Adenomatoid odontogenic tumor
Belmiro Cavalcanti do Egito VasconcelosI; Riedel FrotaII; Álvaro Bezerra CardosoIII; Gabriela Granja PortoIV; Suzana Célia de Aguiar Soares CarneiroV
IPhD, graduate programs coordinator - UPE
IIM.Sc in Maxillo-Facial Surgery - University of Pernambuco, PhD. Student - Maxillo-Facial Surgery - University of Pernambuco
IIISpecialist in Maxillo-Facial Surgery and Trauma - University of Pernambuco. M.Sc. Student in Dentistry (oral diagnosis) - Universidade Federal da Paraíba
IVSpecialist in Maxillo-Facial Surgery and Trauma - University of Pernambuco. M.Sc. Student in Maxillo-Facial Surgery and Trauma - University of Pernambuco
VSpecialist in Maxillo-Facial Surgery and Trauma - University of Pernambuco. M.Sc. Student in Maxillo-Facial Surgery and Trauma - University of Pernambuco
Address for correspondence
Keywords: maxilla/pathology, oral, pathology.
The adenomatoid odontogenic tumor (AOT) is usually an asymptomatic slow growth lesion. When grown, one can palpate a hard and large lesion. It is common for the tumor to cause shifting of neighboring teeth because tumor expansion is more common than teeth root resorption. Radiographically, there is a unilocular mass involving an unerupted tooth, sometimes opaque in the center and sclerotic in the periphery. Considering it to be an encapsulated tumor, treatment of choice is enucleation1. This paper describes three cases of these tumors and their symptoms, their radiographic characteristics and anatomic findings.
REPORT OF CASES
Cases 1 and 2
Both occurred on the second decade of life, the first in a girl and the second in a boy. The tumors evolved for about one year, they were asymptomatic and presented a hard and large mass in the paranasal region, obliterating the nasolabial groove and obstructing the nostril. Radiographic exams revealed an extensive unilocular image involving the maxillary sinus and the nasal cavity of the affected side (Figure 1). Treatment of choice was tumor enucleation under general anesthesia. The patients were followed up for one year after surgery, when there was bone regeneration.
This case refers to a 28 year-old patient, who had a tumor in the anterior portion of her mandible that had been growing for approximately 2 years (Figure 1). The tumor was also resected under general anesthesia and followed for one year.
AOTs present a relative frequency of 2.2 to 7.1% among odontogenic tumors2. This type of tumor affects women more frequently (1.9:1) on their second decades of life. 2,3.
The maxilla location of this tumor is two fold more frequently than that in the mandible4-6. Progressive nasal obstruction is a common finding in lesions larger than 5.0cm located in the maxilla5.
AOTs have three variants (follicular, extra-follicular and peripheric), which make it very difficult to differentiate from other diseases (2). Differential diagnosis depends on the radiographic result, which may show a radiolucent area with or without radioopaqueness5. It is indispensable to make and incisional biopsy of the lesion for surgical planning purposes, as well as aspirating it before any procedure with radiolucent masses because they usually have a vascular origin.
1Parkash H, Sidhu SS, Chopra P. Adenomatoid odontogenic tumour of the jaws. J Dentistry 1984;12:297-301.
2Philipsen HP, Reichart PA. Adenomatoid odontogenic tumor: facts and figures. Oral Oncol 1998;35:125-31.
3Mendis BRRN, MacDonald DG. Adenomatoid odontogenic tumour: a survey of 21 cases from Sri Lanka. Int J Oral Maxillofac Surg 1990;19:141-3.
4Lee JK, Lee KB, Hwang BN. Adenomatoid odontogenic tumor: a case report. J Oral Maxillofac Surg 2000;58:1161-4.
5Philipsen HP, Reichart PA, Zhang KH, Nikai H, Yu QX. Adenomatoid odontogenic tumor: biologic profile based on 499 cases. J Oral Pathol Med 1991;20:149-58.
6Philipsen HP, Srisuwan T, Reichart PA. Adenomatoid odontogenic tumor mimicking a periapical (radicular) cyst: A case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94:246-8.
Publication in this collection
16 June 2008
Date of issue