Adenomatoid Odontogenic Tumor – A Report of Two Cases with Histopathology Correlation

Abstract

Adenomatoid odontogenic tumor (AOT) is an uncommon, hamartomatous, benign, epithelial lesion of odontogenic origin that was first described by Driebaldt in 1907, as a pseudo-adenoameloblastoma. The current World Health Organisation (WHO) classification of odontogenic tumors defines AOT as being composed of the odontogenic epithelium in a variety of histoarchitectural patterns, embedded in mature connective tissue stroma, and characterized by slow, but progressive growth. The current article reports two cases with different presentations; first in a young female patient and the second in a middle-aged male patient. The importance of biopsy, which is the gold standard for diagnosis, and its use in planning of the treatment is discussed.

Clinical and radiographic features of adenomatoid odontogenic tumour

“…However, most authors accept its odontogenic source as it occurs within the tooth bearing areas of the jaws and is often found in close association with impacted teeth. There is evidence that the tumour cells are derived from enamel organ epithelium; investigators have also suggested that the lesion arises from remnants of dental lamina 27 . As the histogenesis is still uncertain, there has long been a debate as to whether it represents a hamartomatous growth or a true benign neoplasm, having cytological features similar to various components of enamel organ, dental lamina and reduced enamel epithelium 6 .…”

“…Adenomatoidni odontogeni tumor se može javiti intraosealno i ekstraosealno 27 . Intraosealni AOT ima ekpanzivni rast i može biti radiografski podeljen na dva tipa: folikularni (perikoronarni) i ekstrafolikularan (ekstrakoronarni).…”

“…AOT can occur both intraosseously and extraosseously 27 . Intraosseous AOT occurs as an expansile growth and can be radiographically divided into two types: follicular (pericoronal) and extrafollicular Ekstraosealna AOT se prezentuje kao sesilna masa na gingivi 27 .…”

“…Većina autora prihvata da je odontogenog porekla, jer se nalazi u vilicama u predelu zuba i povezan je često sa impaktiranim zubima. Postoji dokaz da tumorske ćelije vode poreklo od epitela gleđnog organa; istraživači su takođe sugerisali da tumorske ćelije vode poreklo od ostataka dentalne lamine 27 . Kako je histogeneza još uvek nesigurna, dugo se raspravljalo o tome da li ima hamartomazni rast ili je prava benigna neoplazma, koja ima citološke odlike slične raznim komponentama gleđnog organa, dentalne lamine i redukovanog gleđnog epitela 6 .…”

Adenomatoid odontogenic tumor simulating periapical cyst: case report

“…It is usually associated with impacted teeth, most commonly the canine [7][8] . It mainly affects females, in a ratio of 1.9:1, and this preference is even higher in the Asian population, the highest incidence being in Sri Lanka (3.2:1) and Japan (3:1) 9 .…”