Neoplasm Of Odontogenic Origin Research Articles

IMMUNOHISTOCHEMISTRY OF ODONTOGENIC CYSTS & TUMOURS – A REVIEW ARTICLE

Odontogenic cysts and tumours are lesions that are derived from the tooth producing tissues or their remnants that remain entrapped either within the jaw bones or into the adjacent soft tissues. From a biological point of view, some of these lesions represent hamartomas with varying degrees of differentiation, while the rest are benign or malignant neoplasm with variable aggressiveness and potential to develop metastasis. Immunohistochemistry is the in situ detection of specific antigens in tissue sections by means of an immunologic reaction (based on antigen -antibody binding). Today, immunohistochemistry has applications in a wide variety of oral lesions including cysts and tumours of odontogenic origin. The aim of this review will be to focus on the various aspects of immunohistochemistry in odontogenic cysts and tumours including its advantages, disadvantages, and applications & recent advances. keywords: immunohistochemistry, odontogenic cysts, odontogenic tumours, advantages, disadvantages.

Maxillary sinus mucocele in a 20-year-old male: a case report of a rare occurrence

Mucocele of Maxillary sinus is a rare entity comprising 2-10% of all mucoceles and develops due to obstruction of drainage ostium. Here, we present a case of maxillary sinus mucocele in a 20-year-old male who presented with diffuse swelling on the left side of his face. Provisional diagnosis of mucocele was made on a computed tomography scan, which was later confirmed on histopathology. The lesion was managed surgically with uneventful healing at 2 weeks and 3 months follow-up. Mucoceles are often misdiagnosed as cysts or tumours of odontogenic origin on the conventional radiograph. Delay in diagnosis can result in complications due to the expansion of mucocele towards adjacent structures such as the nose and orbit. Therefore, it becomes crucial to diagnose it appropriately with the help of higher imaging modalities so that it can be managed well in time.

SPINDLE CELL TUMOR INVOLVING THE JAW OF A YOUNG PATIENT

An 18-year-old male patient without previous comorbidities reported pain in the left side of the jaw. Clinically, 34 and 35 teeth mobility were observed. Radiographic images exhibited a poorly defined board radiolucent lesion extending from tooth 33 to 35 with tooth resorption. Antimicrobial and analgesic therapy were prescribed, and the patient was referred to specialized care. Computed tomography and resonance evaluation confirmed previous image findings bringing the diagnostic hypothesis of lateral periodontal cyst or other neoplasm of odontogenic origin. Lesion curettage was performed, complemented by margins ostectomy and cryotherapy. Teeth 33, 34, and 35 were lost. Histopathologic analysis revealed spindle shaped cells proliferation with wavy nuclei, diagnosing a fusocellular neoplasia suggestive of fibroma and/or neurofibroma. Immunohistochemistry analysis was requested. The results showed positive staining to EMA (weak and focal) and to smooth muscle actin and negative staining to AE1/AE3, desmin, CD34, S100, and ALK1. The final diagnosis was inflammatory myofibroblastic tumor. An 18-year-old male patient without previous comorbidities reported pain in the left side of the jaw. Clinically, 34 and 35 teeth mobility were observed. Radiographic images exhibited a poorly defined board radiolucent lesion extending from tooth 33 to 35 with tooth resorption. Antimicrobial and analgesic therapy were prescribed, and the patient was referred to specialized care. Computed tomography and resonance evaluation confirmed previous image findings bringing the diagnostic hypothesis of lateral periodontal cyst or other neoplasm of odontogenic origin. Lesion curettage was performed, complemented by margins ostectomy and cryotherapy. Teeth 33, 34, and 35 were lost. Histopathologic analysis revealed spindle shaped cells proliferation with wavy nuclei, diagnosing a fusocellular neoplasia suggestive of fibroma and/or neurofibroma. Immunohistochemistry analysis was requested. The results showed positive staining to EMA (weak and focal) and to smooth muscle actin and negative staining to AE1/AE3, desmin, CD34, S100, and ALK1. The final diagnosis was inflammatory myofibroblastic tumor.

Odontomas and imaging diagnosis: the concise systematic review

Introduction: Odontomas are tumors of odontogenic origin. They represent on average 70% of all odontogenic tumors found. Early diagnosis and treatment prevent the loss of tissue element, tooth impaction, bone malformations, and displacement of bone structures, differentiating their types through panoramic radiographic images. Objective: To carry out a concise systematic review of the characteristics of odontomas, differentiating their types through panoramic radiographic images. Methods: The research was carried out from May 2021 to June 2021 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, following the Systematic Review-PRISMA rules. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 84 articles were found. A total of 36 articles were evaluated in full and 17 were included and evaluated in the present study. A total of 3 Studies with a High Risk of Bias and 1 Study with Uncertain Risk. Radiographic examination is extremely important for the study and diagnosis of odontomas. Odontomas present a characteristic radiographic appearance. In complex odontomas, radiopacity is not specifically determined, showing itself as an irregular and disorganized mass surrounded by a narrow radiolucent zone. In the composite type, the radiographic image is pathognomonic. In the radiopaque image, dozens of denticles simulate small teeth surrounded by a thin radiolucent area. Composite odontoma, on the other hand, consists of the same calcified structures arranged in an orderly and related manner, similar to normal teeth contained in a fibrous capsule. The differential diagnosis of complex odontoma includes osteomas and condensing osteitis. Conclusion: Radiographic and/or tomographic examination is the best way to obtain an accurate diagnosis, precisely delimiting the lesion and nearby and involved structures.

Plexiform Unicystic Ameloblastoma - A Diagnostic Dilemma

The 2nd most common tumor of odontogenic origin is Ameloblastoma which develops from epithelial cellular elements and dental tissues in various phases of development. It is a slow-growing, persistent and locally aggressive neoplasm of epithelial origin, affecting the posterior area of lower jaw in 80% of cases. Unicystic Ameloblastoma (UA) is one of the less encountered variants of Ameloblastoma. Radiographically it mimics many of the odontogenic cysts and tumors and hence becomes difficult to arrive at a definitive diagnosis. We report here a case of plexiform unicystic variant of ameloblastoma in a 26 years old male patient.

Aggressive Adenomatoid Odontogenic Tumor of Maxilla involving Impacted Third Molar: A Rare Case Report

Adenomatoid odontogenic tumor (AOT) is a rare tumor comprising about 2.2% to 7.1% of all odontogenictumors. It is a neoplasm of odontogenic origin having slow-growth rate, noninvasive and benign in nature.Here, we report a case of a young female patient who presented with an aggressive AOT in maxilla involvingthe impacted third molar. Usually, the treatment for AOT comprises of enucleation and curettage, whereasdue to the fast growth rate and aggressiveness of the lesion, subtotal maxillectomy was performed in thiscase. The authors have described about the clinical, radiographic, histopathological and surgical aspect ofthe case.

TISSUE FLUORESCENCE IMAGING FOR QUICK NON-INVASIVE DIAGNOSIS IN ORAL AND MAXILLOFACIAL SURGERY

Significant vital functions take place in the oral cavity and oropharynx, primarily mastication, as the initial function of the gastrointestinal system, swallowing, respiration and speech. All these vital biological functions can be endangered, ie aggravated, and even disabled by the appearance of neoplasms in that anatomical space. In the maxillofacial region, neoplasms can originate from a variety of tissues, from the mucous membranes of the oral cavity to the jaws, salivary glands, and even tumors of odontogenic origin. However, the most common tumor in the oral cavity is squamous cell carcinoma (OSSC), which originates from the oral mucosa. To determine the accuracy, sensitivity (Se) and specificity (Sp) of the Velscope screening method in the detection of premalignant and initial malignant lesions compared to the gold standard surgical biopsy. The study group consisted of 60 patients divided into two groups. The first group was formed by 30 patients with potentially malignant oral lesions (PML). Another 30 patients with preliminary diagnosis - oral cancer (OC) were included in the second group of examinees. The high sensitivity value of 92.86% and the accuracy of the method of 86.67% largely confirm the reliability and efficacy of the Velscope method in patients with highly suspected oral cancer lesions (OC), significantly more, comparing to the group of premalignant lesions. Key words: Velscope, oral cancer, premalignant lesions, tumor.&nbsp

Compound odontoma in a nine-year-old boy associated with impacted permanent central and lateral incisor — a case report

Abstract
 Odontomas are one of the most common tumours of odontogenic origin. They are usually asymptomatic but may be associated with retained primary teeth or missing permanent teeth. Though the exact aetiology is unknown, the postulated causes include trauma, infection, inheritance and genetic mutation. Early diagnosis and management will result in fewer complications. Conservative surgical excision is the treatment of choice. This case report presents a treated case of compound odontoma associated with delayed eruption of the permanent central incisor in a nine-year-old boy.
 Keywords: Compound Odontoma.
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Deceptive Cyst in the Oral Cavity- A Case Report

Keratocystic odontogenic tumors (KCOTs) are called for their disputed peculiar characteristics, varied origin, unique propensity to recur, disputed treatment methods and can occur anywhere in the jaw, but mainly seen in the posterior part of the mandible. On radiographically, it present, as well-defined radiolucent lesions with smooth and generally corticated margins. They are benign intraosseous tumors of odontogenic origin that occur most mainly in the jaw. The average reported recurrence rate ranges from 30 to 62 present.

A 25-Year-Old Female with Unusually Large Complex Odontoma in Mandibular Molar Area Associated with Unerupted Tooth

Odontomas are benign tumours of odontogenic origin consisting of different dental tissues. Usually they are tooth size or smaller, but occasionally complex variety can exhibit considerable growth. They are usually asymptomatic and often are discovered during routine radiograph. Morphologically odontoma can be classified as complex when present as irregular masses containing different types of dental tissues, or as compound if there is superficial anatomic similarity to even rudimentary teeth known as denticles. We report a case of large complex odontoma that causes pain, infection and facial asymmetry.
 J Enam Med Col 2019; 9(1): 57-59

Histopathologic Diagnoses From Biopsies of the Oral Cavity in 403 Dogs and 73 Cats.

This retrospective study documents the prevalence of various histopathological diagnoses within a practice specializing in veterinary dentistry and oral surgery. Histopathology results obtained from biopsies of oral lesions from 403 dogs and 73 cats were sorted and categorized. Lesions of inflammatory origin represented the most common histopathology result in cats (n = 37; 51%), followed by squamous cell carcinoma (n = 27; 37%). The most common histopathological diagnoses in dogs were malignant neoplasms (n = 151; 37%), followed by tumors of odontogenic origin (n = 138, 34%) and lesions of inflammatory origin (n = 114; 28%). The results of this study are representative of a private referral dentistry practice and are compared to other studies that assessed common oral neoplasia diagnoses in dogs and cats. Treatment options and prognoses of the most common canine and feline neoplasms are discussed.

Ameloblastic Fibroma Associated With Impacted 3rd Molar: A Case Report

Ameloblastic fibroma is an uncommon mixed neoplasm of odontogenic origin with a relative frequency between 1.5 – 4.5%. It can occur either in the mandible or maxilla, but predominantly seen in the posterior region of the mandible. It occurs in the first two decades of life. Most of the times it is associated with tooth enclosure, causing a delay in eruption or altering the dental eruption sequence. The common clinical manifestation is a slow growing painless swelling and is detected during routine radiographic examination. There is controversy in the mode of treatment, whether conservative or aggressive. Here we reported a 38 year old male patient referred for evaluation of painless swelling on the right posterior region of the mandible associated with clinically missing 3rd molar. The lesion was completely enucleated under general anesthesia along with the extraction of impacted molar.

Epidemiological profile of ameloblastoma at Erasto Gaertner Hospital

Ameloblastoma is the most common benign tumor of odontogenic origin, and represents about 11% of all odontogenic tumors. It is characterized by being locally aggressive and having high recurrence rates. Objective: To evaluate the occurrence of ameloblastoma in the Erasto Gaertner Hospital in patients from 1972 to 2012. In addition, to assess the main treatments, the most prevalent histological variants, the recurrence rate, the anatomical location of the lesion and patient profile. Material and methods: A retrospective study of patients diagnosed with ameloblastoma at the Erasto Gaertner Hospital between the years 1972-2012 was performed. Epidemiological data were collected such as gender, age, race, lesion location, type of surgical procedure, follow-up and recurrence rate; and analyzed using descriptive statistics. Results: A total of 40 patients were selected for the study. The most affected age group was between the third and fifth decade of life, with 19 cases (47.5%), followed by the second and fourth decade, with 14 cases (35%); the sixth decade, with 5 cases (12.5%) and seventh decade with 1 case (2.5%). The patients’ ages ranged from 13 to 66 years, with an average age 34.9 years. The mandible was the most affected site, with 38 cases (95%) of cases, and maxilla had only 2 cases (5%). Thirty-eight patients were treated with radical surgery and 5 patients presented recurrence after 1 year of follow-up. Both cases that occurred in maxilla presented recurrence. Conclusion: Recurrence of ameloblastoma decreases significantly when surgery is performed properly, with wide excision and margin. Combination of full tumor resection and reconstruction was the best approach observed in this study. In addition, we recommend a long period of clinical and radiographic follow-up.

Epidemiological profile of ameloblastoma at Erasto Gaertner Hospital

Ameloblastoma is the most common benign tumor of odontogenic origin, and represents about 11% of all odontogenic tumors. It is characterized by being locally aggressive and having high recurrence rates. Objective: To evaluate the occurrence of ameloblastoma in the Erasto Gaertner Hospital in patients from 1972 to 2012. In addition, to assess the main treatments, the most prevalent histological variants, the recurrence rate, the anatomical location of the lesion and patient profile. Material and methods: A retrospective study of patients diagnosed with ameloblastoma at the Erasto Gaertner Hospital between the years 1972-2012 was performed. Epidemiological data were collected such as gender, age, race, lesion location, type of surgical procedure, follow-up and recurrence rate; and analyzed using descriptive statistics. Results:A total of 40 patients were selected for the study. The most affected age group was between the third and fifth decade of life, with 19 cases (47.5%), followed by the second and fourth decade, with 14 cases (35%); the sixth decade, with 5 cases (12.5%) and seventh decade with 1 case (2.5%). The patients’ ages ranged from 13 to 66 years, with an average age 34.9 years. The mandible was the most affected site, with 38 cases (95%) of cases, and maxilla had only 2 cases (5%). Thirty-eight patients were treated with radical surgery and 5 patients presented recurrence after 1 year of follow-up. Both cases that occurred in maxilla presented recurrence. Conclusion: Recurrence of ameloblastoma decreases significantly when surgery is performed properly, with wide excision and margin. Combination of full tumor resection and reconstruction was the best approach observed in this study. In addition, we recommend a long period of clinical and radiographic follow-up.

Peripheral Cemento-ossifying Fibroma: A Report of Two Cases

ABSTRACT Peripheral cemento-ossifying fibroma (PCOF) is an osteogenic neoplasm of odontogenic origin with uncertain pathogenesis, which presents as a localized growth manifesting predominantly in adolescent and young adults. Early diagnosis by thorough radiographic and histologic examination is crucial for positive identification of lesions. Proper surgical excision with aggressive curettage of adjoining tissues and complete elimination of etiological factors is extremely important for prevention of recurrence. This clinical report presents two cases of patients who reported with localized gingival overgrowth, diagnosed as PCOF after histological examination. The clinical, radiographic, and histologic features of the two cases are discussed, and postsurgery, the patients have been followed up for a 1-year period with no recurrence. In conclusion, it is difficult clinically to differentiate between the various gingival lesions. Therefore, this article emphasizes that though recurrence rate of PCOF is high, most of these cases can be adequately managed with sound periodontal treatment. How to cite this article Guru SR, Singh SS, Guru RC. Peripheral Cemento-ossifying Fibroma: A Report of Two Cases. J Health Sci Res 2016;7(2):71-75.

Protein Expression of Giant Cell Lesions of the Maxillofacial Skeleton and Axial/Appendicular Skeleton: A Confirmative Study

Immunostaining revealed the presence of KLK 3, 4, 9 & 11 in all tissue types studied. KLK 5 was present only in KOT’s (p<0.001). Greater KLK 3 staining was present in ameloblastomas (p<0.01) and KOTs (p<0.05) than in the odontogenic control. KLK 9 exhibited greater staining in KOTs (p<0.05) and dentigerous cysts (p<0.05) than the odontogenic control. KLK 11 had greater staining in the ameloblastomas (p<0.05) than in non-odontogenic cystic controls. Expression of KLK 1, 4, 7, 8, 10 & 12 mRNA was found in pooled ameloblastoma tissue. Expression of KLK 7 and 10 mRNA was greater than that of KLK 1, 4, 8 & 12 in the ameloblastoma tissue. KLK 2, 3, 5, 6, 9, 11, 13, 14 & 15 mRNA were not identified in ameloblastoma tissue. For the first time, KLK 3, 4, 5, 9 & 11 have been identified in maxillofacial cysts and tumours. KLK 3 is present in significantly greater amounts in benign neoplasms of odontogenic origin, the ameloblastoma and KOT, when compared to the odontogenic hamartoma. KLK 11 is present in significantly greater amounts in the benign neoplasm (ameloblastoma) compared to non-odontogenic cystic control (nasopalatine duct cyst). Interestingly, KLK 3 and 11 mRNA was not identified in the ameloblastoma using RTPCR, suggesting that KLK 3 and 11 protein may be recruited, sequestered or have a long half life in benign neoplasms of odontogenic origin. As expected, KLK 5, which is known to be involved in the process of keratinization, is present only in the KOT. Identification of KLK 4 mRNA in ameloblastoma tissue was also expected; it is implicated in normal amelogenesis. With further investigation, it may be possible to use KLK’s as biomarkers for identifying and monitoring these lesions. Additionally, if the physiologic role of KLK’s in neoplasia can be identified, they may provide a target for minimally invasive therapeutics.

A case of odontogenic myxoma in a cow

Tumours of odontogenic origin are rare in domestic animals. A case of odontogenic myxoma was recorded in 12 years old cow involving the periodontal region of the left mandible. Tumorous growth was slow growing but progressively increased, locally invasive and recurred after surgical removal. Grossly, the growth was soft and slimy. Histopathologically, it revealed myxoma characterized by large, stellate or triangular fibroblast like cells with cytoplasmic processes, vesicular nuclei and small nucleoli. Mitotic figures were rarely observed. Expression of anti-pancytokeratin and anti-p53 antibodies by immunohistochemistry was not detected. Based on anatomical location, radiographic, gross and histopathological examination, this tumour was diagnosed as an odontogenic myxoma.

Follicular adenomatoid odontogenic tumour in mandible - A Rare case report

Adenomatoid odontogenic tumour is an uncommon tumour of odontogenic origin with relative frequency of 2.2–7.1%. It is benign non invasive lesion with slow but progressive growth. As the histogenesis is still uncertain, it is sometimes regarded as hamartomatous lesion rather than a true neoplasm. Adenomatoid odontogenic tumour which accounts for 1% to 9% of all odontogenic tumours, is predominantly found in young and female patients, located more often in the anterior maxilla, and in most of the cases associated with unerupted permanent tooth. This report illustrates an unusual case of Adenomatoid odontogenic tumour seen in anterior mandible.

Adenomatoid odontogenic tumor of maxilla in a 14-year-old child

Adenomatoid odontogenic tumor (AOT) is an uncommon tumor of odontogenic origin, constituting only 0.1% of tumors and cysts of the jaw and 3% of all odontogenic tumors. A 14-year-old girl presented with right maxillary anterior swelling, facial asymmetry, continuously increase in size of swelling without any symptoms, and delayed eruption of permanent teeth. Orthopantomogram and computed tomography scan revealed a large unilocular radiolucency in right maxilla with permanent lateral incisor embedded within the lesion and permanent canine pushed away from its normal position. Cyst was enucleated completely under general anesthesia along impacted permanent teeth and retained deciduous teeth. Postoperative period was uneventful.

Peripheral odontoma: A case report

Odontomas refers to any tumor of odontogenic origin. The well-differentiated epithelial and mesenchymal cell gives rise to ameloblast and odontoblast which lays down enamel, dentin and pulpal tissue of the odontoma. The enamel thus laid is in an abnormal pattern and is considered as a developmental anomaly rather than true neoplasm. Odontomas are hamartomatous developmental malformations of odontogenic origin which manifest as denticles, or amorphous masses comprising of the dental tissues. Although a majority of odontomas are intraosseous; there are case reports of odontomas that erupted into the oral cavity. Even less common are peripheral or soft-tissue odontomas, only a few of which have been reported to date. They commonly occur in the pre-maxillary region and associated complications include delayed or uneruption of permanent teeth, retention of the primary teeth and dentigerous cyst formation. Management usually requires surgical removal of the odontoma and the impacted tooth followed by subsequent orthodontic intervention to correct the malocclusion. The present case report describes a case of peripheral odontoma that was present in the alveolar mucosa of a 12-year-old female patient who reported with a chief complaint of unerupted left maxillary lateral incisor. The diagnosis, complications, treatment and prognosis of this entity will be discussed.