12 Year Pediatric Patient Having Pindborg Tumour an Intraosseous Variant: A Rare Case Presentation Affecting the Maxilla

A Case Report of Maxillary Calcifying Epithelial Odontogenic Tumor in a Teenage Girl

“…The pathognomonic finding is described as concentric calcifications within the amyloid substance, called "Leisegang rings. " 5 Unlike the majority of CEOT this case occurs in a less common location, in an unusual age demographic, exhibiting both intraosseous and extraosseous components. Apart from the atypical features seen in this patient, perhaps the most important aspect of this case lies in the management dilemma it presents.…”

“…Perhaps the case most similar to ours was presented in a separate report by Tiwari, which involved a 12-year-old boy presenting with a 5-month history of cheek swelling due to a 6 x 4 cm maxillary CEOT. 5 Excision was performed, and although there was no mention of curettage of underlying bone for additional margins, the patient likewise exhibited no recurrence after 2 years of follow-up. 5 There is some evidence suggesting that CEOT does not infiltrate inter-trabecular bony spaces, supporting the consideration of enucleation and curettage of thin remaining bone.…”

“…5 Excision was performed, and although there was no mention of curettage of underlying bone for additional margins, the patient likewise exhibited no recurrence after 2 years of follow-up. 5 There is some evidence suggesting that CEOT does not infiltrate inter-trabecular bony spaces, supporting the consideration of enucleation and curettage of thin remaining bone. However, these reports involved less aggressive tumors found in the mandible.…”

“…12 It has been postulated that certain histologic features such as the presence of more amyloid and calcific tissue, in contrast to more clear cells, confers less aggressive potential. 5 Recommendations regarding radicality of surgery vary due to the unpredictable behavior of CEOTs, but most authors are in agreement that it is imperative to achieve tumor-free hard and soft surgical margins to minimize recurrence. 6 In our case, the decision to adapt a more conservative surgical approach was arrived at by weighing the risk of recurrence against leaving an unsightly scar on a young face, which could yield detrimental psychological effects.…”