This document provides information on various odontogenic tumors through descriptions of clinical presentations, radiographic findings, and histopathological images. It describes tumors such as ameloblastoma, adenomatoid odontogenic tumor, calcifying epithelial odontogenic tumor, and odontogenic myxoma. The tumors are classified based on subtypes defined by their histological patterns and clinical behavior, ranging from benign to locally aggressive to malignant.
Many radiolucent or mixed radiolucent/radiopaque lesions of the mandible & maxilla may present as incidental findings on radiographs or as the main symptom of a patient. Complete history & physical examination with appropriate radiographic examination & pathologic confirmation completes the management of these diseases.
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Many radiolucent or mixed radiolucent/radiopaque lesions of the mandible & maxilla may present as incidental findings on radiographs or as the main symptom of a patient. Complete history & physical examination with appropriate radiographic examination & pathologic confirmation completes the management of these diseases.
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Benign, locally aggressive tumor of odontogenic epithelium, Previously called adamantinoma, Second most common odontogenic tumor after odontoma, Mandible is most common site, Usually asymptomatic and can be found incidentally on routine dental examinations
Odontogenic tumors are growths that develop in the jawbones or soft tissues of the mouth, arising from the tissues that form teeth. These tumors can be benign or malignant and vary widely in their presentation and behavior. Benign tumors include ameloblastoma, odontoma, and cementoblastoma, while malignant tumors include ameloblastic carcinoma and odontogenic sarcoma. Treatment typically involves surgical removal, and prognosis depends on the type and stage of the tumor.
Cementoblastoma is defined as a neoplasm characterized by formation of sheets of cementum like tissue containing a large number of reversal lines and lack of mineralization at the periphery of the mass or in the more active growth area. Locally aggressive resulting in bony expansion, root resorption, displacement of adjacent teeth, and jaw deformity.
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2. Ameloblastoma.
A, Gross photograph of a mandibular resection specimen.
B, The radiograph of the specimen shows a large radiolucent
defect associated with an inferiorly displaced third molar.
6. Ameloblastoma (follicular pattern). Multiple islands of odontogenic epithelium demonstrating
peripheral columnar differentiation with reverse polarization. The central zones resemble stellate
reticulum and exhibit foci of cystic degeneration.
7. Ameloblastoma (follicular pattern) . This high power photomicrograph highlights the
peripheral columnar cells exhibiting reverse polarization.
8. Ameloblastoma (plexiform pattern) . large anastomosing cords of
odontogenic epithelium. The high-power view(inset) reveals columnar cells
with reverse polarization.
9. • Ameloblastom a (acanthomatous pattern) Islands of
ameloblastoma demonstrating central squamous differentiation.
13. Unicystic ameloblastoma. A large radiolucency in a 7-year-old boy with displacement of the
developing second molar to the inferior border of the mandible. This was believed to be a
large dentigerous cyst.
14.
15. Unicystic ameloblastoma (luminal type). The cyst is lined by ameloblastic
epithelium showing a hyperchromatic polarized basal layer. The overlying
epithelial cells are loosely cohesive and resemble stellate reticulum.
16. Unicystic ameloblastoma (intraluminal plexiform type). Photomicrograph of
the intraluminal mass arising from the cyst wall in the same patient shown in
The inset shows the intraluminal mass at higher magnification.
17. Unicystic ameloblastoma (mural type). Islands of follicular ameloblastoma
are infiltrating into the fibrous connective tissue wall.
20. Adenomatoid odontogenic tumor (follicular type) . Radiolucent lesion involving an
unerupted mandibular first premolar. Fine snowflake calcifications are present in the
radiolucent area. In contrast to the usual dentigerous cyst. the radiclucency
extends almost to the apex of the tooth.
22. Adenomatoid odontogenic tumor. Higher magnification showing the duct
like epithelial structures. The nuclei of the columnar calls are polarized away
from the central spaces.
24. Calcifying epithelial odontogenic tumor. Sheets of polyhedral tumor cells with
prominent eosinophilic cytoplasm and intercellular bridging. Pools of
amorphous eosinophilic amyloid are present. Multiple lesegang ring
calcifications are seen in the inset
25. Squamous odontogenic tumor. Lucent defect extending along the roots of
the lateral incisor and first premolar teeth.
26. Squamous odontogenic tumor. Islands of bland appearing squamous epithelium in
a fibrous stroma. Microcyst formation is seen. The inset shows one of the tumor
islands at higher power.
29. Ameloblastic fibroma. long, narrow cords of odontogenic
epithelium in a richly cellular, primitive mesenchymal stroma. Note
the peripheral columnar differentiation (inset).
30. Ameloblastic fibre-odontoma. The soft tissue component of the tumor is
indistinguishable from an ameloblastic fibroma. Developing rudimentary tooth like
structures are shown (inset).
31. Ameloblastic fibrosarcoma. The cellular mesenchymal tissue shows hyperchromatism
and atypical cells.A small island of ameloblastic epithelium is present.
36. Odontogenic fibroma (simple type). Scattered fibroblasts within a collagenous
background. No epithelial rests were found on multiple sections from this tumor.
37. Odontogenic fibroma (World Health Organization [WHO] type. A cellular
fibroblastic lesion containing narrow cords of odontogenic epithelium.
38. Granular cell odontogenic tumor. Radiolucent lesion involving the apical
area of endodontically treated maxillary teeth.
39. Granular cell odontogenic tumor. Sheet of large granular mesenchymal cells
with small nest s of odontogenic epithelium.
44. Ameloblastic carcinoma. A, Rapidly growing tumor showing prominent labial
expansion of the mandible in the incisor and premolar area. B, The panoramic
radiograph shows irregular destruction of the mandible.