Adenomatoid Odontogenic Tumour: Clinical Features, Radiological Features, and Histological Features
Discover the key aspects of Adenomatoid Odontogenic Tumour, including its clinical features, radiological features, and histological features. Learn about its age and sex incidence, site predilection, signs and symptoms, and more. Explore how it is different from dentigerous cysts and its distinctive histological characteristics.
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Presentation Transcript
ADENOMATOID ODONTOGENIC TUMOUR
Earlier, believed to be a variant of Ameloblastoma with glandular elements and was referred to as ADENOAMELOBLASTOMA.
CLINICAL FEATURES: Age incidence: Young individuals, 1st & 2nd Sex incidence: More in females, twice more. Site predilection: Anterior aspect of maxilla.
Signs & symptoms: Small,asymptomatic lesion. Discovered accidentally during routine dental X-ray examination to ascertain unerupted tooth. Larger lesions cause jaw expansion cause for
RADIOLOGICAL FEATURES: Typical well defined unilocular lucency attached to an impacted / unerupted tooth, usually canine (FOLLICULAR VARIETY) Lucency extends past cervical region & must be distinguished from dentigerous cyst.
Extrafollicular well defined lucency not related to unerupted tooth. In both cases, lucency may contain snowflake like radio opacities.
HISTOLOGICAL FEATURES: Thick capsule Lesion is composed of spindle shaped epithelial cells that form sheets, strands or whorls in a scanty stroma.
Rosette like structures may show a central space which may be empty or contain some eosinophilic amyloid like material. Tubular duct like spaces are also seen which show a central space surrounded by columnar cells
Treatment & Prognosis Benign Capsule Recurrence : rare
CALCIFYING EPITHELIAL ODONTOGENIC TUMOUR (PINDBORG TUMOR)
Rare tumor, accounts for > 1% of all odontogenic tumors. Although odontogenic in origin, its histogenesis is uncertain. Tumor cells strongly resemble stratum intermedium of dental organ.
CLINICAL FEATURES: Age incidence: 3rd to 5th decades. Sex incidence: Equal. Site predilection: 75% cases occur in posterior mandible. Signs & symptoms: Asymptomatic, slowly growing swelling.
RADIOLOGICAL FEATURES: Commonly appears as a well defined, uni/multilocular usually associated with an impacted tooth. Lesion may presence of radiopaque material within the lucency. scalloped, lucency, also show scattered
DIFFERENTIAL DIAGNOSIS: 1. Odontogenic cysts like dentigerous, OKC, etc. 2. Odontogenic tumors like Ameloblastoma, etc. 3. Other bony lesion like Central giant cell granuloma, Aneurismal bone cyst etc.
HISTOLOGICAL FEATURES: Tumor shows discrete islands / sheets of polyhedral cells in stroma. Nuclei show lot of size variation, even giant nuclei can be seen. epithelial fibrous a
Tumor islands also enclose large areas of eosinophilic, amorphous, amyloid like material
The cell outlines of tumor epithelial cells are distinct and intercellular bridges may be noted. The amyloid like material usually calcifies to form concentric rings (LEISEGANG RINGS).
Mixed odontogenic tumors Ameloblastic fibroma Ameloblastic fibro-odontoma Ameloblastic fibrosarcoma Odotoameloblastoma Odontoma
Ameloblastic fibroma True mixed tumor Both epithelial and mesenchymal component are tumoral May be this is just a stage in developing odntoma ameloblastic fibroma ameloblastic fibroodontoma odontoma
Clinical features Age : 1-2 decades Site : post of mandible If is small : asymptomatic and unilocular radiolucency If is large : swelling and multilocular It is well defined and has sclerotic border : unerupted tooth
2 ? 4/23/2025
Differential diagnosis Dentigerous cyst (if unilocular and impacted tooth associated) Odontogenic keratocyst Central giant cell granuloma Odontogenic myxoma Central hemangioma Calcifying odontogenic cyst Ameloblastoma
Histopathology Cell-rich mesenchymal tissue resembling the dental papilla Islands of proliferating epithelium
Prognosis recurrence rate: 0-18% Ameloblastic fibrosarcoma should be considered in recurred cases (45%)
TX Conservative curettage Separates easily from its bony bed Because it is well circumscribed , no invasion to surrounding bone has been occurred Px is excellent + no recurrence
Ameloblastic Fibrosarcoma mesenchymal portion shows features of malignancy. arise de novo or transformation of an ameloblastic fibroma.
Clinical features Patient Age: The mean age is 27 years. Gender Predilection: Males Location: 80 % in the mandible. Pain and swelling & Rapid clinical growth
Radiographic Features: ill-defined, destructive, radiolucent lesion.
Treatment & Prognosis Radical surgical excision Locally invasive The long-term prognosis ?
