<p>Peripheral Adenomatoid Odontogenic Tumor — A Rare Cause of Gingival Enlargement: A Case Report with CBCT Findings</p>

Abstract

Introduction: Adenomatoid odontogenic tumor (AOT) is an uncommon benign odontogenic lesion with varied clinical and histological presentation. It has slow growth potential and a low recurrence rate. The tumor is mainly seen in females in the second decade of life, predominantly affecting the maxilla and associated most often with unerupted canine teeth, earning the epithet "two-thirds tumor". There are three variants: intrafollicular, extrafollicular, and peripheral. The peripheral or extra osseous type is a rare form that arises in gingival tissue. Case Presentation: This article describes a case of AOT in a 10-year-old girl who presented with gingival enlargement in relation to the maxillary left central incisor. Interestingly, intraoral periapical radiography did not show any significant findings. However, cone-beam computed tomography of the site revealed significant bone loss in the area. A surgical excision was done. Histopathological examination revealed features of AOT. Based on clinical, radiographic, and histological evidence, a diagnosis of peripheral AOT (PAOT) was made. Conclusion: PAOT is a rare disease entity in children that mimics gingival swelling, and may often be misdiagnosed by dentists. With literature still ambiguous on the origin of the tumor and biological course, it becomes imperative to examine any gingival swelling in children with a proper clinical examination, periapical radiography, and if necessary conebeam computed tomography. Excision and histopathological evaluation will help in confirming the exact disease condition.

Adenomatoid odontogenic tumor in the anterior mandible

“…As mentioned by Câmara et al 20 , 77% of AOT cases are initially identified as a dentigerous cyst. In agreement with Sadasivan et al 10 , the clinical and radiographic diagnosis become inconclusive, requiring the histopathological examination for diagnostic elucidation.…”

“…Liu et al 14 argues that this pathology is asymptomatic, of slow growth, painless and that rarely exceeds 3 cm in the higher diameter 6,10 . Genno et al 4 adds that AOT discovery usually occurs in routine examinations when investigating the absence of a tooth 5 .…”

“…Histologically, the World Health Organization (WHO) defined AOT as a neoplasm of odontogenic epithelium with structures similar to ducts, with varying degrees of alterations in the connective tissue, as well as the presence of a well-developed connective tissue capsule 3,6,9 . The benign aspect of this tumor predicts a more conservative approach through enucleation and curettage 10,11 , and larger lesions may be previously submitted to marsupialization 12 .…”

Radiological features of Adenomatoid odontogenic tumor: Report of a maxillary case and a mandibular one

“…Moreover, CBCT provides a better display of the extent and the complex spatial relationship of the lesions with the surrounding structures. 21,22 The diagnosis suspected based on clinical and radiographic data can only be confirmed by the anatomopathological study of the operative pieces.…”

“…Moreover, CBCT provides a better display of the extent and the complex spatial relationship of the lesions with the surrounding structures. 21 , 22 …”