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Journal of Oral Pathology & Medicine :... Feb 2023Primordial odontogenic tumour is a benign mixed neoplasm of recent description, which has histological similarities with other odontogenic tumours such as the...
BACKGROUND
Primordial odontogenic tumour is a benign mixed neoplasm of recent description, which has histological similarities with other odontogenic tumours such as the ameloblastic fibroma. In this article, we investigate the architecture of the sub-epithelial layer of mesenchymal cells expressing the marker CD34 in primordial odontogenic tumour.
OBJECTIVE
Analyse the spatial patterns of CD34 expression in primordial odontogenic tumour and compare them with those in ameloblastic fibroma and the normal tooth germ by means of objective imaging approaches, to better characterise these lesions.
METHODS
Two cases of primordial odontogenic tumour, four cases of ameloblastic fibroma and two cases of tooth germ in cap and bell stages were used for morphological, structural and immunohistochemical analyses.
RESULTS
CD34 expression was found in vascular endothelium of primordial odontogenic tumour, ameloblastic fibroma and tooth germ. In addition, a characteristic sub-epithelial expression was observed only in primordial odontogenic tumour, corresponding to 84%-86% of the sample boundaries. Moreover, the zone expressing CD34 corresponded with a higher cellularity, which was absent in ameloblastic fibroma and tooth germ.
CONCLUSION
Image analysis of the primordial odontogenic tumour architecture revealed characteristics absent in other odontogenic tumours and tooth germs. This study provides additional information to support the idea that this neoplasm is a distinct entity from early stage AF or developing odontoma.
Topics: Humans; Odontogenic Tumors; Tooth Germ; Odontoma; Cell Adhesion Molecules; Fibroma
PubMed: 36207782
DOI: 10.1111/jop.13370 -
Pathologica Apr 2021The World Health Organization's (WHO) updated classification of head and neck tumors (2017) defined odontogenic fibroma as a rare neoplasm. In this report, we describe...
The World Health Organization's (WHO) updated classification of head and neck tumors (2017) defined odontogenic fibroma as a rare neoplasm. In this report, we describe an unusual, typical and rare variant of a central odontogenic fibroma with diffuse amyloid-like protein stromal deposition, and discuss the differential diagnosis with other entities. Radiographically, this lesion presented as a well-defined radiolucency of the mandible, partially cystic. Histologically, the lesion showed a unique confluence of odontogenic epithelial rests in a moderately cellular connective tissue. Immunohistochemical staining highlighted a mixture of benign epithelial and Langerhans cells within connective tissue with diffuse amyloid-like stromal deposition. The importance of recognizing this variant of odontogenic fibroma is due to its benign prognosis and clinical course.
Topics: Diagnosis, Differential; Fibroma; Humans; Odontogenic Tumors; Prognosis
PubMed: 34042096
DOI: 10.32074/1591-951X-152 -
Current Medical Imaging Sep 2023The jaws can be affected by several lesions that manifest in the oral cavity, but little is known about non-odontogenic benign and malignant lesions and their...
BACKGROUND
The jaws can be affected by several lesions that manifest in the oral cavity, but little is known about non-odontogenic benign and malignant lesions and their radiological findings.
INTRODUCTION
Our aim was to discuss the imaging findings of non-odontogenic jaw lesions to help the surgeon in the diagnosis and formulating a differential diagnosis for this vast spectrum of jaw lesions with overlapping clinical and imaging appearances.
METHODS
CT and MR images of the mandible, maxillofacial region, and neck were retrieved from the archive of the Radiology Department of Pamukkale University for the duration between 2012-2023 and assessed.
RESULTS
A total of 8125 CT and MR images were retrospectively analyzed. The mean age of the patients was 39.5 years in females and 43.2 in males, with a range varying from 15 to 72 years. Histopathologically approved benign and malignant non-odontogenic lesions were detected in only 19 patients out of 8125 images (0.23%). Osteomyelitis and abscess were the most common (n=3; 0.03%), followed by two cases (n=2; 0.02%) of each fibrous dysplasia, hemangioma, osteosarcoma, squamous cell carcinoma, and multiple myeloma, and one case (n=1; 0.01%) of each ossifying fibroma, osteoma, lymphoma, metastasis, and solitary bone cyst.
CONCLUSION
Although non-odontogenic benign and malignant lesions of the jaw are rare, awareness of the radiological features of these lesions plays an important role in their diagnosis and management.
PubMed: 37654125
DOI: 10.2174/1573405620666230901102904 -
Journal of Dental Sciences Apr 2023
PubMed: 37021260
DOI: 10.1016/j.jds.2022.12.021 -
World Journal of Clinical Oncology Dec 2021Ameloblastic fibromas and ameloblastic fibrosarcomas are rare odontogenic tumors, and controversy exists in the classification of cases presenting hard-tissue...
BACKGROUND
Ameloblastic fibromas and ameloblastic fibrosarcomas are rare odontogenic tumors, and controversy exists in the classification of cases presenting hard-tissue production: Ameloblastic fibrodentinoma (AFD) and ameloblastic fibro-odontoma (AFO). These cases are currently considered "developing odontomas" (hamartomatous lesions).
AIM
To analyze the clinicopathologic features of these lesions and discuss the changes in the 2017 World Health Organization classification.
METHODS
An electronic literature search was performed in the PubMed/MEDLINE database. An electronic search of the English language literature was performed and last updated in September 2020 in the PubMed/MEDLINE database using the following terms: "ameloblastic fibroma", "ameloblastic fibrodentinoma", "ameloblastic fibro-odontoma", "ameloblastic sarcoma", "ameloblastic fibrosarcoma", "ameloblastic fibrodentinosarcoma", "ameloblastic fibroodontosarcoma" and "odontogenic carcinosarcoma". The inclusion criteria were odontogenic tumor series, case reports and systematic reviews that provided sufficient clinical, radiological and microscopic documentation to confirm the diagnosis.
RESULTS
The database search strategy resulted in 947 papers. Articles focusing on other topics, articles that were not in English, duplicate articles, and articles without fulfilling the inclusion criteria were excluded. Finally, 96 publications were included in this review to describe and discuss the main features of the searched entities. Several aspects of AFO and AFD, such as biological behavior, age of occurrence, amount of hard tissue, and potential for malignant transformation into odontogenic sarcomas, support the neoplastic nature in most of the reported cases. Considering the clinical, radiographic, histopathological and molecular characteristics of odontogenic lesions with hard tissue production, we suggest that these types of lesions should continue to be recognized as odontogenic tumors by maintaining the classically used terms.
CONCLUSION
This recommendation will be relevant for future clinical, microscopic, and molecular studies to better understand the biology of these interesting odontogenic tumors.
PubMed: 35070741
DOI: 10.5306/wjco.v12.i12.1227 -
Head and Neck Pathology Jun 2023Cementoblastoma (CB) is unique among odontogenic tumors because its gross pathological anatomy is pathognomonic in most cases, i.e., a rounded calcified growth that is...
Cementoblastoma (CB) is unique among odontogenic tumors because its gross pathological anatomy is pathognomonic in most cases, i.e., a rounded calcified growth that is fused to the root of a tooth and completely encapsulated by fibrous tissue. The resulting radiographic appearance is a well-defined, globular mixed radiopaque/lucent or completely radiopaque mass obliterating some details of the root, with a thin radiolucent zone surrounding the central opacity. Although hundreds of publications have covered the clinicopathologic features of CB, almost nothing is known about its true history. Also it seems there is little understanding about how the term "CB" was originally introduced as a pathologic entity. This report covers some overlooked papers on CB dating back to the 19th century, including the first complete description in 1888 and the first radiographic presentation in 1906.
Topics: Humans; Cementoma; Odontogenic Tumors
PubMed: 36723849
DOI: 10.1007/s12105-022-01499-6 -
Head and Neck Pathology Jun 2023Ossifying fibroma (OF) is a fibro-osseous lesion of the jaws and craniofacial bones. Accurate diagnosis can be challenging due to significant overlap of...
BACKGROUND
Ossifying fibroma (OF) is a fibro-osseous lesion of the jaws and craniofacial bones. Accurate diagnosis can be challenging due to significant overlap of clinicopathological features. This study aimed to evaluate the clinical, radiological and histological features that can aid in diagnosis and identify characteristics that allow categorisation into the three subtypes: juvenile trabecular, psammomatoid and cemento-ossifying OF.
METHODS
A total of 74 cases of OF were systematically reviewed for their principle features. Of these, 46 cases were evaluated for their radiographic features including size, location and relationship to the teeth. Histological assessment and stereological point counting were performed in 69 cases to assess the pattern, type and proportion of calcification, the nature of the stroma, the border of the lesion and the presence of secondary changes. Fisher's exact test and Chi-squared tests were used to determine associations between clinicopathological parameters and maxillary, mandibular, odontogenic, non-odontogenic and psammomatoid or trabecular lesions.
RESULTS
OF showed a female predilection (F: M; 2:1) and a slight bimodal age distribution with peaks in the second (23%) and fourth decades (27%) (Mean age: 32.4 years). 83% of cases presented as an intra-oral swelling, with the mandible being the most common site (73%). Histologically, a range of morphological patterns were seen, with 50% of cases showing mixed trabecular and psammomatoid features. However, there were no significant differences between the variants of OF in terms of age, gender or histological features.
CONCLUSION
Histological features of OF cannot be used to differentiate between the subtypes.
Topics: Humans; Female; Adult; Fibroma, Ossifying; Skull Neoplasms; Cementoma; Calcinosis; Mandible; Cartilage Diseases
PubMed: 36622534
DOI: 10.1007/s12105-022-01522-w -
Head and Neck Pathology Jun 2023The World Health Organization's (WHO) chapter on odontogenic and maxillofacial bone tumors provides a global reference for diagnosis of these tumors. In the fifth... (Review)
Review
Proceedings of the 2023 North American Society of Head and Neck Pathology Companion Meeting, New Orleans, LA, March 12, 2023: Odontogenic Tumors: Have We Achieved an Evidence-Based Classification.
BACKGROUND
The World Health Organization's (WHO) chapter on odontogenic and maxillofacial bone tumors provides a global reference for diagnosis of these tumors. In the fifth edition, the inclusion of consensus definitions and development of essential and desirable diagnostic criteria help improve recognition of distinct entities. These are key enhancements since the diagnosis of odontogenic tumors is largely based on histomorphology which is taken in combination with clinical and radiographic appearances.
METHODS
Review.
RESULTS
Despite delineation of diagnostic criteria for ameloblastoma, adenoid ameloblastoma, and dentinogenic ghost cell tumor, a subset of these tumors continues to show overlapping histological features that can potentially lead to misdiagnosis. Accurate classification may be challenging on small biopsies, but potentially enhanced by refining existing diagnostic criteria and utilization of immunohistochemistry and/or molecular techniques in a specific cases. It has become clear that the clinical and histologic features of the non-calcifying Langerhans cell-rich subtype of calcifying epithelial odontogenic tumor and the amyloid-rich variant of odontogenic fibroma converge into a single tumor description. In addition, this tumor shows remarkable clinical, histological overlap with a subset of sclerosing odontogenic carcinoma located in the maxilla. Benign perineural involvement vs perineural invasion is an underexplored concept in odontogenic neoplasia and warrants clarification to reduce diagnostic confusion with sclerosing odontogenic carcinoma.
CONCLUSION
While controversial issues surrounding classification and discrete tumor entities are addressed in the WHO chapter, ambiguities inevitably remain. This review will examine several groups of odontogenic tumors to highlight persistent knowledge gaps, unmet needs and unresolved controversies.
Topics: Humans; Ameloblastoma; New Orleans; Odontogenic Tumors; Mouth Neoplasms; Carcinoma
PubMed: 37278887
DOI: 10.1007/s12105-023-01561-x -
Medicina Oral, Patologia Oral Y Cirugia... May 2022Odontogenic tumors (OTs) are considered important among oral lesions because of their clinicopathological heterogeneity and variable biological behavior. The purpose of...
BACKGROUND
Odontogenic tumors (OTs) are considered important among oral lesions because of their clinicopathological heterogeneity and variable biological behavior. The purpose of this retrospective cross-sectional study was to evaluate the frequency and distribution of different types of odontogenic tumors based on the current 2017 WHO Classification of Head and Neck Tumors over a period of 5 years. This was achieved by reviewing the records of Cairo's educational hospitals and institutions and comparing the results with findings in the literature.
MATERIAL AND METHODS
The records of patients diagnosed with odontogenic tumors were obtained from six educational hospitals and a single institute in Cairo which included: Oral and Maxillofacial Pathology Department, Faculty of Dentistry, Cairo University; General Pathology Department, Faculty of Medicine, Cairo University; Oral Pathology Department, Faculty of Dentistry, Ain Shams University; Eldemerdash Hospital, Ain Shams University; El-Sayed Galal Hospital, Al-Azhar University; Ahmed Maher Teaching Hospital and National Cancer Institute. These records were reviewed over a 5-year (2014-2018) period and the odontogenic tumors were investigated for frequency, age, gender and site. The data were recorded, then analyzed using SPSS software.
RESULTS
Intraosseous (central) odontogenic tumors constituted 2.56% of all 8974 registered oral and maxillofacial biopsies. A total of 230 cases of OTs were collected and reviewed. Of these, 97.8% were benign and 2.17% were malignant. The mandible was the most commonly affected anatomic location. Ameloblastoma, with a predilection for the posterior mandible, was the most frequent odontogenic tumor (55.65%), followed by cemento-ossifying fibroma (14.78%) and odontoma (9.13%). Females were more commonly affected than males. Most of the patients were in the third and fourth decades of life. There were no peripheral odontogenic tumors diagnosed in this period.
CONCLUSIONS
Some similarities and differences between our findings and those of previous studies of various populations were witnessed. OTs may greatly diverge according to the version of the classification used and by the sample size of the study. Retrospective analysis of the relative frequency of OTs in different countries will be helpful in enhancing the understanding of OTs, which is important for both oral maxillofacial surgeons and pathologists.
Topics: Ameloblastoma; Cross-Sectional Studies; Egypt; Female; Humans; Male; Odontogenic Tumors; Organic Chemicals; Retrospective Studies
PubMed: 35420069
DOI: 10.4317/medoral.24661 -
Head and Neck Pathology Sep 2021Gingival growths, barring a few are mostly reactive and seldom exhibit significant true neoplastic potential. The common etiology is local irritation from dental...
Gingival growths, barring a few are mostly reactive and seldom exhibit significant true neoplastic potential. The common etiology is local irritation from dental plaque/calculus, trauma as well as medication-related overgrowth. Such lesions are easily distinguishable and categorized into diagnoses such as pyogenic granuloma, peripheral ossifying fibroma, etc. We present a previously undescribed, but commonly encountered, reactive gingival growth with unique histologic features and suggest the diagnostic term "gingival fibroma." An IRB approved retrospective review of the University of Florida Oral Pathology Biopsy Service encompassing years 2010-2019, was performed to select cases. Demographics, clinical data, and microscopic diagnoses were recorded and analyzed. Four board-certified oral and maxillofacial pathologists agreed upon and established the diagnostic criteria. These are: a prominent fibromyxoid stroma, variable cellularity, a whorled or storiform pattern of arrangement of the cellular elements, lack of significant inflammation or vascularity, and complete absence of calcification, and/or odontogenic islands. A total of 60 cases met all criteria and were included in the study. Age range in years was 14-87 with the mean at 45.11 years. A striking female predilection (90%) was noted. Approximately 62% of cases were reported on the maxillary gingiva, followed by 38.3% in the mandibular gingiva. Majority, 66.7% were in the anterior incisor region followed by 11.7% in the canine/first premolar areas. All lesions were submitted as excisional biopsy, and 4 cases recurred within 2-3 years of excision. In all cases, lesional tissue appeared to extend to the surgical base of the specimen. We present 60 cases of a histologically unique entity occurring exclusively on the gingiva and introduce the diagnostic term "Gingival Fibroma" for these lesions. Further studies with adequate clinical follow-up may help understand the exact clinical behavior of these lesions.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Fibroma; Gingival Neoplasms; Humans; Male; Middle Aged; Retrospective Studies; Young Adult
PubMed: 33686583
DOI: 10.1007/s12105-021-01315-7