Ameloblastic Fibro-Odontoma: A Diagnostic Challenge

An 11-year-old girl presented to our department to have a second opinion regarding a lesion involving her left mandible. She had previously undergone several radiographic exams including panoramic, helical, and cone-beam computed tomography. Radiographic examinations revealed a well-defined radiolucent region, which contained an irregular radiopaque mass of 3 cm in diameter, localized to the left angle of the mandible. Our presumptive diagnosis was complex odontoma. Excisional biopsy was performed, and microscopic features showed strands and islands of odontogenic epithelium showing peripheral palisading and loosely arranged central cells, identical to stellate reticulum, embedded in a myxoid cell-rich stroma resembling the dental papilla. Dentin and enamel were also presented. The diagnosis was ameloblastic fibro-odontoma, which is a rare mixed odontogenic tumor, derived from epithelial and ectomesenchymal elements that form the dental tissues.

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Erupting Compound Odontome - A Case Report

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/287 ◽

2021 ◽

Vol 10 (18) ◽

pp. 1361-1364

Author(s):

Shreyas N. Shah ◽

Falguni Patel

Keyword(s):

World Health Organization ◽

World Health ◽

Radiographic Evaluation ◽

Dental Tissue ◽

Odontogenic Tumours ◽

Dental Tissues ◽

Odontogenic Epithelium ◽

Complex Odontoma ◽

Health Organization ◽

Compound Odontoma

Odontomas are asymptomatic, benign odontogenic tumours comprised of dental tissue. Most of the cases usually get detected on routine radiographic evaluation. Odontoma can be classified according to morphology in two different variants, compound odontoma showing anatomic similarity or miniature version of the tooth and complex odontoma having irregular masses with different type of dental tissues. Early detection of such type of silent lesion is mandatory to rule out certain silent but aggressive pathologies. Here, we present a case of erupting compound odontoma of maxillary area in 15-year-old male patient. Development of tooth is a result of complicated interaction between ectodermal and ecto mesenchymal tissue. Sometimes the remnants of such tissues are left behind in the jaw after development and eruption of tooth, which can become a source of development of odontogenic lesions later on.1 As revealed by World Health Organization (WHO), Odontogenic tumours can be classified in three different categories according to their histopathological form.2 1. Odontogenic tumours which develop from odontogenic epithelium without involvement of odontogenic ectomesenchyme, 2. Odontogenic tumours which develop from odontogenic epithelium with involvement of odontogenic ectomesenchyme, with or without formation of dental hard tissue and 3. Odontogenic tumours which develop from odontogenic ectomesenchyme with or without involvement of odontogenic epithelium.2 For such lesions “Odontoma” word was initially given by Paul Broca in 1866, who revealed the term as tumour occurred by the overgrowth of entire dental tissue. The growth of absolutely differentiated epithelial cells as functional ameloblast and mesenchymal cells as functional odontoblast can give rise to a different developmental anomaly coined as Odontomas.3 According to their behaviour and composition, odontomas can be considered as malformations or hamartomas rather than a true neoplasm. 4,5,6 In 2005, World Health Organization (WHO) classified two variants of odontomas, 1. Compound odontomas, which typically appears as unilocular lesions containing multiple radiopaque, tiny tooth like structures commonly known as denticles; and 2. Complex odontomas, which is comprised of an irregular mass of soft and hard dental tissues.

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Ameloblastic Fibrosarcoma of the Mandible: A Case Report and Brief Review of the Literature

Case Reports in Pathology ◽

10.1155/2015/245026 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Abelardo Loya-Solis ◽

Karla Judith González-Colunga ◽

Cynthia M. Pérez-Rodríguez ◽

Natalie Sofía Ramírez-Ochoa ◽

Luis Ceceñas-Falcón ◽

...

Keyword(s):

Histopathological Examination ◽

Surgical Excision ◽

Second Molar ◽

Odontogenic Epithelium ◽

Left Mandible ◽

Long Term Follow Up ◽

History Of ◽

Ameloblastic Fibrosarcoma ◽

Mitotic Figures ◽

One Year

Ameloblastic fibrosarcoma is an uncommon odontogenic tumor composed of a benign epithelial component and a malignant ectomesenchymal component most frequently seen in the third and fourth decades of life. It mainly presents as a painful maxillary or mandibular swelling. Radiographs show a radiolucent mass with ill-defined borders. Radical surgical excision and long-term follow-up are the suggested treatment. We report the case of a 22-year-old female with a 2-month history of an asymptomatic swelling in her left mandible. Examination revealed an exophytic growth measuring3×3 cm extending from the mandibular left first premolar to the second molar. The patient underwent a left hemimandibular resection. Histopathological examination revealed a biphasic tumor composed of inconspicuous islands of benign odontogenic epithelium and an abundant malignant mesenchymal component with marked cellularity, nuclear pleomorphism, hyperchromatism, and moderate mitotic figures with clear margins; one year after the surgical procedure, the patient is clinically and radiologically disease-free.

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

Journal of Enam Medical College ◽

10.3329/jemc.v9i1.39907 ◽

2019 ◽

Vol 9 (1) ◽

pp. 57-59

Author(s):

Abdullah Al Faruq ◽

Sharmin Sultana ◽

Hasan Ibn Showkat

Keyword(s):

Facial Asymmetry ◽

Dental Tissues ◽

Unerupted Tooth ◽

Large Complex ◽

Mandibular Molar ◽

Complex Odontoma ◽

Complex Variety ◽

Different Types ◽

Odontogenic Origin ◽

Benign Tumours

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

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Pulmonary Kaposi's Sarcoma: Diagnostic Features and Natural History in Patients with Acquired Immuneodeficiency Syndrome

Canadian Respiratory Journal ◽

10.1155/1996/695819 ◽

1996 ◽

Vol 3 (3) ◽

pp. 181-186

Author(s):

Willis Tsai ◽

Charles K Chan ◽

Frances Shepherd ◽

Carol Sawka

Keyword(s):

Natural History ◽

Median Survival ◽

Kaposi's Sarcoma ◽

Opportunistic Infections ◽

Radiological Finding ◽

Kaposi’S Sarcoma ◽

Diagnostic Challenge ◽

Diagnostic Features ◽

Presumptive Diagnosis ◽

Presenting Symptoms

OBJECTIVE:This retrospective descriptive study was undertaken to highlight the diagnostic features and natural history of pulmonary Kaposi's sarcoma (KS).METHODS:Thirty-three patients with symptomatic pulmonary KS were assembled from a cohort of 239 patient with KS. Pulmonary KS was diagnosed by visualization of endobronchial lesions at bronchoscopy or based on clinical-radiological correlation and exclusion of opportunistic infections.RESULTS:The median time from initial presentation with KS to the development of pulmonary involvement was nine months. Dyspnea (79%) and dry cough (79%) were the most common presenting symptoms. Oral palatal involvement was present in 58% of patients with pulmonary KS. Pulmonary nodules (58%) were the most common radiological finding, but an interstitial pattern was noted in 42% of patients. Pleural effusion was present in 39%. Radiological patterns were not static, as 50% of patients with an initial interstitial pattern progressed to develop poorly formed nodules in the peripheral lung fields. Endobronchial lesions were noted on bronchoscopy in 23 patients. A presumptive diagnosis of pulmonary KS was made in 10 patients, with autopsy confirmation in four. Chemotherapy completely resolved symptoms in nine of 25 treated (36%) patients, and a further nine (36%) experienced a significant reduction in symptoms. Radiological improvement was noted in two of the clinical responders. Median survival from the time of diagnosis of pulmonary KS was only eight months, and symptoms relapsed within six weeks of achieving the best clinical response with chemotherapy.CONCLUSIONS:Pulmonary KS presents a difficult diagnostic challenge due to a nonspecific constellation of symptoms and radiological findings. Bronchoscopy is diagnostic when endobronchial lesions are visualized but, more important, it can exclude opportunistic infections. In some patients, even with a negative bronchoscopy, the diagnosis may still be established using clinical-radiographic correlation, particularly if there is radiological evolution to a nodular pattern over time. Multidrug chemotherapeutic regimens appear to have some symptomatic benefit, but radiological improvement is extremely limited. Progression of disease occurs in virtually all patients, and the median survival is only eight months from the point of recognition of pulmonary KS.

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Ameloblastic Fibroodontoma: Uncommon Case Presentation in a 6-Year-Old Child with Review of the Literature

Case Reports in Medicine ◽

10.1155/2017/9483738 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

Anshad Mohamed Abdulla ◽

G. Sivadas ◽

L. K. Surej Kumar ◽

C. S. Sheejith Hari Peeceeyen ◽

Vaishnavi Vedam

Keyword(s):

Review Of The Literature ◽

Radiographic Findings ◽

Case Presentation ◽

Irregular Shapes ◽

Odontogenic Epithelium ◽

Ameloblastic Fibroma ◽

Complex Odontoma ◽

Uncommon Case ◽

Odontogenic Neoplasm ◽

Unerupted Teeth

Ameloblastic fibroodontoma is a benign mixed odontogenic neoplasm considered in patients with asymptomatic swelling and unerupted teeth that exhibit histologic features between ameloblastic fibroma and complex odontoma. Radiographically, this lesion appears as radiolucency admixed with focal radio opaque masses of irregular shapes and sizes. This lesion is confirmed by the presence of proliferating odontogenic epithelium, ectomesenchyme, and dental hard tissue formation on pathological analysis supplementing clinical and radiographic findings. As this tumour is less commonly seen in routine clinical practice, ameloblastic fibroodontoma with detailed orofacial features and periodic approach to its diagnosis is discussed. This paper reports a case of ameloblastic fibroodontoma of the mandible in a 6-year-old male patient with an uncommon case presentation and review of the literature.

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Volume measurement of mandibular teeth pulp chamber as a prediction tool of gender and ethnicity in a Brazilian population

Brazilian Dental Science ◽

10.14295/bds.2021.v24i1.2230 ◽

2020 ◽

Vol 24 (1) ◽

Author(s):

Karolina Aparecida Castilho Fardim ◽

Eurico Oliveira Junior ◽

Rafael Rodrigues ◽

Elaine Araújo ◽

João Pedro Gomes ◽

...

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Cone Beam ◽

Dental Arch ◽

P Value ◽

Forensic Dentistry ◽

Pulp Chamber ◽

Dental Tissues ◽

Chamber Volume ◽

Volumetric Assessment

Objective: Forensic dentistry has used some methods for the human identification process. However, there is a need to study characteristics that are able to perform identification more specifically, increasing accuracy. Considering the role of dental arch assessment in prediction of gender and ethnicity, the purpose of this study was to assess the volume of pulp chamber as a mean to obtain new forensic evidence. Material and methods: For this task, 1.190 cone beam computed tomography (CBCT) images were retrospectively selected and subdivided according to the population number, gender, age and ethnicity. All DICOM files were imported to the open-source software ITK-SNAP® (http://www.itksnap.org/pmwiki/pmwiki.php). The segmentation process was performed in all pulp chamber aiming to obtain pulp tissue´s volume. Results: As a result, the pulp chamber volume of mandibular canine teeth showed to be larger in white population than in non-white (P-value = 0.003) and in male individuals in comparison with female (P-value = 0.038). Conclusion: These results, however, must be confirmed by future studies with a larger sample size and by the assessment of other variables, including texture analysis and density of dental tissues. KEYWORDS Cone beam computed tomography; Ethnicity; Forensic dentistry; Gender; Pulp chamber volume; Volumetric assessment.

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Gambaran radiograf compound odontoma yang berhubungan dengan impaksi insisivus sentral maxilla: laporan kasus

Jurnal Ilmiah dan Teknologi Kedokteran Gigi ◽

10.32509/jitekgi.v15i2.698 ◽

2019 ◽

Vol 15 (2) ◽

pp. 33

Author(s):

Fitri Angraini Nasution

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Cone Beam ◽

Complex Odontoma ◽

Compound Odontoma ◽

True Neoplasm

Latar Belakang: Odontoma adalah tumor odontogenik yang memiliki sifat klinis jinak, dianggap sebagai kelainan perkembangan (hamartoma) dan bukan merupakan tumor sejati (true neoplasm). Tumor odontogenik ini terdiri dari jaringan email, dentin, sementum dan pulpa. Odontoma terdiri dari dua jenis yaitu compound dan complex odontoma. Compound odontoma sering terjadi pada regio insisivus-kaninus maxilla. Tumor ini berhubungan dengan erupsi gigi yang tertunda, impaksi dan persistensi gigi sulung.Tujuan: Untuk mendeteksi gambaran radiograf panoramik dan CBCT pada kasus compound odontoma.Laporan kasus: Pasien perempuan berusia 10 tahun bersama orang tuanya datang ke bagian Pedodonsia Rumah Sakit Gigi dan Mulut Universitas Padjadjaran Bandung dengan keluhan gigi depan rahang atas kiri belum tumbuh. Kemudian pasien dirujuk ke bagian radiologi untuk dilakukan pemeriksaan panoramik dan Cone Beam Computed Tomography (CBCT). Hasil radiograf panoramik dan CBCT menunjukkan lesi dengan struktur densitas multiple radioopak berbentuk seperti gigi pada rongga radiolusen dengan batas well-defined corticated . Suspek radiodiagnosis adalah compound odontoma yang berhubungan dengan impaksi gigi insisivus sentral.Simpulan: Radiograf panoramik dan CBCT dapat digunakan untuk mendeteksi gambaran compound odontoma.

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Use of GaAlAs Diode Laser for Excisional Biopsy of Gingival Giant Cell Fibroma: A Case Report of a Rare Lesion

Frontiers in Dentistry ◽

10.18502/fid.v18i3.5433 ◽

2021 ◽

Author(s):

Sabiha Naaz ◽

Abdul Ahad ◽

Afshan Bey ◽

Hena A Ansari

Keyword(s):

Giant Cell ◽

Diode Laser ◽

Thermal Damage ◽

Histopathological Examination ◽

Excisional Biopsy ◽

Vital Role ◽

Biopsy Specimens ◽

Microscopic Features ◽

Rare Lesion ◽

Excised Tissue

Giant cell fibroma (GCF) is a relatively rare lesion in the oral cavity. Despite having unique microscopic features, it can be easily misdiagnosed clinically as any common hyperplastic lesion. This report presents a case of a 21-year old male with a lesion involving the papilla between the mandibular central incisors. The lesion was excised completely under topical anesthesia using a 980 nm diode laser. On histopathological examination of the excised tissue, no thermal damage or any other alteration was observed, while the features were suggestive of GCF. Healing of the gingiva was uneventful and without any signs of recurrence. Apart from the widely known advantages of the diode laser, it also appears to maintain the integrity of biopsy specimens, if used with appropriate settings. This advantage may play a vital role in the biopsy of rare lesions where the diagnosis is entirely based on accurate histopathological examination.

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Calcifying epithelioma of Malherbe of cheek: a diagnostic challenge

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20150213 ◽

2015 ◽

Vol 1 (1) ◽

pp. 96

Author(s):

Ameya Bihani ◽

Yogesh Dokhe ◽

Priyanka Hardikar ◽

Jyoti Dabholkar

Keyword(s):

Imaging Technique ◽

Excisional Biopsy ◽

Needle Aspiration ◽

Radiological Imaging ◽

Diagnostic Challenge ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology ◽

Rare Benign Tumour ◽

Cheek Swelling

Malherbe’s calcifying epithelioma is a very rare benign tumour in area of cheek but generally present in first two decades of life. Fine Needle Aspiration Cytology (FNAC) and radiological imaging technique are not of great help in diagnosing this tumour. We hereby present a case of 15 year female with cheek swelling since 3 years which turned out to be pilomatricoma on histopathology of specimen of excisional biopsy. Keywords: Malherbe’s calcifying epithelioma, Pilomatrixoma, BCL-2, CTNNB1

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The use of cone-beam computed tomography (CBCT) in radiocarpal fractures: a diagnostic test accuracy meta-analysis

Skeletal Radiology ◽

10.1007/s00256-021-03883-9 ◽

2021 ◽

Author(s):

Emma Fitzpatrick ◽

Vivek Sharma ◽

Djamila Rojoa ◽

Firas Raheman ◽

Harvinder Singh

Keyword(s):

Sensitivity And Specificity ◽

Imaging Modality ◽

Meta Analysis ◽

Cone Beam Ct ◽

Diagnostic Algorithm ◽

Cone Beam ◽

Acquisition Time ◽

Test Accuracy ◽

Diagnostic Challenge ◽

Bivariate Model

Abstract Objective Occult radiocarpal fractures often present a diagnostic challenge to the emergency department. Accurate diagnosis of these injuries is crucial as a missed fracture can lead to significant morbidity. Cone-beam CT (CBCT) scan is a novel imaging modality, with minimal radiation exposure and comparatively fast acquisition time. Our aim was to evaluate its use in the diagnosis of cortical fractures in the upper limb extremity. Materials and methods We conducted a systematic review of literature and included all studies that evaluated the use of CBCT in the diagnosis of radiocarpal fractures. We used a mixed-effects logistic regression bivariate model to estimate the summary sensitivity and specificity and constructed hierarchical summary receiver operative characteristic curves (HSROC). Results We identified 5 studies, with 439 patients, and observed CBCT to be 87.7% (95% CI 77.6–93.6) sensitive and 99.2% (95% CI 92.6–99.9) specific for scaphoid fractures. For carpal fractures, CBCT was observed to have a pooled sensitivity and specificity of 90.6% (95% CI 72.7–97.2) and 100% (95% CI 99–100) respectively. For distal radius fractures, CBCT sensitivity was 90% (95% CI 67–98) and specificity was 100% (95% CI 10–100). The overall inter-rater agreement effect was shown to be 0.89 (95% CI 0.82–0.96), which is deemed to be almost perfect. Conclusion CBCT is an accurate diagnostic tool for occult radiocarpal cortical fractures, which could replace or supplement radiographs. We believe CBCT has a promising role in the acute radiocarpal fracture diagnostic algorithm in both emergency and trauma departments.

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