A Recent Update on Histogenesis of Adenomatoid Odontogenic Tumor: A Review

Abstract

Adenomatoid odontogenic tumor (AOT) is a relatively rare benign, epithelial tumor of odontogenic origin. There is varying class of thoughts contemplating this lesion to be a hamartoma or neoplastic growth of odontogenic epithelium. Controversy regarding the histogenesis of the lesion is plentiful in earlier literature. The recent advent of immunohistochemical and ultrastructural studies has aided in throwing light on the tissue of origin of this tumor. This review aims at understanding the evolving concepts of histogenesis of AOT to better understand the biological behavior of the lesion. The review of AOT was carried out using PubMed and Google Scholar databases and 39 articles from the year 2001 to 2016 which contributed to the histogenesis of AOT were included for review. Since the origin of the cystic lining is similar to a reduced enamel epithelium and not the dental lamina, we propose the former to be the progenitor of AOT. Furthermore, we consider extra-follicular, as well as peripheral AOTs, originate from the remnants of Hertwig’s epithelial root sheath (epithelial rests of Malassez), which complies with the common histology for all these variants.

Adenomatoid odontogenic tumor: True neoplasm vs hamartoma

“…While on the other hand, the small size, anterior location and thus prompt removal prevent excessively large destructive lesion and all these point it to be a true neoplasm. 3 The neoplasm has been time and again called as two-thirds tumor pertaining to 2/3 r d of the cases affecting the anterior maxilla in females in second to third decade of life.Our patient was also a female in her second decade of life with tumor involving the anterior maxillary region. This odontogenic tumor has three radio graphic variants-Follicular, extrafollicular and peripheral and as a characteristic it is usually small with slow progression., 1,6 In the present case being discussed, the lesion was a comparatively larger unilocular radiolucency with destruction and resorption of the roots of associated teeth.…”

“…The evidence supporting both schools of thoughts are available but in our opinion this neoplasm behaves like a true solid tumor with foci of cystic degeneration and should be continued to be treated as a tumor. [2][3][4] The latest WHO classification 5 t h edition places AOT in the Benign epithelial odontogenic tumor category and defines it as a "benign encapsulated epithelial odontogenic tumour that contains rosette or duct-like structures and has an indolent behaviour". 5 In this article we discuss a case of AOT in 28 year old female involving anterior maxilla with emphasis on the characteristic histopathological features.…”

Adenomatoid Odontogenic Tumor: True Neoplasm Vs Hamartoma

“…While on the other hand, the small size, anterior location and thus prompt removal prevent excessively large destructive lesion and all these point it to be a true neoplasm. 3 The neoplasm has been time and again called as two-thirds tumor pertaining to 2/3 rd of the cases affecting the anterior maxilla in females in second to third decade of life. 1,5,7,8 Our patient was also a female in her second decade of life with tumor involving the anterior maxillary region.…”

“…The evidence supporting both schools of thoughts are available but in our opinion this neoplasm behaves like a true solid tumor with foci of cystic degeneration and should be continued to be treated as a tumor. 2,3,5 The latest WHO classification places AOT in the Benign epithelial odontogenic tumor category and defines it as a "benign encapsulated epithelial odontogenic tumour that contains rosette or duct-like structures and has an indolent behaviour". 6 In this article we discuss a case of AOT in 28 year old female involving anterior maxilla with emphasis on the characteristic histopathological features.…”

Peripheral adenomatoid odontogenic tumour

“…Some variants are also categorized as hybrid variant by Philipsen et al . [ 3 4 10 12 ] Lesions of early age are generally regarded as hamartoma and those that occur later in life as tumours. Our case is in agreement to the tumour form, as it is seen in third decade and has presented with well-formed tumour capsule.…”