Adenomatoid odontogenic tumor: Difference between revisions
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==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
AOT occurs mainly in the second decade of life, and is uncommon in patients older than 30 years of age. Females are more commonly affected than males with a ratio of 2:1, but it was not so in our analysis.[3,7] This female predilection is even more marked in Asian populations, the highest female incidence being observed in Sri Lanka (3.2:1) and Japan (3:1). The maxillary arch is the predominant site of occurrence, being almost twice as frequent as that of the mandible, and the anterior part of the jaw is more frequently involved than the posterior part.[5] Giansanti et al. (1970) reported that 65% AOTs were seen in the maxilla and 35% in the mandible. Of the maxillary lesions, 80% occurred in the anterior region, 14% in the premolar region, and few in the molar area. Of the mandibular lesions, 69% were found in the anterior region, 27% in the premolar region, and a few in the molar region.[8] It is pertinent to note that all our four cases had AOT in the anterior as well as posterior part of the mandible. | |||
It is more common in young people and affects females more than males.<ref name="pmid31402313">{{cite journal| author=Chaves RRM, Júnior AACP, Gomes CC, de Castro WH, Gomez RS| title=Multiple adenomatoid odontogenic tumors in a patient with Schimmelpenning syndrome. | journal=Oral Surg Oral Med Oral Pathol Oral Radiol | year= 2019 | volume= | issue= | pages= | pmid=31402313 | doi=10.1016/j.oooo.2019.06.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31402313 }} </ref><ref name="pmid31205401">{{cite journal| author=Mohanty R, Singh V, Dey AK, Behera S| title=A rare nonsyndromic case of adenomatoid odontogenic tumor associated with multiple impacted supernumerary teeth. | journal=Natl J Maxillofac Surg | year= 2019 | volume= 10 | issue= 1 | pages= 114-117 | pmid=31205401 | doi=10.4103/njms.NJMS_25_18 | pmc=6563630 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31205401 }} </ref><ref name="pmid27461816">{{cite journal| author=Dhirawani RB, Pathak S, Mallikaarjuna K, Sharma A| title=An adenomatoid odontogenic tumor in disguise. | journal=J Indian Soc Pedod Prev Dent | year= 2016 | volume= 34 | issue= 3 | pages= 291-3 | pmid=27461816 | doi=10.4103/0970-4388.186752 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27461816 }} </ref><ref name="pmid15996761">{{cite journal| author=Bravo M, White D, Miles L, Cotton R| title=Adenomatoid odontogenic tumor mimicking a dentigerous cyst. | journal=Int J Pediatr Otorhinolaryngol | year= 2005 | volume= 69 | issue= 12 | pages= 1685-8 | pmid=15996761 | doi=10.1016/j.ijporl.2005.03.055 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15996761 }} </ref><ref name="pmid27857774">{{cite journal| author=Sethi S, Kumar M, Aggarwal P, Indra Kumar HS, Sugandhi CD, Singh S| title=A case report and short review on changing trends in the site of occurrence of adenomatoid odontogenic tumor: Unravelling the past 15 years. | journal=Dent Res J (Isfahan) | year= 2016 | volume= 13 | issue= 5 | pages= 462-471 | pmid=27857774 | doi= | pmc=5091007 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27857774 }} </ref><ref name="pmid31077195">{{cite journal| author=Dwivedi D, Prabhakar N, Kasetty S, Ahuja R| title=Peripheral adenomatoid odontogenic tumor in a cloak of an epulis: report of a rare case. | journal=BMC Oral Health | year= 2019 | volume= 19 | issue= 1 | pages= 81 | pmid=31077195 | doi=10.1186/s12903-019-0759-8 | pmc=6511215 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31077195 }} </ref> | It is more common in young people and affects females more than males.<ref name="pmid31402313">{{cite journal| author=Chaves RRM, Júnior AACP, Gomes CC, de Castro WH, Gomez RS| title=Multiple adenomatoid odontogenic tumors in a patient with Schimmelpenning syndrome. | journal=Oral Surg Oral Med Oral Pathol Oral Radiol | year= 2019 | volume= | issue= | pages= | pmid=31402313 | doi=10.1016/j.oooo.2019.06.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31402313 }} </ref><ref name="pmid31205401">{{cite journal| author=Mohanty R, Singh V, Dey AK, Behera S| title=A rare nonsyndromic case of adenomatoid odontogenic tumor associated with multiple impacted supernumerary teeth. | journal=Natl J Maxillofac Surg | year= 2019 | volume= 10 | issue= 1 | pages= 114-117 | pmid=31205401 | doi=10.4103/njms.NJMS_25_18 | pmc=6563630 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31205401 }} </ref><ref name="pmid27461816">{{cite journal| author=Dhirawani RB, Pathak S, Mallikaarjuna K, Sharma A| title=An adenomatoid odontogenic tumor in disguise. | journal=J Indian Soc Pedod Prev Dent | year= 2016 | volume= 34 | issue= 3 | pages= 291-3 | pmid=27461816 | doi=10.4103/0970-4388.186752 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27461816 }} </ref><ref name="pmid15996761">{{cite journal| author=Bravo M, White D, Miles L, Cotton R| title=Adenomatoid odontogenic tumor mimicking a dentigerous cyst. | journal=Int J Pediatr Otorhinolaryngol | year= 2005 | volume= 69 | issue= 12 | pages= 1685-8 | pmid=15996761 | doi=10.1016/j.ijporl.2005.03.055 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15996761 }} </ref><ref name="pmid27857774">{{cite journal| author=Sethi S, Kumar M, Aggarwal P, Indra Kumar HS, Sugandhi CD, Singh S| title=A case report and short review on changing trends in the site of occurrence of adenomatoid odontogenic tumor: Unravelling the past 15 years. | journal=Dent Res J (Isfahan) | year= 2016 | volume= 13 | issue= 5 | pages= 462-471 | pmid=27857774 | doi= | pmc=5091007 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27857774 }} </ref><ref name="pmid31077195">{{cite journal| author=Dwivedi D, Prabhakar N, Kasetty S, Ahuja R| title=Peripheral adenomatoid odontogenic tumor in a cloak of an epulis: report of a rare case. | journal=BMC Oral Health | year= 2019 | volume= 19 | issue= 1 | pages= 81 | pmid=31077195 | doi=10.1186/s12903-019-0759-8 | pmc=6511215 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31077195 }} </ref> | ||
Revision as of 20:55, 17 August 2020
| Adenomatoid odontogenic tumor | |
| ICD-O: | M9300/0 |
|---|---|
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Mohsin, M.D.
Overview
The adenomatoid odontogenic tumor is an odontogenic tumor arising from the enamel organ or dental lamina. The most common location is in the anterior maxilla. In 75% of cases, it is associated with an unerupted tooth. Adenomatoid odontogenic tumor (AOT) is a rare tumor of epithelial origin comprising 3% of all the odontogenic tumors. It is a benign, painless, noninvasive, and slow-growing lesion, with a relative frequency of 2.2-13% and often misdiagnosed as an odontogenic cyst on clinical examination. AOT affects young individuals with a female predominance, occurs mainly in the second decade, and usually surrounds the crown of unerupted teeth. This lesion is most commonly located in the anterior maxilla and rarely in the mandible. It is usually associated with an impacted canine. AOT frequently resembles lesions like dentigerous cyst or ameloblastoma. AOT has three variants, follicular, extrafollicular, and peripheral. The intraoral periapical radiograph is the best radiograph to show radiopacities in AOT as discrete foci having a flocculent pattern within radiolucency even with minimal calcified deposits. These calcified deposits are seen in approximately 78% of the lesions. Herewith, we present the report of four unusual cases of AOT located in the mandible, with an emphasis on radiographic findings and on pathologic correlation, and on reviewing the existing literature on this tumor. Adenomatoid odontogenic tumor (AOT) is a rare tumor of epithelial origin comprising 3% of all the odontogenic tumors.[1,2] It was first described by Steensland in 1905. In 1907, AOT was described as pseudo-adenoameloblastoma by Dreibladt.[1] Stafne in 1948 considered AOT as a distinct entity, whereas others believed it to be a variant of ameloblastoma.[3,4] In 1969, Philipsen and Birn declined this thought and suggested the name ‘adenomatoid odontogenic tumor’. In 1971, the World Health Organization (WHO) adopted the term ‘adenomatoid odontogenic tumor’. Max and Stern, in 2003, coined the name ‘adenomatoid odontogenic cyst’.[3] Various terms like adenoameloblastoma, ameloblastic adenomatoid tumor, adamantinoma, epithelioma adamantinum, and teratomatous odontoma were used before the term AOT.[2,3]
AOT is a benign, painless, noninvasive, and slow-growing tumor that does not infiltrate the bone.[5] Clinically, it is often misdiagnosed as an odontogenic cyst. The tumor appears as an intraoral-extraoral swelling in the maxilla and is sometimes referred to as ‘two-third tumor’ because it occurs in the maxilla in about two-third cases, about two-third cases arise in young females, two-third cases are associated with an unerupted tooth, and two-third affected teeth are canines.[5,6] The origin of the AOT is controversial. It is thought to arise from odontogenic epithelium because it occurs in the tooth-bearing areas of the jaws, is often associated with the impacted tooth, and has various components of the enamel organ, dental lamina, reduced enamel epithelium, and/or their remnants.[4]
The purpose of this article is to report and analyze four unusual cases of AOT located in the mandible, with an emphasis on radiographic findings and with pathologic correlation, and to review the existing literature on this tumor.
Differential Diagnosis
It should be differentially diagnosed from a dentigerous cyst and the main differnce is that the radiolucency in case of AOT extends apically beyond the cementoenamel junction. Radiographs will exhibit faint flecks of radiopacities surrounded by a radiolucent zone.
Epidemiology and Demographics
AOT occurs mainly in the second decade of life, and is uncommon in patients older than 30 years of age. Females are more commonly affected than males with a ratio of 2:1, but it was not so in our analysis.[3,7] This female predilection is even more marked in Asian populations, the highest female incidence being observed in Sri Lanka (3.2:1) and Japan (3:1). The maxillary arch is the predominant site of occurrence, being almost twice as frequent as that of the mandible, and the anterior part of the jaw is more frequently involved than the posterior part.[5] Giansanti et al. (1970) reported that 65% AOTs were seen in the maxilla and 35% in the mandible. Of the maxillary lesions, 80% occurred in the anterior region, 14% in the premolar region, and few in the molar area. Of the mandibular lesions, 69% were found in the anterior region, 27% in the premolar region, and a few in the molar region.[8] It is pertinent to note that all our four cases had AOT in the anterior as well as posterior part of the mandible. It is more common in young people and affects females more than males.[1][2][3][4][5][6]
Diagnosis
On radiographs, the adenomatoid odontogenic tumor presents as a radiolucency (dark area) around an unerupted tooth extending past the cementoenamel junction.
References
- Zahid,Arsalan from Contemporary Oral and Maxillofacial Pathology
- Kahn, Michael A. Basic Oral and Maxillofacial Pathology. Volume 1. 2001.
- ↑ Chaves RRM, Júnior AACP, Gomes CC, de Castro WH, Gomez RS (2019). "Multiple adenomatoid odontogenic tumors in a patient with Schimmelpenning syndrome". Oral Surg Oral Med Oral Pathol Oral Radiol. doi:10.1016/j.oooo.2019.06.006. PMID 31402313.
- ↑ Mohanty R, Singh V, Dey AK, Behera S (2019). "A rare nonsyndromic case of adenomatoid odontogenic tumor associated with multiple impacted supernumerary teeth". Natl J Maxillofac Surg. 10 (1): 114–117. doi:10.4103/njms.NJMS_25_18. PMC 6563630 Check
|pmc=value (help). PMID 31205401. - ↑ Dhirawani RB, Pathak S, Mallikaarjuna K, Sharma A (2016). "An adenomatoid odontogenic tumor in disguise". J Indian Soc Pedod Prev Dent. 34 (3): 291–3. doi:10.4103/0970-4388.186752. PMID 27461816.
- ↑ Bravo M, White D, Miles L, Cotton R (2005). "Adenomatoid odontogenic tumor mimicking a dentigerous cyst". Int J Pediatr Otorhinolaryngol. 69 (12): 1685–8. doi:10.1016/j.ijporl.2005.03.055. PMID 15996761.
- ↑ Sethi S, Kumar M, Aggarwal P, Indra Kumar HS, Sugandhi CD, Singh S (2016). "A case report and short review on changing trends in the site of occurrence of adenomatoid odontogenic tumor: Unravelling the past 15 years". Dent Res J (Isfahan). 13 (5): 462–471. PMC 5091007. PMID 27857774.
- ↑ Dwivedi D, Prabhakar N, Kasetty S, Ahuja R (2019). "Peripheral adenomatoid odontogenic tumor in a cloak of an epulis: report of a rare case". BMC Oral Health. 19 (1): 81. doi:10.1186/s12903-019-0759-8. PMC 6511215 Check
|pmc=value (help). PMID 31077195.