odontogenic tumor in anterior maxilla: A case report

Adenomatoid odontogenic tumor (AOT) is an uncommon benign lesion of odontogenic origin. This tumor mainly affects young individuals in the second decade with a female predilection and is most commonly located in the anterior maxilla, usually associated with an impacted canine tooth. The aim of this report is to discuss the case of a 24-year-old female with AOT in the maxillary incisor region and includes the surgical management of the case.

Expression of Calretinin Expression in Odontogenic Cysts and Odontogenic Tumors – Original Research

ABSTRACT Aim: The present study was conducted for assessing variability in calretinin expression among odontogenic cysts as well as tumor cases. Materials and Methods: Fifteen cases were included in the present research consisting of cases like – dentigerous cyst, odontogenic keratocyst, apical radicular cyst along with tumors like ameloblastoma, ameloblastic carcinoma, adenomatoid odontogenic tumor. Calretinin antibody was used for immunohistochemical staining. The amount of expression of this calretinin was statistically analyzed with the help of Chi-square test where P &lt; 0.05 was considered noteworthy statistically. Results: Most cases of ameloblastomas were highly positive for calretinin expression as compared to other cysts and tumors. Therefore, the correlation of this variation of expression of calretinin was statistically noteworthy (P = 0.00). Conclusion: In this study, we concluded that for ameloblastomas, calretinin can be a specific marker immunohistochemically and can help in identifying the amount of aggressive spread of various odontogenic tumors.

Adenomatoid Odontogenic Tumour of Maxilla: A Case Report

An Adenomatoid Odontogenic Tumor (AOT) isa hamartomatous lesion rather than truly neoplastic and one among the rare tumors of the oral cavity. The adenomatoid odontogenic tumor is treated by surgical enucleation along with the involved tooth. This tumor has the least chance for recurrence and hence it does not require radical excision. The adenomatoid odontogenic tumor is more common in females than males. This paper was a case report on the follicular variant of AOT of anterior maxilla associated with impacted canine and its surgical enucleation in a young male patient.

Adenomatoid odontogenic tumor. Presentation of a clinical case

Adenomatoid odontogenic tumor (ATO) is a rare benign tumor that represents 3% of odontogenic tumors. Originated from remains of the dental lamina or odontogenic epithelium, it occurs in three variants: follicular (73%), extracystic (24%) and intraosseous (3%). The follicular variant is the most common and is usually associated with the crown of an unerupted tooth, typically a maxillary canine. It mainly affects young people in their second decade of life and presents as a painless and slow-growing increase in volume in the anterior maxillary region. In this study, the case of a 16-year-old patient with a follicular variant unicystic TOA in the right mandibular region is presented. A complete enucleation of the lesion, which measured 4 cm, was performed, observing expansion of the external cortex, a close relationship with the included tooth 4.3 and root resorption in adjacent teeth. The diagnosis was confirmed by histopathology, and one year later, the patient showed a favorable evolution, with bone repair and no significant complications. Despite its low incidence, it is crucial to report clinical cases of TOA to improve the understanding of its clinical characteristics, surgical management, and postoperative evolution. In addition, they provide information on the prognosis and possible long-term complications of this odontogenic neoplasm

A Case of Adenomatoid Odontogenic Tumour in a 14-year-old Female

Adenomatoid Odontogenic Tumour (AOT) is a rare odontogenic neoplasm that primarily affects adolescents and young adults. The present case report discusses the presentation, diagnosis, and successful surgical management of AOT in a 14-year-old patient with a six-month history of upper left jaw swelling. Radiological investigations confirmed the lesion’s characteristics, leading to a provisional diagnosis of AOT. Subsequently, surgical enucleation and histopathological examination {Haematoxylin and Eosin (H&amp;E)} confirmed the diagnosis. The patient showed no recurrence during follow-up at three weeks and six months postsurgery, with excellent functional and aesthetic outcomes. Postoperative follow-up is essential for optimal patient care and long-term outcomes. The present case report contributes to the existing literature on AOT, providing real-world clinical insights and data, which aids in a better understanding and management of this rare condition.

Cystic Extrafollicular Adenomatoid Odontogenic Tumour: A Case Report and Pictorial Update

Adenomatoid Odontogenic Tumour (AOT) constitutes about 5% of all odontogenic tumours and is most commonly seen in young females, in association with impacted maxillary canines in a Dentigerous Cyst (DC) like relationship. Extrafollicular AOT is an uncommon variant seen unassociated with impacted teeth. Rare cystic presentation is reported with most cases seen arising from or in association with DC. Here, the authors present a case of extrafollicular AOT in a 29-year-old Dravidian male, who reported with a chief complaint of swelling of lower anterior jaw region. Radiographically, a well-defined radiolucent lesion was noted extending from mesial aspect of the roots of right mandibular second molar, crossing the midline to involve the body of mandible till mesial aspect of lower left canine. There was evidence of cortical perforation. The lesion was excised and sent for histopathological evaluation. Histopathologically, the lesion was diagnosed as cystic AOT-extrafollicular variant. There was adequate healing and no signs of recurrence or residual disease were noted 18 months after the surgery. The present case is a unique presentation of cystic extrafollicular AOT with pictorial demonstration and detailed explanation of its pathogenesis.

“Two-thirds tumor”: A case report on Management and outcome of Adenomatoid Odontogenic Tumor

“Two-thirds tumor”: A case report on Management and outcome of Adenomatoid Odontogenic Tumor