Clinico-Pathological Presentations of Cystic and Classic Adenomatoid Odontogenic Tumors

Abstract

The objective of the study is to present the clinico-pathological features of cystic and classic adenomatoid odontogenic tumors (AOTs) in order to identify the differences between the two variants of AOT. Materials and method: The study sample comprised of 41 AOTs, which were categorized into cystic and classic AOTs. Cystic AOTs are diagnosed as such when macroscopic and microscopic evidence of a cyst is present together with histopathological criteria of AOT (WHO–2017). Results: The study sample comprised of eleven cystic and thirty classic AOTs. Eight cystic AOTs were regarded as arising from dentigerous cysts as these lesions were attached to the cemento-enamel junction of the impacted teeth. Though not statistically significant, in contrast to classic AOTs which showed female predilection, cystic AOTs were more prevalent in males. Cystic AOTs tend to present as significantly larger lesions compared to classic AOTs (p < 0.02). In both cystic and classic AOTs, duct-like structures and epithelial whorls were the two most prominent histopathological features present in the majority of tumors. Two AOTs with massive amounts of dentinoid occurred in the mandible and presented as large lesions that eroded cortical bone. None of the 12 patients with follow-up information presented with recurrences. Conclusion: Except for the size of the lesion, no significant clinico-pathological differences were observed between cystic and classic AOTs. Therefore the cystic AOTs can be considered as a variant of AOT with enucleation, simple excision, or radical excision as the treatment of choice depending on the extent of the lesion, similar to classic AOTs.

Peripheral adenomatoid odontogenic tumor of mandible - A synchronous presentation or a subtype?!

“…[ 11 ] Studies even consider cystic AOTs as a separate variant with a few arising from unclassifiable odontogenic cyst having no relation to an impacted tooth. [ 2 ]…”

“…However, assumptions on their aggressiveness have been attributed to the presence of perivascular hyalinization, osteodentin formation and mandibular involvement in few cases. [ 2 ]…”

“…Debated to be hamartomatous or neoplastic by factions, the WHO (2017) defines it as a benign hamartomatous lesion and has classified it under category I originating and composed of only odontogenic epithelium even though its propensity for inductive changes indicate type II categorization. [ 2 ] The three commonly encountered forms are, (i) Follicular/Coronal, (ii) Extra Follicular/Extra Coronal and (iii) Peripheral AOT (PAOT) variants.…”

Unusual case report of an adenomatoid odontogenic tumor in the mandible: 3-years of follow-up

“…Commonly, these structures are surrounded by a well-developed connective tissue capsule. It may present as a solid mass, a single large cystic space, or as numerous small cystic spaces [10][11][12] . Differential diagnosis regarding to AOT is extensive and includes dentigerous and lateral periodontal cysts, ameloblastoma and calcifying epithelial odontogenic tumor [13][14][15] .…”