Hybrid Variant of Adenomatoid Odentogenic Tumour
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 3
Abstract
Adenomatoid odontogenic tumour (AOT) is a rare slow growing tumour, usually associated with an impacted tooth commonly situated in anterior maxillary region. A 14 year old young female complained of swelling on left side of her face which was increasing progressively in size. Aspiration revealed yellow coloured fluid and radiographically a unilocular radiolucent area was seen associated with an impacted canine. The lesion was suspected to be dentigerous cyst. Enucleation was performed and the excised tissue was sent for histopathological examination. Microscopic examination revealed AOT showing presence of spindle shaped cells and numerous cystic spaces surrounded by cuboidal or columnar cells. Few epithelial cells formed rosette like structure with eosinophillic coagulum in between.The features of both dentigerous cyst and AOT were overlapping in the lesion. Therefore proper clinical, radiographic and histopathological examination is critical for accurate diagnosis and treatment planning for lesions associated with impacted tooth.The Adenomatoid odontogenic tumour is considered as a benign, nonneoplastic,non invasive, lesion with a slow but progressive growth [1]. Philipsen and Birn suggested the most widely accepted abbreviated terminology for Adenomatoid odontotgenic tumour, as AOT [2]. Various names have been used in the literature for AOT like adenoameloblastoma, ameloblastic adenomatoid tumour, adamantinoma, epithelioma adamantinoma, or teratomatous odontoma [3]. AOT is an uncommon tumour of odontogenic origin, accounting for 2.2-7.1 % of all odontogenic tumours [4]. The lesion was initially described by Steensland in 1905 and later further described by Philipsen and Reichart in 1907 as they described three clinical-topographic variants of AOT: follicular (71%), extrafollicular (23%) and peripheral (4%). The follicular and extra follicular occur in intrabony sites while peripheral variant occurs in the gingival issue of the tooth bearing area [4]. The lesion usually presents as an asymptomatic slow growing lesion which is often associated with an unerupted tooth [1,3]. The tumour may be partly cystic and in some cases the solid lesion may be present as masses in the wall of a large cyst. Few reports have suggested the epithelial lining of the odontogenic cyst may transform to an odontogenic tumor like AOT or ameloblastoma [5-8]. We present a case of follicular type of AOT in a 14 year old young girl in anterior maxillary region with clinical and histological presentation overlapping with dentigerous cyst.
Authors and Affiliations
Sonia Nath, Shaju Jacob Pulikkotil, Jayant Prakash, Ajoy Kumar Shahi, Sultan Omer Sheriff
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