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Turk Patoloji Dergisi 2022The 5th edition of the World Health Organization (WHO) Classification of Head and Neck Tumors opened to online access in March 2022. This edition is conceptually similar... (Review)
Review
The 5th edition of the World Health Organization (WHO) Classification of Head and Neck Tumors opened to online access in March 2022. This edition is conceptually similar to the previous classification of odontogenic lesions. The only newly defined entity in odontogenic lesions is adenoid ameloblastoma, which is classified under benign epithelial odontogenic tumors. While not odontogenic, the surgical ciliated cyst is a new entry to the cyst classification of the jaws. In other respects, a very important change was made in the new blue books that added 'essential and desirable diagnostic criteria' for each entity to highlight the features considered indispensable for diagnosis. In this article, we review the odontogenic tumors and cysts of the jaw sections of the Odontogenic and Maxillofacial Bone Tumors Chapter, outlining changes from the 2017 WHO classification and summarizing the essential diagnostic criteria and new developments.
Topics: Ameloblastoma; Head and Neck Neoplasms; Humans; Odontogenic Cysts; Odontogenic Tumors; World Health Organization
PubMed: 35578902
DOI: 10.5146/tjpath.2022.01573 -
Head and Neck Pathology Mar 2022The 5 edition of the World Health Organization (WHO) Classification of Head and Neck Tumours (2022) comes out only five years after the previous edition, however it...
The 5 edition of the World Health Organization (WHO) Classification of Head and Neck Tumours (2022) comes out only five years after the previous edition, however it presents important updates that run in parallel with the rapid progression involving the increasingly sophisticated molecular investigation and its interpretation, some of which already have therapy-related impact. This manuscript provides an overview of the leading changes introduced in the classification of Odontogenic and Maxillofacial Bone Tumours that encompasses cysts of the jaws, odontogenic tumours, giant cell lesions and bone cysts, and bone and cartilage tumours. This is the first edition that Essential and Desirable Diagnostic Features were added for each entity, so that the most important clinical, microscopic and/or radiologic features were encapsulated and briefly highlighted. Surgical ciliated cyst was added to the group of odontogenic cysts, adenoid ameloblastoma was a newly recognized benign epithelial odontogenic tumour, and segmental odontomaxillary dysplasia was introduced in the group of fibro-osseous tumours and dysplasia. In addition, rhabdomyosarcoma with TFCP2 rearrangement, was introduced into the group of malignant jawbone tumours. The unique genetic aberrations distinguish it from other types of rhabdomyosarcomas. On the other hand, melanotic neuroectodermal tumour of infancy and osteoid osteoma were deleted from the benign bone and cartilageneous tumours, as was the hematolymphoid tumour of solitary plasmacytoma of bone. We systematically reviewed each entity in this chapter and provided important updated findings for selected topics that can further aid in the diagnostic process for challenging cases, broaden insights on the logic of the present classification, and finally, emphasize the potential that some of the molecular results may have in the near future to set new treatment approaches.
Topics: Bone Neoplasms; DNA-Binding Proteins; Head and Neck Neoplasms; Humans; Odontogenic Cysts; Odontogenic Tumors; Transcription Factors; World Health Organization
PubMed: 35312978
DOI: 10.1007/s12105-021-01404-7 -
Head and Neck Pathology Mar 2021This article reviews odontogenic and developmental oral lesions encountered in the gnathic region of pediatric patients. The process of odontogenesis is discussed as it... (Review)
Review
This article reviews odontogenic and developmental oral lesions encountered in the gnathic region of pediatric patients. The process of odontogenesis is discussed as it is essential to understanding the pathogenesis of odontogenic tumors. The clinical presentation, microscopic features, and prognosis are addressed for odontogenic lesions in the neonate (dental lamina cysts/gingival cysts of the newborn, congenital (granular cell) epulis of the newborn, melanotic neuroectodermal tumor, choristoma/heterotopia, cysts of foregut origin), lesions associated with unerupted/erupting teeth (hyperplastic dental follicle, eruption cyst, dentigerous cyst, odontogenic keratocyst/keratocystic odonogenic tumor, buccal bifurcation cyst/inflammatory collateral cyst) and pediatric odontogenic hamartomas and tumors (odontoma, ameloblastic fibroma, ameloblastoma, adenomatoid odontogenic tumor, primordial odontogenic tumor). Pediatric odontogenic and developmental oral lesions range from common to rare, but familiarity with these entities is essential due to the varying management implications of these diagnoses.
Topics: Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Jaw Diseases; Male; Odontogenesis; Tooth Abnormalities
PubMed: 33723756
DOI: 10.1007/s12105-020-01284-3 -
International Journal of Oral and... Nov 2022The treatment of odontogenic keratocysts is reviewed in light of the aetiology and pathogenesis of these lesions. The role of the dental lamina and submucosal hamartias,... (Review)
Review
The treatment of odontogenic keratocysts is reviewed in light of the aetiology and pathogenesis of these lesions. The role of the dental lamina and submucosal hamartias, as frequently seen in nevoid basal cell carcinoma syndrome, is discussed, and the implications for treatment are emphasized.
Topics: Humans; Neoplasm Recurrence, Local; Odontogenic Cysts; Odontogenic Tumors; Basal Cell Nevus Syndrome
PubMed: 35277291
DOI: 10.1016/j.ijom.2022.02.005 -
Cureus Aug 2022Ameloblastoma is one of the most common benign odontogenic tumors of the jaw that constitutes about 10% of all tumors that arise in the mandible and maxilla. It is a... (Review)
Review
Ameloblastoma is one of the most common benign odontogenic tumors of the jaw that constitutes about 10% of all tumors that arise in the mandible and maxilla. It is a slow-growing but locally invasive tumor that presents with painless swelling of the mandible or maxilla. The World Health Organization (WHO) classification of 2017 describes ameloblastomas of the following four types: ameloblastoma; unicystic ameloblastoma; extraosseous/peripheral ameloblastoma; and metastasizing ameloblastoma. The diagnosis of ameloblastoma requires computerized tomography (CT) imaging as well as a biopsy. A biopsy is helpful in differentiating ameloblastoma from ossifying fibroma, osteomyelitis, giant cell tumor, cystic fibrous dysplasia, myeloma, and sarcoma. The best treatment of ameloblastoma is aggressive en bloc resection with simultaneous reconstruction. The high recurrence rate and large tissue defects have been long-standing issues in the treatment of ameloblastoma. Recent molecular developments strongly suggest the possibility of targeted therapy with better outcomes in ameloblastomas. We present a detailed updated narrative review of our current understanding and management of this enigmatic tumor.
PubMed: 36127985
DOI: 10.7759/cureus.27734 -
JNMA; Journal of the Nepal Medical... Jul 2022Ameloblastomas of jaws are benign odontogenic tumors of epithelial origin with four clinical variants: solid multicystic type, unicystic type, desmoplastic type, and...
UNLABELLED
Ameloblastomas of jaws are benign odontogenic tumors of epithelial origin with four clinical variants: solid multicystic type, unicystic type, desmoplastic type, and extraosseous type. The incidence rate of ameloblastoma is 0.92 per million person-years. Unicystic ameloblastoma refers to those cystic lesions that show clinical and radiologic characteristics of an odontogenic cyst but shows a typical ameloblastomatous epithelium lining part of the cyst cavity, with or without luminal and/or mural tumor proliferation on histological examination. Here is a unique case of unicystic ameloblastoma involving the mandible in a 70-year-old patient. The case was managed by segmental mandibulectomy and flap repair. Unicystic ameloblastoma accounts for only 13% of all known cases in scientific literature. Considering the rarity of the lesion, the purpose of presenting this report on a clinical case is to emphasize the importance of radiological evaluation and histopathological examination for the diagnosis of ameloblastoma.
KEYWORDS
ameloblastoma; odontogenic cysts; odontogenic tumors; segmental mandibulectomy.
Topics: Humans; Aged; Ameloblastoma; Mandible; Odontogenic Tumors; Odontogenic Cysts; Jaw
PubMed: 36705195
DOI: 10.31729/jnma.7566 -
The British Journal of Oral &... Jun 2023The odontogenic keratocyst (OKC) is a common cystic lesion in the jaw. Its management, however, is highly debated with no consensus on the best treatment option.... (Review)
Review
The odontogenic keratocyst (OKC) is a common cystic lesion in the jaw. Its management, however, is highly debated with no consensus on the best treatment option. Clinicians base their approach on treatment efficacy and associated morbidity. Management often consists of enucleation with peripheral ostectomy and adjunctive therapy to prevent recurrence. The aim of our systematic review was to evaluate the safety and efficacy of these different modalities. Embase, Medline, and Cochrane were searched according to the PRISMA guidelines for articles that presented non-syndromic patients with histopathologically confirmed OKC treated with 5-fluorouracil (5FU), Carnoy's solution (CS), or modified Carnoy's solution (MCS) as adjunctive therapy after enucleation and peripheral ostectomy. The outcomes of interest were safety (measured as adverse events) and efficacy (expressed as recurrence). Risk of bias was evaluated using the Newcastle-Ottawa scale. Four studies were included and 62 patients were evaluated. The results show that recurrence occurred only in patients treated with MCS. Reported adverse events were mostly limited to paraesthesia that could be permanent (in the CS and MCS treatment groups) or transient (across all adjunctive therapies). With the prohibition of CS, both MCS and 5FU are promising replacement adjunctive therapies. From a safety and efficacy perspective we consider 5FU, which was associated with the lowest recurrence and fewest adverse events, to be the most viable option. More high-evidence prospective studies, such as randomised controlled trials, with a longer follow-up period are necessary to draw definite conclusions.
Topics: Humans; Prospective Studies; Odontogenic Cysts; Acetic Acid; Chloroform; Odontogenic Tumors
PubMed: 37248124
DOI: 10.1016/j.bjoms.2023.04.006 -
Dental and Medical Problems 2019Based on a literature review, we analyzed the World Health Organization (WHO) classification and the treatment algorithm for the odontogenic keratocyst (OKC), formerly...
Based on a literature review, we analyzed the World Health Organization (WHO) classification and the treatment algorithm for the odontogenic keratocyst (OKC), formerly referred to as keratocystic odontogenic tumor (KCOT). The KCOT reclassification from benign odontogenic tumors to odontogenic developmental cysts resulted from the emergence of new evidence regarding their morphogenesis and biological behavior. The authors of the most recent 2017 classification do not provide specific guidelines for OKC. Nevertheless, it has been observed that conservative surgical management is not necessarily associated with recurrences characteristic of neoplastic disease. The aim of this paper was to present the effective management strategy for a local recurrence that developed following conservative OKC enucleation in a 53-year-old patient. The treatment for recurrence consisted of enucleation, marginal osteotomy and augmentation with a cancellous bone graft harvested from a tibial tuberosity. A 6-year observation period (clinical and radiological monitoring) revealed normal bone regeneration and no evidence of recurrence. The algorithm applied in our center for the treatment of OKC/KCOT was compared with the management strategies proposed by other authors.
Topics: Humans; Mandible; Middle Aged; Neoplasm Recurrence, Local; Odontogenic Cysts; Odontogenic Tumors; Radiography
PubMed: 31689015
DOI: 10.17219/dmp/110682