Odontogenic tumours part 2
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CEOT (calcifying epithelial odontogenic tumor) is a rare odontogenic tumor that comprises less than 1% of all tumors. It arises from dental lamina or reduced enamel epithelium and can be central or peripheral. CEOT typically presents as a slow-growing, painless mass in the molar/premolar region of the mandible in patients from 20-60 years old. Radiographically, it appears as a radiolucent lesion with flecks of radio-opacities and may be associated with an impacted tooth. Histologically, it is characterized by sheets of polyhedral cells with intercellular bridges, calcifications, and pools of eosinophilic material.
Odontogenic tumours part 2
- 1. CEOT Dr. Ali Tahir. M.Phil Oral Pathology
- 2. CEOT Also called ‘Pindborg’ tumour Rare, < 1% of all tumours Locally aggressive like ameloblastoma Arises from rests of dental lamina or reduced enamel epithelium Central & peripheral types Dr. Ali Tahir. M.Phil Oral Pathology
- 3. Clinical features 20-60yrs of age More common in mandible Molar premolar area Slow growing painless mass Maxillary lesions can cause nasal, sinus & eye sypmtoms Peripheral appears as a small, sessile mass, often without calcification Oral Pathology Dr. Ali Tahir. M.Phil
- 4. Radiographical Features Radiolucent with flecks of radio-opacities Less commonly appears as a mixture of radio-opaque & radiolucent areas Unilocular/Multilocular May appear as mixed areas Mostly associated with an impacted tooth Indistinct line of demarcation Dr. Ali Tahir. M.Phil Oral Pathology
- 5. Radiograph Calcifications are prominent around the crown of impacted tooth Dr. Ali Tahir. M.Phil Oral Pathology
- 6. CEOT D.D: Dentigerous cyst AOT Ameloblastic fibro-odontoma Dr. Ali Tahir. M.Phil Oral Pathology
- 7. Histological Features Sheets of polyhedral cells Prominent intercellular bridges Nuclie vary in size, pleomorphism may be seen but it doesn’t indicate malignancy Unlike ameloblastoma, it has calcifications which may be spherical or diffuse Pools of amorphous, eosinophilic, hyalinized material A clear cell variant also exists Nature of Eosinophilic material is controversial Dr. Ali Tahir. M.Phil Oral Pathology
- 8. Histopathology Sheets of Polyhedral cells Prominent intercellular bridges Pools of Eosinophilic material Dr. Ali Tahir. M.Phil Oral Pathology
- 9. Histopathology Spherical calcifications can be seen Dr. Ali Tahir. M.Phil Oral Pathology
- 10. Clear cell variant Dr. Ali Tahir. M.Phil Oral Pathology
- 11. Congo red stain in polarized light Dr. Ali Tahir. M.Phil Oral Pathology
- 12. AOT Dr. Ali Tahir. M.Phil Oral Pathology
- 13. Adenomatoid Odontogenic tumour An odontogenic tumour arising from odontogenic epithelium, around the crowns of un-erupted anterior teeth in young patients Biologically non-aggressive Dr. Ali Tahir. M.Phil Oral Pathology
- 14. Clinical Features 3-7% of all odontogenic tumours Common in anterior jaws More common in maxilla Frequently associated with an impacted tooth Common in younger patients (14-15yrs) Female predilection Presents as swelling around un-erupted tooth Usually asymptomatic Peripheral appears as small, sessile mass on Dr. Ali Tahir. M.Phil Oral Pathology gingiva
- 15. Clinical Features Presents as swelling around un-erupted tooth Usually asymptomatic Large lesions cause painless expansion of bone, although seldom exceeds 3cm Peripheral appears as small, sessile mass on gingiva Dr. Ali Tahir. M.Phil Oral Pathology
- 16. Radiographic features Well corticated, unilocular radiolucency around an impacted tooth Flecks of radio-opacity (snow-flake calcifications) Extends apically beyond CE junction Dr. Ali Tahir. M.Phil Oral Pathology
- 17. Extra-follicular type Dr. Ali Tahir. M.Phil Oral Pathology
- 18. Histological Features Outer capsule of thick fibrous CT Surrounds a nodular,/ductal/whorled pattern of epithelium (spindled or columnar) surrounding pools of PAS positive material (type of basement membrane) Spherical calcifications Dr. Ali Tahir. M.Phil Oral Pathology
- 19. Histological Features • Columnar epithelium arranged in duct-like tubular structures • These are not true ducts or glands • Foci of calcifications may be seen Dr. Ali Tahir. M.Phil Oral Pathology
- 20. Gorlin cyst Odontogenic Ghost Cell Tumour Dr. Ali Tahir. M.Phil Oral Pathology
- 21. COC A rare, well circumscribed solid or cystic lesion with a wide spectrum of histological features & contains ghost cells & spherical calcifications Associated with odontomas Mostly occurs as solid, non-cystic lesion called odontogenic ghost cell tumour Dr. Ali Tahir. M.Phil Oral Pathology
- 22. Clinical Features Common in areas anterior to molars 2nd decade Intraosseous/extraosseo us Intraosseous causes expansion of cortical plates Usually painless Dr. Ali Tahir. M.Phil Oral Pathology
- 23. Radiographical Features Well defined unilocular radiolucency Flecks of radio-opacities which may be irregular calcifications or tooth- like structures 1/3rd cases associated with unerupted canine Root resorption & divergence Dr. Ali Tahir. M.Phil Oral Pathology
- 24. R/F Dr. Ali Tahir. M.Phil Oral Pathology
- 25. Histology Variable Cystic/Solid Epithelium resembles that of ameloblastoma Outer layer of palisaded columnar cells Inner layer ressembels stellate reticulum Dr. Ali Tahir. M.Phil Oral Pathology
- 26. Eosinophilic epithelial cells without nuclie Histopathology referred to as ‘ghost cells’ Spherical calcifications Hyalinized material Dr. Ali Tahir. M.Phil Oral Pathology
- 27. Squamous Odontogenic Tumour Rare benign odontogenic neoplasm that may be clinically aggressive Clinical Features: Anterior to molars Peak incidence in 3rd decade Presents as painless swelling with loosening of teeth Slow growing Dr. Ali Tahir. M.Phil Oral Pathology
- 28. Radiographical features Small lesions have Unilocular radiolucency Large are multilocular Indistinct borders Displaces teeth Dr. Ali Tahir. M.Phil Oral Pathology
- 29. Histology Islands of normal appearing stratified squamous epithelium Islands may have microcyst formation in the centre Spherical or irregular shaped calcifications Dr. Ali Tahir. M.Phil Oral Pathology
- 30. Histopathology Dr. Ali Tahir. M.Phil Oral Pathology