Peripheral Adenomatoid Odontogenic Tumour Research Articles

Case series of Adenomatoid Odontogenic Tumors: Clinical, Radiographic, and Histologic Features

<h3>Objective</h3> We present a case series of adenomatoid odontogenic tumor (AOT), a benign odontogenic tumor from a large biopsy service. AOT has a limited growth potential and is often seen in children and young adults, between the ages of 10-19 years. AOT has uncertain pathogenesis and studies suggest enamel organ, reduced enamel epithelium, and rests of Malassez as potential sources. Clinically, AOT's are asymptomatic and identified upon routine radio- graphic examination. <h3>Methods</h3> Information was collected from the University of Florida Oral Pathology Biopsy Service archives (1994-2019). The clinical and demographic data along with any accompanying radiographic images and original slides were evaluated. <h3>Results</h3> A total of 26 cases of AOT were identified, with a mean age of 22.3 years (range: 12-67). A slight female predilection was noted (57.7%, n=15). Most cases presented in the anterior region of the jaw (73%, n=19) and a slight maxillary predilection was observed (61.5%, 16 cases). Most patients were aged under 20 (69.2%, n=18). Clinical impression included dentigerous cyst, lateral periodontal cyst, and odontogenic keratocyst (57.7%, n=15). Radiographs were available for six cases and all presented as a unilocular radiolucency. The histologic diagnosis was consistent with AOT in 24 cases and peripheral AOT in two cases.One case had a fo- cal area of CEOT that tested positive with a Congo Red stain. <h3>Conclusion</h3> In almost all cases within the study the clinical impression of AOT was not rendered. This implied that AOT is rarely considered in the differential of such lesions. In addition, while most patients were children or young adults, there were a few outliers above thirty (19.2%, n=5). This may suggest that AOT is diagnosed late in some cases due to its benign nature. Clinicians should be sentient of this lesion as the treatment and prognosis differs from other odontogenic cysts and tumors.

Peripheral adenomatoid odontogenic tumor in a cloak of an epulis: report of a rare case

BackgroundAdenomatoid odontogenic tumor constitutes an uncommon benign odontogenic tumor which is well-known as “two-thirds tumor” (two-thirds of adenomatoid tumors occur in the maxilla, two-thirds occur in young females, two-thirds of the cases are associated with un-erupted teeth and two-thirds of the affected teeth are canines). Larger part of these present as intra - osseous tumors while peripheral counterparts are extremely rare. Peripheral adenomatoid odontogenic tumor is a unique entity which generally presents as a slow growing gingival swelling with minimal bone involvement. This often leads to its erroneous diagnosis as a simple gingival lesion and the real diagnosis is only revealed after its microscopic evaluation. It exhibits a marked predilection for maxillary gingiva of incisor region and most commonly affects the younger females.Case presentationWe report a case of 25 years old female patient of African ethnicity who presented with a 2 × 2 cm mass attached to the left mandibular gingiva in cuspid- bicuspid region which is an unusual site for AOT. It was accompanied by slight bone loss. With the differential diagnosis of gingival epulis and peripheral ossifying fibroma; surgical excision was performed. The light microscopic examination of the specimen aided the final diagnosis of Adenomatoid odontogenic tumor with the histopathological features identical to its intra osseous counterpart.ConclusionIn this case, the tumor is present on the mandibular gingiva in a 25 years old patient which is an atypical location and age for this tumor; also, the only individual case reported in an African patient. Only, a meager number of peripheral adenomatoid odontogenic tumor cases have been logged so far with majority of them occurring in maxillary gingiva. Furthermore, an ambiguity still prevails regarding its true origin and possible biological course. Hence, reporting of similar cases should be encouraged to facilitate the better understanding of its varied epidemiological details and clinical presentation.

A RECENT UPDATE ON HISTOGENESIS OF ADENOMATOID ODONTOGENIC TUMOR: A REVIEW

Adenomatoid odontogenic tumor (AOT) is a relatively rare benign, epithelial tumor of odontogenic origin. There is varying class of thoughts contemplating this lesion to be a hamartoma or neoplastic growth of odontogenic epithelium. Controversy regarding the histogenesis of the lesion is plentiful in earlier literature. The recent advent of immunohistochemical and ultrastructural studies has aided in throwing light on the tissue of origin of this tumor. This review aims at understanding the evolving concepts of histogenesis of AOT to better understand the biological behavior of the lesion. The review of AOT was carried out using PubMed and Google Scholar databases and 39 articles from the year 2001 to 2016 which contributed to the histogenesis of AOT were included for review. Since the origin of the cystic lining is similar to a reduced enamel epithelium and not the dental lamina, we propose the former to be the progenitor of AOT. Furthermore, we consider extra-follicular, as well as peripheral AOTs, originate from the remnants of Hertwig’s epithelial root sheath (epithelial rests of Malassez), which complies with the common histology for all these variants.

Adenomatoid odontogenic tumor: An updated analysis of the cases reported in the literature.

To review the clinical and radiographic features of the available data published on adenomatoid odontogenic tumor (AOT) with special emphasis on the comparison of its variants. An electronic search was undertaken in July 2018. Eligibility criteria included publications having enough clinical/radiological/histological information to confirm the diagnosis. A total of 436 publications reporting 1558 cases were included, of which 739 follicular, 247 extrafollicular, and 30 peripheral AOTs. Impacted canine is associated with follicular AOTs in almost 70% of the cases. AOTs were more prevalent in females, in the second decade of life, in maxillae, in anterior region of the jaws, and most are asymptomatic, with a considerable number of lesions presenting cortical bone perforation. Most of the lesions were treated by enucleation. Some cases of recurrence were reported in the literature, but only one was well documented. No difference was found when comparing the clinical/radiological features of the follicular, extrafollicular, and peripheral variants. Adenomatoid odontogenic tumor variants do not show distinctive clinical radiological features. Recurrence of AOT is very rare, which justify its conservative management.

The adenomatoid odontogenic tumour: an update of selected issues.

The aim of this update was to present the recent notable progress within remaining questions relating to the adenomatoid odontogenic tumour (AOT). Selected issues that were studied included the following: (i) AOT history and terminology, (ii) the so-called peripheral AOT, (iii) AOT and the gubernaculum dentis and (iv) the so-called adenomatoid odontogenic cyst (AOC). The earliest irrefutable European case of AOT was described in 1915 by Harbitz as 'cystic adamantoma'. Recently, Ide et al. have traced two Japanese cases with irrefutable proof described by Nakayama in 1903. The so-called peripheral (gingival) variant of AOT seems to cover a dual pathogenesis, both an 'erupted intraosseous' and an 'extraosseous' (gingival) one. In 1992, we theorized that the generally unnoticed gubernaculum dentis (cord and canal) seems to be involved in the development of AOT. Ide et al. have concluded that the dental lamina in the gubernacular cord seems to be an embryonic source of the vast majority of AOTs. The suggestion by Marx and Stern to change the nomenclature of AOT to adenomatoid odontogenic cyst (AOC) is critically discussed. The present authors agree on the background of the work of several groups of researchers and WHO/IARC classifications that the biology of the follicular variant of AOT is already fully explained and does not make room for any change in diagnostic terms. Further, there is no reason to change terminology in this case where improvements or conditions to better clinical management are not an issue.

Peripheral Adenomatoid Odontogenic Tumor Related to Dentigerous Cyst Marsupialization

This study reports an unusual case of a peripheral adenomatoid odontogenic tumor arising in a post-marsupialization site and its relationship to a dentigerous cyst. Boy, 14, was referred to treat swelling in the left anterior maxilla that was associated with impaction of teeth #22 and #23. Treatment planning included marsupialization and posterior orthodontic traction of the impacted teeth. The marsupialization reduced significantly the swelling after 4 months, but in the access site of the marsupialization a 3-cm wide sessile nodule developed at the vestibular gingiva.

Peripheral Adenomatoid Odontogenic Tumor Presented as a Gingival Swelling: Case Report

Adenomatoid odontogenic tumor (AOT) is a rare tumor that has a peripheral variant which can manifest as gingival swelling. Peripheral AOT is more commonly found in women and at the maxilla. Caucasian girl, 11, presented with a gingival swelling of 1 year duration located on the attached and free labial gingival margin, apical to the upper permanent left central incisor. The lesion was normochromic, with soft to firm consistency. No signs or symptoms such as pain, bleeding, discharge, or fever were present; oral hygiene was inadequate.

Adenomatoid odontogenic tumor—Report of a posterior mandibular case with the presence of ghost cells

Adenomatoid odontogenic tumor (AOT) occurs more frequently in the maxillary anterior region. Recurrence of AOT after surgical excision is very rare. In this case report, we describe a left posterior mandibular AOT case that exhibited three recurrences after surgical removal. A 25-year-old female patient was first seen by an oral surgeon in a regional hospital with the chief complaint of a swelling at the left mandibular molar region. The tumor was removed by enucleation. Five years later, the tumor recurred at the same region. The patient was referred to our hospital for treatment, and the recurrent tumor was widely excised. The pathological report was an extrafollicular AOT. Eleven years later, the tumor recurred again. It was removed using segmental mandibulectomy with titanium plate reconstruction. The pathological report was also an extrafollicular AOT. Nine months later, the mandibular bone defect was further reconstructed by a segment of iliac bone graft fixed by a new titanium plate and screws. Twenty-eight years after the initial surgery, the tumor recurred again in the alveolar mucosa covering the graft bone. It was further excised, and the pathological report was a peripheral AOT with the presence of amyloid materials and globules of ghost cells. Our AOT case recurred thrice after two conservative excisions and one more radical surgical resection. The multiple recurrences of the tumor indicate the importance of initial complete resection of the tumor. In addition, our case may represent the first reported AOT with the presence of ghost cells in the tumor tissue.

Peripheral Adenomatoid Odontogenic Tumour — Is It Really Peripheral?: A Case Report

A Peripheral Adenomatoid Odontogenic Tumour (PAOT) is quite a rare entity which has been infrequently reported in the literature. These uncommon clinical variants of an Adenomatoid Odontogenic Tumour (AOT), typically manifest as a soft tissue mass of the gingiva, which mimick a common epulis, but yet have an identical histopathologic presentation as their intraosseous counterpart. These lesions, though they are indolent in nature, have a tendency to cause well defined deep bony pockets. Only fourteen cases have been adequately documented so far. We are reporting a case of a PAOT of the anterior maxillary gingiva, with a periodontal bone defect in a 12 year old girl. The relevant literature has been briefly reviewed, with an insight into the probable origin of PAOTs with bony defects.

The peripheral adenomatoid odontogenic tumour: a case report

AbstractAn 11‐year‐old male presented with a localised erythematous gingival enlargement of the anterior maxillary gingiva and an associated deep facial pocket. Biopsy specimens were obtained. Histopathological examination of the submitted tissue showed a cystic lining consisting of proliferating odontogenic epithelium with spindle‐shaped cells forming small ductules and well‐formed duct‐like structures lined by pseudo‐stratified columnar epithelium. A diagnosis of peripheral adenomatoid odontogenic tumour (PAOT) was rendered. The PAOT is a rare entity that can present as an erythematous gingival swelling, similar to an epulis or fibroma. Dentists should be aware that unusual pathological entities can have a variety of presentations and that definitive diagnosis may require submission of tissue for histopathological examination.

An updated clinical and epidemiological profile of the adenomatoid odontogenic tumour: a collaborative retrospective study

Adenomatoid odontogenic tumour (AOT) is a benign odontogenic jaw lesion. The aim of this study was to update the biological profile of AOT. Cases published in the literature and cases in files of co-authors were included. 550 new cases were retrieved, and of a total of 1082 cases analysed, 87.2% were found in the second and third decades. The M:F ratio was 1:1.9. 70.8% were of the follicular variant (extrafollicular: 26.9%, peripheral: 2.3%). 64.3% occurred in the maxilla. 60% of follicular AOTs were associated with unerupted canines. Nineteen cases of AOT (2.8%, M:F ratio was 1:1.4) were associated with embedded third molars. Twenty-two peripheral AOTs (2.3%, M:F ratio was 1:5.3) were recorded. The relative frequency (RF) of AOT ranged between 0.6% and 38.5%, revealing a considerably wider AOT/RF range than hitherto reported (2.2-7.1%). This updated review based on the largest number of AOT cases ever presented, confirms the distinctive, although not pathognomonic clinicopathological profile of the AOT, its worldwide occurrence, and its consistently benign behaviour.

Peripheral adenomatoid odontogenic tumour

The adenomatoid odontogenic tumour (AOT) is a benign (hamartomatous), non-invasive lesion with a slow but progressive growth. It occurs in intraosseous as well as in peripheral forms. The peripheral variant is still by far the most rarely reported type constituting only 4.4% of all AOT cases. This article presents the clinical, radiological and microscopic features of a peripheral AOT occurring in the soft tissue overlying the tooth-bearing areas of the anterior maxilla in a 19-year-old female patient.