Odontogenic Tumors Overview

Odontogenic Tumors

• Odontogenic tumors are tumors that originate from the tissues that form teeth. They can be benign or malignant.

• Benign tumors usually do not spread to other parts of the body.

• Malignant tumors can spread to other parts of the body (metastasize).

Epithelial Origin Tumors

• Ameloblastoma (conventional):

  • Clinical features: Age range 30-60, commonly in the posterior mandible, painless swelling.
  • Radiographic features: Multilocular, soap-bubble appearance, root resorption, displaced teeth.
  • Histological features: Follicular pattern is most common. May contain cystic spaces.

• Ameloblastoma (unicystic):

  • Clinical features: Younger patients (often in the second decade of life), commonly in the molar or premolar region of the mandible.
  • Radiographic features: Unilocular radiolucency, may be difficult to differentiate from other cysts.
  • Histological features: Dense capsule surrounding a solitary, fluid-filled lumen.

• Unicystic ameloblastoma:

  • Clinical features: Younger patients, often in the second decade of life.
  • Types of growth: Luminal, intraluminal, or mural.
  • Histological features: Dense capsule surrounding solitary, fluid-filled lumen.

• Calcifying epithelial odontogenic tumor (Pindborg tumor):

  • Clinical features: Rare, affects older adults, slowly enlarging painless mass, often found in the posterior mandible.
  • Histological features: Composed of sheets of large, polyhedral epithelial cells with abundant eosinophilic cytoplasm and prominent intercellular bridges. May show calcification.

• Adenomatoid odontogenic tumor:

  • Clinical features: Commonly in the second decade of life, often associated with unerupted canine.

• Squamous odontogenic tumor:

  • Clinical features: Young adults, anterior to molars (PM or canine region), painless swelling, tenderness and loosening of teeth.
  • Histological features: Composed of stratified squamous epithelium with keratinization.

Mesenchymal Origin Tumors

• Odontogenic fibroma:

  • Clinical features: Painless swelling, often asymptomatic.
  • Histological features: Composed of fibrous tissue with scattered cellular mesenchymal areas.

• Odontogenic myxoma:

  • Clinical features: Usually asymptomatic lesions, rapid growth.
  • Histological features: Composed of myxoid tissue, often with stellate reticulum, collagen fibers, and cartilage.

• Ameloblastic fibroma:

  • Clinical Features: Can be found as a well defined mass in young people.
  • Histological features: composed of stellate reticulum like cells.

• Cemento-ossifying fibroma:

  • Clinical Features: A painless swelling in young people.
  • Histological Features: Composed of fibrous tissue frequently ossified and/or cementoid tissue

Metastasizing Odontogenic Tumors

• Metastasizing ameloblastoma:
  • Clinical features: Rare, usually occurs in patients who have had prior treatment for conventional ameloblastoma.
  • Pattern: Aspiration from an existing tumor to the lung may result in the formation of a new focus within the lung. The histology matches that of the original tumor.

Additional Details

• Metastasis: The spread of cancer from one part of the body to another.
• Histopathology: Microscopic examination of tissue to determine the nature of a disease.
• Radiographs: X-ray images used to diagnose bone and dental abnormalities.
• Impacted tooth: A tooth that is unable to erupt through the gum tissue.
• Radiolucency: An area of radiographic opacity, indicating a space-occupying lesion.
• Radiodensity: Density in an x-ray or computed tomography scan.