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      Adenomatoid odontogenic tumor of the mandible with unusual radiographic features: A case report

      case-report

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          Abstract

          Adenomatoid odontogenic tumor (AOT) usually presents as a unilocular, pericoronal radiolucency in the maxillary anterior region in adolescent females. Very few conditions occur in such a narrow age range and at such a restrictive site. Rarely, these tumors present with varied clinical features. A case of AOT of the mandible is reported with unusual features such as large size, multilocular appearance, and aggressive behavior. The role of radiology in diagnosis of atypical AOT is extremely important. The unique radiological manifestations of the lesion helped in the diagnosis, and it was managed conservatively with no evidence of recurrence.

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          Most cited references15

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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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              Adenomatoid odontogenic tumour (adenoameloblastoma). Case report and review of the literature.

              G Gürbüz, O Bilge, M Akif Ciftcioglu … (1997)
              An adenomatoid tumour was found in the anterior maxillary region of a 15 year old female patient. Two impacted teeth were found in the tumour. The lateral incisor found in the tumour was dilacerated, and the roots of the first premolar were resorbed. A review of the English literature indicated that 294 similar cases have been reported.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Imaging Sci Dent
                Journal ID (iso-abbrev): Imaging Sci Dent
                Journal ID (publisher-id): ISD
                Title: Imaging Science in Dentistry
                Publisher: Korean Academy of Oral and Maxillofacial Radiology
                ISSN (Print): 2233-7822
                ISSN (Electronic): 2233-7830
                Publication date (Print): June 2013
                Publication date (Electronic): 14 June 2013
                Volume: 43
                Issue: 2
                Pages: 111-115
                Affiliations
                Department of Oral Medicine and Radiology, Coorg Institute of Dental Sciences, Virajpet, India.
                [* ]Department of Oral Medicine and Radiology, Peoples' Dental Academy, Bhopal, India.
                [** ]Department of Oral Pathology and Microbiology, Peoples' Dental Academy, Bhopal, India.
                Author notes
                Correspondence to: Dr. Veena S Narayanan. Department of Oral Medicine and Radiology, Coorg Institute of Dental Sciences, Kanjithanda Kushalappa Campus, Maggula, Virajpet 571 218, India. Tel) 91-08274-256479, Fax) 91-08274-260156, veesn@ 123456rediffmail.com
                Article
                DOI: 10.5624/isd.2013.43.2.111
                PMC ID: 3691371
                PubMed ID: 23807935
                SO-VID: 8646e8e3-41ce-47bd-98dc-a77950fcac77
                Copyright © Copyright © 2013 by Korean Academy of Oral and Maxillofacial Radiology
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 29 August 2012
                Date revision received : 01 December 2012
                Date accepted : 25 January 2013
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Dentistry
                Keywords: adenomatoid odontogenic tumor,mandible,odontogenic tumors,root resorption
                Data availability:
                ScienceOpen disciplines: Dentistry
                Keywords: adenomatoid odontogenic tumor, mandible, odontogenic tumors, root resorption

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