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Diagnostically challenging epithelial odontogenic tumors: a selective review of 7 jawbone lesions.

Ide F, Mishima K, Saito I, Kusama K - Head Neck Pathol (2009)

Bottom Line: Of two unsuspected keratocystic odontogenic tumors, one depicted deceptive features of pericoronitis, while the other case has long been in our files with the diagnosis of globulomaxillary SOT.Two cases of primary intraosseous squamous cell carcinoma appeared benign clinically and exhibited unexpected findings; an impacted third molar began to erupt in association with the growth of carcinoma and another periradicular carcinoma showed dentinoid formation.Cases selectively reviewed in this article present challenging problems which require clinical and radiographic correlation to avoid potential diagnostic pitfalls.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan. ide-f@tsurumi-u.ac.jp

ABSTRACT
Considerable variation in the clinicopathologic presentation of epithelial odontogenic tumors can sometimes be confusing and increase the chance of misdiagnosis. Seven diagnostically challenging jawbone lesions are described. There were 2 cases of mistaken identity in our ameloblastoma file. One unicystic type, initially diagnosed and treated as a lateral periodontal cyst, showed destructive recurrence 6 years postoperatively. The other globulomaxillary lesion was managed under the erroneous diagnosis of adenomatoid odontogenic tumor and recurred 4 times over an 11-year period. This tumor was found in retrospect to be consistent with an adenoid ameloblastoma with dentinoid. The diagnosis of cystic squamous odontogenic tumor (SOT) occurring as a radicular lesion of an impacted lower third molar was one of exclusion. Of two unsuspected keratocystic odontogenic tumors, one depicted deceptive features of pericoronitis, while the other case has long been in our files with the diagnosis of globulomaxillary SOT. Two cases of primary intraosseous squamous cell carcinoma appeared benign clinically and exhibited unexpected findings; an impacted third molar began to erupt in association with the growth of carcinoma and another periradicular carcinoma showed dentinoid formation. Cases selectively reviewed in this article present challenging problems which require clinical and radiographic correlation to avoid potential diagnostic pitfalls.

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Keratocystic odontogenic tumor. a Panoramic radiograph, b non-descript cyst lining with elongated rete pegs, c typical feature of keratocystic odontogenic tumor (Hematoxylin–Eosin—b ×100, c ×200)
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Fig4: Keratocystic odontogenic tumor. a Panoramic radiograph, b non-descript cyst lining with elongated rete pegs, c typical feature of keratocystic odontogenic tumor (Hematoxylin–Eosin—b ×100, c ×200)

Mentions: The patient was a 39-year-old man who had several episodes of pericoronitis related to a horizontally impacted left lower third molar. During the past 2 years, the lesion was repeatedly incised, drained and treated with antibiotics. Radiographically, osteolytic changes extending to the root apices thought to be due to the pericoronal infection was noted (Fig. 4a). Histologically, fragments of inflamed tissue below the tooth were lined with the non-keratinizing, spongiotic squamous epithelium (Fig. 4b) and only one area had diagnostic features of keratocystic odontogenic tumor (Fig. 4c). Extraction wound was subsequently curetted, but no residual tumor remained. At 1 year follow-up there is no evidence of recurrence.Fig. 4


Diagnostically challenging epithelial odontogenic tumors: a selective review of 7 jawbone lesions.

Ide F, Mishima K, Saito I, Kusama K - Head Neck Pathol (2009)

Keratocystic odontogenic tumor. a Panoramic radiograph, b non-descript cyst lining with elongated rete pegs, c typical feature of keratocystic odontogenic tumor (Hematoxylin–Eosin—b ×100, c ×200)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2807539&req=5

Fig4: Keratocystic odontogenic tumor. a Panoramic radiograph, b non-descript cyst lining with elongated rete pegs, c typical feature of keratocystic odontogenic tumor (Hematoxylin–Eosin—b ×100, c ×200)
Mentions: The patient was a 39-year-old man who had several episodes of pericoronitis related to a horizontally impacted left lower third molar. During the past 2 years, the lesion was repeatedly incised, drained and treated with antibiotics. Radiographically, osteolytic changes extending to the root apices thought to be due to the pericoronal infection was noted (Fig. 4a). Histologically, fragments of inflamed tissue below the tooth were lined with the non-keratinizing, spongiotic squamous epithelium (Fig. 4b) and only one area had diagnostic features of keratocystic odontogenic tumor (Fig. 4c). Extraction wound was subsequently curetted, but no residual tumor remained. At 1 year follow-up there is no evidence of recurrence.Fig. 4

Bottom Line: Of two unsuspected keratocystic odontogenic tumors, one depicted deceptive features of pericoronitis, while the other case has long been in our files with the diagnosis of globulomaxillary SOT.Two cases of primary intraosseous squamous cell carcinoma appeared benign clinically and exhibited unexpected findings; an impacted third molar began to erupt in association with the growth of carcinoma and another periradicular carcinoma showed dentinoid formation.Cases selectively reviewed in this article present challenging problems which require clinical and radiographic correlation to avoid potential diagnostic pitfalls.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan. ide-f@tsurumi-u.ac.jp

ABSTRACT
Considerable variation in the clinicopathologic presentation of epithelial odontogenic tumors can sometimes be confusing and increase the chance of misdiagnosis. Seven diagnostically challenging jawbone lesions are described. There were 2 cases of mistaken identity in our ameloblastoma file. One unicystic type, initially diagnosed and treated as a lateral periodontal cyst, showed destructive recurrence 6 years postoperatively. The other globulomaxillary lesion was managed under the erroneous diagnosis of adenomatoid odontogenic tumor and recurred 4 times over an 11-year period. This tumor was found in retrospect to be consistent with an adenoid ameloblastoma with dentinoid. The diagnosis of cystic squamous odontogenic tumor (SOT) occurring as a radicular lesion of an impacted lower third molar was one of exclusion. Of two unsuspected keratocystic odontogenic tumors, one depicted deceptive features of pericoronitis, while the other case has long been in our files with the diagnosis of globulomaxillary SOT. Two cases of primary intraosseous squamous cell carcinoma appeared benign clinically and exhibited unexpected findings; an impacted third molar began to erupt in association with the growth of carcinoma and another periradicular carcinoma showed dentinoid formation. Cases selectively reviewed in this article present challenging problems which require clinical and radiographic correlation to avoid potential diagnostic pitfalls.

Show MeSH
Related in: MedlinePlus