Peripheral ameloblastoma with neoplastic osseous invasion versus peripheral intraosseous ameloblastoma: A challenging diagnosis

Janardhanan, Mahija; Rakesh, S; Savithri, Vindhya; Aravind, Thara

doi:10.4103/jomfp.jomfp_130_17

Cited by 5 publications

(3 citation statements)

References 12 publications

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“…Although peripheral ameloblastoma and peripheral intraosseous ameloblastoma exhibit similar clinicopathological features presenting as an exophytic soft-tissue lesion, the difference in their biological behavior often challenges diagnosis. 13 This is where CBCT plays a pivotal role in clearly demarcating the penetration of intraosseous tumor from inside by perforating the buccal cortical plate thus eliminating peripheral ameloblastoma, which is completely superficial and seldom causes bone infiltration, even before confirming it through histopathological criteria.…”

Section: Discussionmentioning

confidence: 99%

Clinical Dilemma and the Role of Cone-Beam Computed Tomography in the Diagnosis of an Unusual Presentation of Central Odontogenic Tumor—A Case Report

Surenthar

Srinivasan

Jimsha

et al. 2021

Indian J Radiol Imaging

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Cone beam computed tomography (CBCT) provides a detailed analysis of the dentition and of cortical and medullary bone free of superimposition inherent in radiographs, which are effortlessly plausible, easily available, and relatively inexpensive when compared with other cross-sectional imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI). This article presents a case report of a 23-year-old male patient with a complaint of a mass in the right side lower back tooth region for the past 2 and a half months, which had the unusual presentation of prominent exophytic growth masking the central odontogenic tumor, wherein the diagnostic performances of CBCT in unveiling the diagnostic challenge that led to the clinical dilemma is emphasized. Routine radiographs such as orthopantomogram, mandibular occlusal view were taken along with CBCT, which accentuated the precise diagnosis in this case. The lesion was surgically enucleated with curettage and extraction of the involved teeth. CBCT unveiled the classic multilocularity of ameloblastoma, which routine imaging failed to display. CBCT played a pivotal role in counteracting the diagnostic challenges faced and also in distinguishing it from a cystic lesion that was initially deceived by routine two-dimensional radiographs.

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Section: Discussionmentioning

confidence: 99%

Clinical Dilemma and the Role of Cone-Beam Computed Tomography in the Diagnosis of an Unusual Presentation of Central Odontogenic Tumor—A Case Report

Surenthar

Srinivasan

Jimsha

et al. 2021

Indian J Radiol Imaging

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“…Peripheral ameloblastoma and peripheral intraosseous ameloblastoma are two clinical variants of ameloblastoma, which present as an exophytic soft-tissue lesion 5. The pathogenesis of such tumors is still unclear.…”

Section: Introductionmentioning

confidence: 99%

“…4 Peripheral ameloblastoma and peripheral intraosseous ameloblastoma are two clinical variants of ameloblastoma, which present as an exophytic soft-tissue lesion. 5 The pathogenesis of such tumors is still unclear. There are evidences of association of HPV with the development of benign and premalignant lesions, and malignant tumours.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological study of ameloblastoma and detection of human papilloma virus by immunohistochemistry

et al. 2019

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Objective: To study the clinocopathological factors and presence of Human Pappiloma Virus in ameloblastoma by immnohistochemistry. Methods: It was a cross sectional study on 50 surgical specimens of ameloblastoma, completed in six months. These were selected and processed for initial screening by H&E and then by immunohistochemistry (IHC) for detection of Human Papilloma Virus (HPV). The questionnaire was designed to study the clinicopathological factors associated in these patients. Sections of 4µm were cut, placed on special positive charged glass slides in the Department of Pathology, King Edward Medical University. It was then examined by the histopathologists for grading and scoring of these lesions. Chi Square test was used to assess the differences found in types of ameloblastomas. The p-value was smaller than 0.05 (p < 0.05). Results: The mean age of the patients (12-80 years old) was 38.6±15.1 years, with male-female ratio 2.84: 1. HPV was positive in 9 (18%), whereas negative in of 41 (82%) patients. Among the positive, reactive HPV with score-1 was 8 and score-2 was 1. According to histological variant, follicular was present in 78%, Plexiform pattern in 8%, Conventional and Desmoplastic variants in one patient each; and Cystic and Acanthomatous were seen in two and three patients respectively. The mandible was involved in 39 patients, maxilla and right maxilla involved in 4 patients each, right retromolar, cheek and angle of mandible was seen in one patient each. About 16% patients had anterior, 66% had posterior and 18% had both anterior and posterior regions involved. Among the HPV positive reactive statistically, no significant difference was found with smoking, Paan and exposure to pesticides, factory or mine (p-value > 0.05). Among HPV positive reactive patients, eight had ameloblastoma whereas, 1 had ameloblastomic fibroma. There was no statistical significance of type, location and region of tumor in HPV positivity. Conclusion: Mandible and posterior region was more commonly involved. Follicular pattern was most common. There was no effect of exposure to pesticides, factory or mine, smoke and human papilloma virus in the etiology of ameloblastoma because only 18% of patients showed the association of HPV16 doi: https://doi.org/10.12669/pjms.35.6.909 How to cite this:Ali M, Bukhari MH, Hassan F, Illyas M. Clinicopathological study of ameloblastoma and detection of human papilloma virus by immunohistochemistry. Pak J Med Sci. 2019;35(6):1691-1696. doi: https://doi.org/10.12669/pjms.35.6.909 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Peripheral calcifying odontogenic cyst in maxillary anterior gingiva: A case report

Alsabbagh,

Speakman,

Wang

et al. 2024

Clin Adv Periodontics

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BackgroundCalcifying odontogenic cysts (Gorlin cysts) most commonly present centrally and have only rarely been reported in peripheral locations. The purpose of this report is to describe a new case of peripheral calcifying odontogenic cyst (PCOC) occurring in the anterior maxillary gingiva and to review the management and differential diagnosis of such a lesion.MethodsA 37‐year‐old female presented with a long‐standing submucosal nodule on the gingiva between the maxillary central incisors, with asymptomatic growth over the last three years. Following an initial incisional biopsy, a diagnosis of PCOC was established. To exclude the possibility of a central process, a corresponding small field of view cone beam CT scan was obtained and the patient returned for a 6 mm excisional biopsy to the depth of the periosteum.ResultsResults of these additional assessments supported the original diagnosis of PCOC. Following uneventful healing of the second biopsy, no recurrence or other clinical findings were noted at 1‐year follow‐up.ConclusionWhile rare, the peripheral variant of calcifying odontogenic cyst, and other peripheral counterparts to recognized central cysts and tumors, should be considered in a differential diagnosis for a benign gingival nodule. Gingival tissue should be submitted for histologic evaluation to ensure a neoplastic process is not present.Key points Various lesions may present on the gingiva as a “bump”; these can represent common clinical entities, such as pyogenic granuloma, peripheral ossifying fibroma, peripheral giant cell granuloma, and fibroma, or more rare conditions that may not be adequately considered in the differential diagnosis. A rarely documented case of peripheral calcifying odontogenic cyst (PCOC; Gorlin cyst) on the maxillary anterior gingiva of an adult female is reported here and compared with the few other similar PCOC cases in the literature. A biopsy of gingival lesions is always necessary to establish the correct diagnosis and provide the appropriate treatment. Plain language summarySeveral different lesions can appear on the gingiva (gums). Some are quite common, and some are rare. This report documents the occurrence of a new case of calcifying odontogenic cyst (Gorlin cyst), a type of cyst that has been rarely found outside the jawbone, presenting as a “bump” on the gingiva between the maxillary central incisor teeth of an adult female. Because of the patient history, a peripheral calcifying odontogenic cyst (PCOC) was not initially suspected. Following a biopsy, a PCOC diagnosis was given. The possibility of a lesion within the bone was then excluded by an X‐ray (cone beam CT) scan examination. A second, more extensive biopsy confirmed the diagnosis and the removal of the lesion. The patient had no complications or recurrence for the following 12 months. This case highlights the need to always biopsy lesions presenting on the gums to obtain a proper diagnosis and provide the correct treatment.

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Peripheral ameloblastoma with neoplastic osseous invasion versus peripheral intraosseous ameloblastoma: A challenging diagnosis

Cited by 5 publications

References 12 publications

Clinical Dilemma and the Role of Cone-Beam Computed Tomography in the Diagnosis of an Unusual Presentation of Central Odontogenic Tumor—A Case Report

Clinical Dilemma and the Role of Cone-Beam Computed Tomography in the Diagnosis of an Unusual Presentation of Central Odontogenic Tumor—A Case Report

Clinicopathological study of ameloblastoma and detection of human papilloma virus by immunohistochemistry

Peripheral calcifying odontogenic cyst in maxillary anterior gingiva: A case report

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