Peripheral Adenomatoid Odontogenic Tumour — Is It Really Peripheral?: A Case Report

Abstract

A Peripheral Adenomatoid Odontogenic Tumour (PAOT) is quite a rare entity which has been infrequently reported in the literature. These uncommon clinical variants of an Adenomatoid Odontogenic Tumour (AOT), typically manifest as a soft tissue mass of the gingiva, which mimick a common epulis, but yet have an identical histopathologic presentation as their intraosseous counterpart. These lesions, though they are indolent in nature, have a tendency to cause well defined deep bony pockets. Only fourteen cases have been adequately documented so far. We are reporting a case of a PAOT of the anterior maxillary gingiva, with a periodontal bone defect in a 12 year old girl. The relevant literature has been briefly reviewed, with an insight into the probable origin of PAOTs with bony defects.

The adenomatoid odontogenic tumour: an update of selected issues

“…A recent literature survey disclosed that the number of published PAOT cases is 27 at present [Philipsen et al and data from eight further reports ]. The number of reported PAOTs is, however, still too restricted to clarify the true biological profile of this variant.…”

“…(A) Central (or intraosseous) variants: 1 The follicular (or pericoronal) type in which the AOT is associated with the crown of an unerupted tooth. (2) and data from eight further reports (12)(13)(14)(15)(16)(17)(18)(19)]. The number of reported PAOTs is, however, still too restricted to clarify the true biological profile of this variant.…”

Asymptomatic gingival nodule in the anterior maxilla

“…In the subsequent recurrence and biopsy, it was unclear if the lesion was a primary gingival lesion that had eroded the underlying alveolar bone or was a primary intraosseous lesion that has expanded into the gingiva. 8,9,12,22 Nevertheless, we suggest that this is probably a case of a central lesion with peripheral involvement, since the final diagnosis of AOT was established only after the intraosseous specimen was obtained. Moreover, the odontogenic neoplastic aspects of AOT were observed neither in the initial histopathological analysis nor in the complete "peripheral" component of the recurrent lesion.…”

Tumor odontogénico adenomatoide en la región mandibular: reporte de un caso / Adenomatoid Odontogenic Tumor in Mandibular Region: Case Report

“…La variedad periférica es la menos frecuente, afecta la mucosa gingival maxilar y representa el 2,3 % de los TOA. Son similares a un épulis en su apariencia clínica y predominan en el sexo femenino en una relación de 2:1 (8). Las características histológicas son idénticas para las tres presentaciones clínicas del TOA (8,9).…”

“…Son similares a un épulis en su apariencia clínica y predominan en el sexo femenino en una relación de 2:1 (8). Las características histológicas son idénticas para las tres presentaciones clínicas del TOA (8,9). Muestran presencia de cápsula, necrosis, hialinización y pigmentación melánica.…”