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      Adenomatoid odontogenic tumor of the mandible: review of the literature and report of a rare case

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          Abstract

          Adenomatoid odontogenic tumor (AOT) is a rare odontogenic tumor which is often misdiagnosed as odontogenic cyst. To acquire additional information about AOT, all reports regarding AOT and cited in "pubmed" since 1990 onward were reviewed. AOT accounts for about 1% until 9% of all odontogenic tumors. It is predominantly found in young and female patients, located more often in the maxilla in most cases associated with an uneruppted permanent tooth. For radiological diagnose the intraoral periapical radiograph seems to be more useful than panoramic. However, AOT frequently resemble other odontogenic lesions such as dentigerous cysts or ameloblastoma. Immunohistochemically AOT is characterized by positive reactions with certain cytokeratins. Treatment is conservative and the prognosis is excellent. For illustration a rare case of an AOT in the mandible is presented.

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          Odontogenic tumors in Mexico: a collaborative retrospective study of 349 cases.

          J Portilla, L Rivera, Gabriel Galaviz-Mosqueda … (1997)
          Reports about the frequency of odontogenic tumors are scarce, and diagnostic criteria used in the reports are not uniform. This article presents the results of a retrospective study of odontogenic tumors recorded in four services of diagnostic pathology in Mexico City (two dental schools, one cancer hospital, and one private oral pathology service). The final diagnosis in each case was based on the 1992 histologic criteria of the World Health Organization. The frequency of odontogenic tumors, expressed as a percent of all oral and maxillofacial specimens, ranged from 0.8% in the cancer hospital (0.02% of all biopsies) to 3.7% in the private oral pathology service. The frequency was identical for the two dental schools (2.5%). We found a total of 349 odontogenic tumors; of these, 345 were benign (98.8%), and 4 (1.1%) were malignant (3 were primary intraosseous carcinomas and 1 was a malignant ameloblastoma). The most frequently occurring tumors were odontoma (34.6%), ameloblastoma (23.7%), myxoma (17.7%), adenomatoid odontogenic tumor (7.1%), and calcifying odontogenic cyst (6.8%). Although relatively rare, odontogenic tumors are still an important cause of extensive surgical procedures in Mexico.
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            Adenomatoid odontogenic tumor: biologic profile based on 499 cases.

            K Zhang, R. Philipsen, Q Yu … (1991)
            Topographically, the AOT occurs in peripheral and central variants, the latter further in follicular (with embedded tooth) and extrafollicular (no embedded tooth) types. The AOT is slow growing with few or no symptoms. Tumor growth may cause displacement of teeth rather than root resorption. The follicular AOT mimics a follicular cyst, the extrafollicular a residual or "globulo-maxillary" cyst and the peripheral a gingival fibroma. All variants of AOT show identical histologic features. The central variants account for 97.2%, 73.0% of which are follicular. The follicular variant (M:F ratio 1 to 1.9) is three times as frequent as the extrafollicular. The follicular variant is diagnosed earlier in life (mean age 17 yr) than the extrafollicular (mean age 24 yr). 53.1% of all variants occur within the teens (13-19 yr). Follicular AOT is associated with one embedded tooth in 93.2%. Maxillary permanent canines account for 41.7% and all four canines for 60.1% of AOT-associated embedded teeth. Ranking four among the odontogenic tumors the AOT is not a particularly rare tumor. Conservative surgical excision is the treatment of choice. Documented recurrences have not been reported.
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              Adenomatoid odontogenic tumour: facts and figures.

              H. Philipsen (1999)
              The present profile of the adenomatoid odontogenic tumour represents an update based on data collected from 1991 onwards. Our present knowledge discloses the AOT being a benign (hamartomatous), slow growing lesion which occurs in several intraosseous (follicular (F) and extrafollicular (EF)) and one peripheral variant all having identical histology. The F and EF variants account for 96 per cent of all AOT's of which 71 per cent are F variants alone. F and EF variants together are more commonly found in the maxilla than in the mandible with a ratio of 2.1:1. Age distribution shows that more than two thirds are diagnosed in the second decade of life and more than half of the cases occur within the teens (13-19 years of age). The female:male ratio for all age groups and AOT variants together is 1.9:1. The marked female predominance (around 3:1) among certain Asian populations needs further clarification. The distribution of unerupted permanent teeth found in association with the F variant shows that all four canines account for 59 per cent and the maxillary canines alone for 40 per cent. Recent findings strongly indicate the AOT is derived from the complex system of dental laminae or its remnants. Occurrence of areas of CEOT-like tissue in an otherwise "classic" AOT should be considered a normal feature within the continuous histomorphological spectrum of AOT. Immunohistochemical and ultrastructural findings have revealed that the eosinophilic deposits or "tumour-droplets" most probably represent some form of enamel matrix.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Head Face Med
                Title: Head & Face Medicine
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1746-160X
                Publication date Collection: 2005
                Publication date (Electronic): 24 August 2005
                Volume: 1
                Page: 3
                Affiliations
                [1 ]Department for Cranio- and Maxillofacial Surgery, Heinrich-Heine-University, Moorenstr. 5, D-40225 Düsseldorf, Germany
                [2 ]Department for Pathology, Heinrich-Heine-University, Moorenstr. 5, D-40225 Düsseldorf, Germany
                Article
                Publisher ID: 1746-160X-1-3
                DOI: 10.1186/1746-160X-1-3
                PMC ID: 1266042
                PubMed ID: 16270916
                SO-VID: 272b1921-5417-453f-adf5-693d231ea79f
                Copyright © Copyright © 2005 Handschel et al; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 25 March 2005
                Date accepted : 24 August 2005
                Categories
                Subject: Review

                ScienceOpen disciplines: Orthopedics
                Keywords: adenomatoid odontogenic tumor,review
                Data availability:
                ScienceOpen disciplines: Orthopedics
                Keywords: adenomatoid odontogenic tumor, review

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