Even though there are classical clinical features for each of the odontogenic lesions, at times, it may be difficult to arrive at a clinical. Ameloblastoma, a type of odontogenic tumor involving ameloblasts. Not only does aot predominantly present radiologically as a unilocular cystic lesion enclosing the unerupted tooth which is commonly mistaken as a. Maybe uni or multisoap bubble, may cause root absorption. Calcifying cystic odontogenic tumor ccot is an uncommon odontogenic tumor. Odontogenesis, odontogenic cysts, and odontogenic tumors. The radiographic appearance is one of a unilocular or multilocular wellcircumscribed. It describes the epidemiologic, radiologic, and histopathologic features of presently known neoplasms and hamartomatous or tumor like lesions arising from the toothforming structures, as well as a number of distinctive jaw lesions that must be distinguished from odontogenic tumors. The 2005 classification divides ameloblastic carcinoma into three types. A keratocystic odontogenic tumor is a benign but locally aggressive developmental odontogenic tumor that derives from dental lamina or form their remains and is most commonly located in the mandibular ramus and body. Review article a rare case of multilocalcalcifying epithelial. Definition of odontogenic tumor in the medical dictionary by the free dictionary. Presentation of a keratocystic odontogenic tumor with. This condition is often encountered in young patients, who are in their 2nd or 3rd decade of life.
The patient with a biopsyconfirmed keratocystic odontogenic tumor is brought to the operating room. Odontogenic keratocyst okc has been the subject of great interest since philipsen introduced the term in 1956. Three types of calcifications have been reported in the literature. They may arise from the epithelial part of the tooth germ, the mesenchymal part or from both. It is a tumor composed of odontogenic epithelium in a variety of histoarchitectural patterns which are embedded in a mature. Keratocystic odontogenic tumour canadian dental association. Case report keratocystic odontogenic tumor with an ectopic. Aug 24, 2005 adenomatoid odontogenic tumor aot is a rare odontogenic tumor which is often misdiagnosed as odontogenic cyst. Enucleation is performed when cysts are not large and when only minor damage to adjacent anatomical structures is expected. This is a temporary file and hence do not link it from a website, instead link the url of this page if you wish to link the pdf. Adenomatoid odontogenic tumor keratocystic odontogenic tumour. This article is from journal of medical case reports, volume 8. In this work twenty cases of keratocystic odontogenic tumor were stained by perlecan, syndecan1 cd8 and ki67 to study the biological behavior of the tumor. Squamous odontogenic tumor sot is a benign odontogenic tumor classified.
Lining epithelium of odontogenic keratocysts is classified into parakeratosis and orthokeratosis. Benign yet locally aggressive and grows quite large. Maxillary peripheral keratocystic odontogenic tumor. D, frcpath assistant prof of general pathology senior lecturer of oral pathology and oral histology slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Keratocystic odontogenic tumor kcot has recently been recommended to describe the lesion previously named odontogenic keratocyst 15 kcot is a developmental cyst which is locally aggressive and rapidly prolifera.
All books are in clear copy here, and all files are secure so dont worry about it. Keratocystic odontogenic tumor kot represents form 515% of all maxillar cystic lesions. Keratocystic odontogenic tumor kcotokcclinical guidelines. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.
Unfortunately you usually cant just enucleate the tumor, typically have to resect the part of the jaw where the tumor occurs. Keratocystic odontogenic tumour an overview sciencedirect. A, panorex and b, computed tomographic images are used as necessary in the preoperative workup and evaluation, which includes incisional biopsy examination. The purpose of this study was to determine prognostic factors for the recurrence of keratocystic odontogenic tumors kcots following simple enucleation by examining clinico.
The guest edited thematic issues are published free of charge. Firat selvi 1, merva soluk tekkesin 2, sirmahan cakarer 1, s. Ive gotten a few questions about odontogenic keratocysts lately, so i figured it would be good to write an article detailing what we know about them. A 70yearold woman presented with a large painful radiolucent mandibular lesion from the right canine to the left angle area through the midline. Odontogenic tumor an overview sciencedirect topics. The clinical presentation, gross and microscopic features, differential diagnosis, prognosis, and diagnostic pitfalls are addressed for inflammatory cysts periapical cyst, mandibular infected buccal cystparadental cyst, developmental cysts dentigerous, lateral periodontal, glandular odontogenic. Article information, pdf download for diagnosis and treatment of an. Calcifying epithelial odontogenic tumor ceot is a rare entity, comprising about 1% of all odontogenic tumors ots. This lesion is categorised into three variants of which the more common variant is follicular type which is often mistaken for dentigerous cyst. The orthokeratinizing odontogenic cyst is considered an unrelated entity without risk of recurrence or aggressive growth or association with nevoid basal cell carcinoma syndrome. Its locally aggressive behavior contrasts with its cystic histological appearance.
The differential diagnosis for a multilocular, radiolucent lesion in the body of the mandible is ameloblastoma, keratocystic odontogenic tumor parakeratinizing odontogenic keratocyst, odontogenic myxoma or central giant cell lesion. Keratocystic odontogenic tumor kcot is recently considered as one of benign odontogenic tumors due to its unique clinical, histopathological and biological features. Clear cell odontogenic carcinoma ccoc is a rare intraosseous carcinoma of the jaw. Odontogenic keratocyst because of its behavior, many oral pathologists now consider the okc an odontogenic tumor that has a cystic form 2005 classi. It might have a role in pathogenesis of odontogenic lesions and might be a reliable proliferation marker. Keratocystic odontogenic tumor formerly odontogenic keratocysts koct is a unique cyst because of its locally aggressive behavior, high recurrence rate, and characteristic histological appearance and comprises approximately 11% of all cysts of the jaws. Correct diagnosis and treatment should include a careful assessment of clinical, radiological and histopathological. Odontogenic keratocyst okc is a developmental cyst that was first described by philipsen 1956.
Odontogenic keratocyst symptoms, treatment, pictures. Calcifying epithelial odontogenic tumor ceot is a rare benign neoplasia, locally aggressive, that tends to invade bone and adjacent soft tissues. A keratocystic odontogenic tumor kot formerly known as an odontogenic keratocyst is a benign cystic tumor of dental origin that probably arises from primitive dental lamina, most commonly occurs in the posterior mandible, and almost certainly represents the lesion that used to be known as a primordial cyst. These epithelial islands will be cytopathologically benign without evidence of dysplasia. Odontogenic and non odontogenic tumors of the jaws are a relatively rare and heterogeneous group of benign and malignant neoplasms, hamartomas, and other bonerelated lesions that demonstrate great variability in etiology, biologic behavior, and clinical significance. The present study showed mcm3 and ki67 expression in the most common odontogenic cysts and tumors, and a higher expression rate in okc and ameloblastoma. Keratocystic odontogenic tumor in the maxillary sinus. Nov 20, 2014 this is an update on selected odontogenic malignancies.
Odontogenic cysts and tumors periapical cyst or granuloma chronic localized osteitis dentigerous cyst odontogenic keratocyst keratocystic odontogenic. Odontogenic and non odontogenic tumors update from the 4th edition of who 2017 classification 1. The 2005 who histological classification of odontogenic tumors lays out a classification system for neoplasms and other tumors related to the odontogenic apparatus. Ppt odontogenic keratocyst powerpoint presentation. Adenomatoid odontogenic tumor associated with dentigerous cyst of the maxillary antrum. Review of the literature and report of a rare case. Although rare, because of its variable presentation calcifying cystic odontogenic tumor should be included in the differential diagnosis of jaw lesions. This neoplasia is predominantly found in males and people of white origin. The odontogenic keratocyst is a relatively common developmental odontogenic cyst that represents approximately 10% to 14% of all jaw cysts. The odontogenic cysts are a diverse groups of odontogenic lesions of the jaws the radicular cyst is an inflammatory lesion, and although by far the most common, it is clinically easy to diagnose and manage other cysts are less frequently encountered and some e. According to their size, location, and relations with surrounding structures, they are treated by cyst enucleation or enucleation after either marsupialization or decompression.
In the whoiarc classification of head and neck pathology, this clinical entity had been known for years as the odontogenic keratocyst. Our knowledge and understanding continues to evolve and it is clearly time for a more contemporary classification and discussion of odontogenic tumors. The odontogenic keratocyst is a very well known odontogenic cyst. Among the jaw lesions, keratocystic odontogenic tumor, ameloblastoma, dentigerous cyst forms the common ones. Keratocystic odontogenic tumors can occur in any area of the maxilla or mandible. Files are available under licenses specified on their description page. In this chapter, only those composed of both odontogenic epithelium and mesenchyme will be dealt with, separate chapters being devoted to the. Before i get started, let me say that in 2005, the world health organization actually changed the name of odontogenic keratocyst to keratocystic odontogenic tumor. Odontogenic tumor definition of odontogenic tumor by. All structured data from the file and property namespaces is available under the creative commons cc0 license. The diagnosis may be confirmed by the anatomical pathology report.
Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect. Calcifications or hard tissue deposits in the wall of keratocystic odontogenic tumor kcot are rare and uncommon. Update from the 4th edition of the world health organization. The new edition, like those earlier, has a profound impact on the practice of head and neck surgical pathology throughout the world. The keratocystic odontogenic tumor is a benign odontogenic cystic neoplasia characterized by its thin, squamous epithelium with superficial parakeratosis. Ameloblastoma was the most frequent benign tumour 43% followed by keratocystic odontogenic tumour 19% and adenomatoid odontogenic tumour 10%.
As in all common odontogenic cysts, squamous odontogenic tumorlike proliferations may be seen in longstanding lesions. Historically who benign odontogenic tumor classification from 1971 to 2017. Even though histopathology continues to be staple in the diagnosis of odontogenic. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. Conservative management of keratocystic odontogenic tumors. Keratocystic odontogenic tumor kcot, formerly referred to as odontogenic keratocyst, is a benign neoplasm of odontogenic origin which may present an aggressive and infiltrative behavior leading. Formerly called keratocystic odontogenic tumor the orthokeratinizing odontogenic cyst is considered an unrelated entity without risk of recurrence or aggressive growth or association with nevoid basal cell carcinoma syndrome epidemiology. Aot accounts for about 1% until 9% of all odontogenic tumors. Cd166 expression in dentigerous cyst, keratocystic. An odontogenic tumor is a neoplasm of the cells or tissues that initiate odontogenic processes examples include. The odontogenic keratocyst can be defined as a cystic benign tumor, being localized at the level of the mandible or the maxilla. View enhanced pdf access article on wiley online library html view download pdf for offline viewing. Kcots are regarded as benign aggressive tumors and resection is usually considered as a last option. Keratocystic odontogenic tumor article about keratocystic.
Prognostic factors for keratocystic odontogenic tumor. Finally, treatment consists of surgical excision and follow up is characterized by a high rate of recurrence. Odontogenic and nonodontogenic tumors update from the. Adenomatoid odontogenic tumor aot is a wellrecognised slow growing benign tumor derived from complex system of dental lamina or its remnants. Okc is now referred to by the world health organization who as a keratocystic odontogenic tumour kcot, and who defined it as a benign uni or multicystic, intraosseous tumour of odontogenic origin, with a characteristic lining of parakeratinized stratified. Odontogenic tumours manifesting in the first two decades of life in a. Reconstruction of extensive jaw defects induced by. Keratocystic odontogenic tumor kcot is a benign tumor that arises sporadically or associated with nevoid basal cell carcinoma syndrome nbccs. It has the potential for infiltration and local aggressiveness and has a high rate of recurrence. Keywords odontogenic epithelial tumor, squamous odontogenic tumor. No recurrence was observed during 57month followup.
In other words, odontogenic tumors arise from odontogenic tissues. Winner of the standing ovation award for best powerpoint templates from presentations magazine. Aug 11, 2009 many treatment modalities have been advocated for its treatment, but none in particular has been regarded as the best treatment option. At the time of writing 2016, it is still the most widely used classification system although a new revision is due to come up in 2017. Case 3 the adenomatoid odontogenic tumor aot is usually an asymptomatic slow growth lesion. Mandibular clear cell odontogenic carcinoma world journal. Definean aggressive jaw tumor of odontogenic origin aradiolucent lesion that usually occurs in the mand. Keratocystic odontogenic tumor 40 51 ameloblastoma 18 23 odontoma 17 odontogenic myxoma 2 3 calcifying cystic odontogenic tumor 2 3 cementoblastoma 1 central odontogenic fibroma 1 1 calcifying epithelial odontogenic tumor 1 1 total 78 100 table 2 cases diagnosed distributed by gender.
It can occur either in the lower jaw or upper jaw bones. The adenomatoid odontogenic tumor aot is a rare, slow growing, benign, odontogenic epithelial tumor with characteristic clinical and histological features. The keratocystic odontogenic tumor is a benign developmental tumor with many distinguishing clinical and histologic features. Overall, the recurrence rate was approximately 29%. Multilocalcalcifying epithelial odontogenic tumor 17080 int j clin exp med 2016. This book greatly expands the body of knowledge in the field of odontogenic tumor pathology. This case report describes the thirteenth known case of ceot with maxillary sinus extension and the second one that also involves the buccal vestibule mucosa with peculiar histopathological and immunohistochemical data. Odontogenic keratocyst keratocystic odontogenic tumor figs. Odontogenic tumors encompass a group of lesions that share a common origin from odontogenic tissues. Discussion adenomatoid odontogenic tumour is a slowly growing lesion, with a predilection for the anterior maxilla ratio of cases 2.
The 2005 who classification now uses the term keratocystic odontogenic tumor. Maxillary calcifying epithelial odontogenic tumor with sinus. Adenomatoid odontogenic tumor aot is a relatively uncommon odontogenic tumor characterized by the formation of ductlike structures by the epithelial component of the lesion. The latest who classification of odontogenic tumors was published in pathology and genetics. Sixtynine percent of adenomatoid odontogenic tumours are diagnosed in the second decade of life, and more than half occur during the. Bhagawati, 1 manishgupta, 1 gauravnarang, 1 andsharanammabhagawati 2 department of oral medicine and radiology, shree bankey bihari dental college, masuri, ghaziabad, utta pradesh, india. The odontogenic keratocyst okc, currently designated by the world health organization as a keratocystic odontogenic tumor is a locally aggressive, cystic jaw lesion with a putative high growth potential and a propensity for recurrence. A 14yearold caucasian girl presented for observation of bilateral agenesis. Recurrence rate of keratocystic odontogenic tumor after conservative surgical treatment without. The article deals with aspects of recognized odontogenic carcinomas, odontogenic sarcoma and a yet unrecognized entity, sclerosing odontogenic carcinoma. The keratocystic odontogenic tumor vrije universiteit amsterdam. Teeth examination revealed that teeth 22 and 23 are missing, and teeth 21 and 24 are positive at cold sensitivity test without mobility.
It is predominantly found in young and female patients, located more often in the maxilla in. Chapter 21 odontogenic and non odontogenic tumors of the jaws introduction. Surgical treatment of keratocystic odontogenic tumour. Also known as the keratocystic odontic tumor, it is believed to be stemming from the dental lamina. Diagnosis and treatment of an odontogenic epithelial tumor in a. Figure 2 depicts the percentage of patients who re mained free of recurrent kcots after the initial interven. Mcm3 and ki67 proliferation markers in odontogenic cysts.
Following enucleation, the frequency of recurrence among 32 subjects diagnosed with kcot was analyzed for tumor site, radiographic and histologic features. The who classified odontogenic keratocysts with parakeratosis as keratocystic odontogenic tumors kcot in 2005. Which of the following scenarios represents the most common set of clinical features associated with the follicular variant of adenomatoid odontogenic tumor aot. Investigations continue into the lesions pathologic classification, diagnosis and. Mar 10, 2018 the topic odontogenic tumor of jaw you are seeking is a synonym, or alternative name, or is closely related to the medical condition ameloblastoma. We analyzed the etiopathogenetic, clinical, radiographic, and.
Dentigerous cyst associated with adenomatoid odontogenic. Odontogenic keratocysts make up around 19% of jaw cysts. Adenomatoid odontogenic tumor with impacted mandibular canine. Mcqs on odontogenic cysts and tumors oral pathology part 2. Case report keratocystic odontogenic tumor with an ectopic tooth in maxilla basavarajt. Topical 5fluorouracil is a novel targeted therapy for the. Keratinocystic odontogenic tumor odontogenic keratocyst keratinocystic odontogenic tumor three important things associated with this diagnosis. Immunohistochemical analysis of matrix metalloproteinases. Different manifestations of calcifying cystic odontogenic tumor.
The calcifying cystic odontogenic tumor normally presents as a painless, slow growing mass, involving both maxilla and mandible, primarily the anterior. There is no clinical consensus for the treatment of keratocystic odontogenic tumor kcot. We analyzed the etiopathogenetic, clinical, radiographic, and histopathologic aspects of keratocystic odontogenic tumors, particularly in association with dental anomalies of number, with the aim of providing useful information for their correct diagnosis, treatment, and prognosis within a multidisciplinary approach. A free powerpoint ppt presentation displayed as a flash slide show on id. This is a retrospective study of patients with kcot treated in a single unit over 17 years. Benign odontogenic epithelial tumors ameloblastoma squamous odontogenic tumor calcifying epithelial odontogenic tumor adenomatoid odontogenic tumor keratocystic odontogenic tumor odontogenic keratocyst odontogenic epithelial ectomesenchymal ameloblastic. Diagnoses male female n % n % keratocystic odontogenic. Pathology outlines benign tumors tumorlike conditions. Istanbul university, dentistry faculty, department of oral and maxillofacial surgery, istanbul, turkey. If squamous odontogenic cystlike proliferations are noted, they should essentially be ignored and are of no prognostic.