Adenomatoid Odontogenic Tumour - The Master of Disguise

Adenomatoid odontogenic tumour, truly coined as one of the masters of disguise of orofacial pathologies, was first reported in the literature by Steen Lands.1 Philipson and Brin used the terminology adenomatoid odontogenic tumour for this pathology with its commonly accepted abbreviation AOT.2 Later on, adenomatoid odontogenic tumour (AOT) name was accepted by the World Health Organization (WHO) in 1971. In 2005, WHO revealed the histological variants of the adenomatoid odontogenic tumour and classified it as a tumour comprised of odontogenic epithelium showing various patterns in histopathologic view within a mature connective tissue stroma.3 It is seldom noticed neoplasm which comprises only 3 % of all the odontogenic tumours. It was commonly found in the maxilla with female predilection and mostly in association with impacted canines.4-6 Adenomatoid odontogenic tumour is an odontogenic epithelial tumour usually seen in females in their second decade of life. The tumour is slow growing in nature which eventually results in painless expansion of jaw. The maxilla is commonly affected than mandible. Being benign in nature, most of the AOT cases usually got treated with conservative surgical enucleation but the greater size of tumour can leave behind an oro-facial defect. To prevent such type of incident, it is important to diagnose them early and treat accordingly. Herewith, we are presenting a case report of adenomatoid odontogenic tumour of mandible in a male patient.

Adenomatoid Odontogenic Tumour Associated with Dentigerous Cyst: Case Report with Literature Review

Adenomatoid Odontogenic Tumour (AOT) is a relatively uncommon benign odontogenic tumour composed of odontogenic epithelium in a variety of histoarchitectural patterns. Conventional AOT is predominantly seen in females in second decade of life exhibiting predilection for anterior region of maxilla. Very few cases of AOT associated with dentigerous cyst have been reported till date. The present case is unique associated with an impacted lower first premolar in the front region of the mandible of an 18-year-old female patient. The patient reported to the institute with gradually increasing swelling. The orthopantomogram revealed a unilocular radiolucency with displaced premolar. Histopathological examination confirmed 4×2.5×2 cm lesion in dimension, brownish black in colour, firm in consistency with a smooth surface grossly while cut surface revealed a cystic lumen with an impacted premolar embedded into the lining, cystic wall being nodular. Microscopic evaluation revealed a well encapsulated lesion with a thin 2-3 cell layered non keratinised stratified epithelial lining in patterns such as nests, rosette like structures and duct like structures. Thus the diagnosis of AOT arising from dentigerous cyst was confirmed. Patient's six month follow-up was uneventful. Literature search of similar cases with the review of hypothesised aetiopathogenesis is discussed in brief. The available data can help researchers resolve the uncertainty whether the AOT derived from dentigerous cyst could represent a distinct hybrid variety.

Hybrid Lesion of Ameloblastoma and Adenomatoid Odontogenic Tumour (AOT): Report of Two Cases from a Tertiary Referral Hospital in Sub-Saharan Africa

Introduction: Hybrid lesions are lesions showing the combined histopathological characteristics of two or more previously recognized odontogenic tumours and /cysts of different categories. Hybrid lesions do exist because of close interrelationship of several odontogenic lesions and also because odontogenic tumors and cysts can arise at any stage of odontogenesis. The objective of this study was to present 2 cases of hybrid odontogenic tumour that is composed of adenomatoid odontogenic tumour (AOT) and ameloblastoma. Case Reports: Case 1: A 33year old female patient with a bucco-lingual swelling in the left mandibular premolar-molar-ramus regions of 13years duration. The lesion measured about 15x5x3cm, it is non tender. Surgical specimen revealed hybrid lesion of granular cell type ameloblastoma and AOT. Case 2: An 18year old female patient with a painless right mandibular molar-ramus swelling of 10years duration. Mandibulectomy specimen measured about 11 cm x 8.5 cm x 5 cm and was found to be hybrid lesion of acanthomatous ameloblastoma and AOT. Conclusion: Both cases had a very long clinical duration and showed more buccal bone expansion with barely noticeable lingual bone expansion. With such clinical scenarios, a suspicion of hybrid tumour should be made.

A CLINICO-RADIOLOGICAL PRESENTATION OF ADENOMATOID ODONTOGENIC TUMOR OF MAXILA –A CASE REPORT

Adenomatoid Odontogenic Tumour (AOT) is odontogenic epithelial tumour, also known as pseudoadenoameloblastoma/adenoameloblastoma, which was described by Dreibaldt in 1907 [1]. The term “Adenomatoid odontogenic tumour” was proposed by Philipsen et al [2] indicating that it was not a variant of ameloblastoma. In the World Health Organization classification of odontogenic tumours established in 1971, AOT was mentioned as a mixed odontogenic neoplasm, an epithelial tumour with an inductive effect on the odontogenic mesenchyme [3].It represents 3–7% of all odontogenic tumours largely limited to younger patients and striking tendency to occur in anterior maxilla, and over 750 examples have been reported in the literature [4]. This case report presents a case of an Adenomatoid Odontogenic Tumour in the left maxillary anterior region which was diagnosed using radiographs and removed by surgical excision. KEYWORDS: Adenomatoid Odontogenic Tumor; Maxilla; Odontogenic tumor; Mixed radio opacity

Case series of adenomatoid odontogenic tumour of jaws with variations in presentation

Adenomatoid odontogenic tumour (AOT) is a rare tumour of odontogenic origin with distinct clinicopathological appearance but is often clinically misdiagnosed as a cyst. The most common site is the anterior maxilla in the canine region. We present here two cases, one at its commonest location in the maxillary canine while the other is at the uncommon location of the anterior mandible. Its clinical features of painless slow growing swelling, association with impacted tooth and radiographic appearance of well defined predominantly radiolucent lesion are overlapping with other oral pathologies like dentigerous cyst, radicular cyst, calcifying odontogenic cyst, calcifying epithelial odontogenic tumour, unicystic ameloblastoma etc. One must be aware and updated with the variation in appearance of AOT. Encapsulation of tumour causes less cumbersome enucleation of the tumour, a successful treatment as it reduces the chances of recurrence.

Comparative Study of FOXC1 Expression in Selective Odontogenic Cysts and Tumours

Introduction: Many studies have indicated that Forkhead Box C1 (FOXC1) is highly expressed in a various malignant neoplasms and its over expression is associated with tumour development, progression and metastasis. However, the role of FOXC1 in odontogenic lesions remains to be elucidated. Aim: This study aimed to investigate FOXC1 expression in selective Odontogenic Cysts (OC) and Odontogenic Tumours (OT). Materials and Methods: A descriptive study on OC and OT was performed on oral biopsy specimens at Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand, between January 2009 and December 2016. Institute of Cancer Research (ICR) mouse were used as study animal. Immunohistochemical reaction was performed using antibody against FOXC1 in 23 formalin-fixed and paraffin-embedded tissues of eight Ameloblastoma (AM), one Adenomatoid Odontogenic Tumour (AOT), seven Odontogenic Keratocyst (OKC), five Dentigerous Cyst (DC), two Calcifying Odontogenic Cyst (COC) and three mouse embryonic head at Embryonic Day (E)14. The expression level of FOXC1 was evaluated using semi-quantitative analysis. Results: Immunoreactivity of FOXC1 was not detected in the epithelial lining of OKC, DC and COC but it was identified in the epithelial compartment of AM and AOT. Overall, semi-quantitative analysis demonstrated moderate staining of FOXC1 and staining score was 4.13 in AM and 5 in AOT. In addition, FOXC1 was not detected in normal tooth bud of mouse including both enamel organ and condensing ectomesenchyme. Conclusion: Expression of FOXC1 may contribute in tumouriogenesis of OT whereas it is may not be related with normal odontogenesis.

Adenomatoid odontogenic tumour: A rare threat to orthodontic treatment planning

This case report aims to increase awareness of how an adenomatoid odontogenic tumour (AOT) can present in a similar fashion to a dentigerous cyst and the importance of accurate histopathological diagnosis. In this case, the AOT resulted in loss of the upper left permanent canine in a patient who already had a congenitally absent upper left second premolar, compromising the original orthodontic treatment plan.