Cysts and Odontogenic Tumors 3 Flashcards
• An expansile, slow-growing, locally invasive lesion, typically
of posterior mandible of adults (mean = 35 y)
• Recurrence is common, but does not metastasize *
• The histopathology of ameloblastoma recapitulates the
enamel organ
• does not form and hard tissue
Ameloblastoma
The histopathology of ameloblastoma recapitulates the
________
enamel organ
______ histo:
- Ameloblastic islands
- Stellate reticulum in lumen
- Reverse polarity in epithelium
Follicular ameloblastoma
• Anterior jaws, equally distributed between mandible and
maxilla
• Mottled mixed density with diffuse margins
• Solid tumor with dense, collagenous stroma
Desmoplastic Ameloblastoma
_____:
Can be radiopaque or radiolucent
- contains fibrous CT that compromises the ameloclastic islands
Desmoplastic ameloblastoma
____ is a soft tissue lesion of the ameloblastoma that doesn’t occur in bone
Peripheral ameloblastoma
• Cystogenic ameloblastoma
• Unilocular radiolucency, usually of posterior mandible –
mimics a dentigerous cyst radiographically
• 2nd to 3rd decades (Mean age = 18 y)
• Recurrence uncommon
Unicystic Ameloblastoma
Histo of \_\_\_\_\_: • Nuclear hyperchromatism • Nuclear palasading • Reverse polarity of basal cell nuclei • Subnuclear vacuolation
Unicystic Ameloblastoma
Vickers-Gorlin Change
What are the demographics for adenomatoid odontogentc tumor?
Young females in anterior maxilla
If the histo shows pseudoducts, what is the lesion?
Adenomatoid odontogenic tumors
- Adults (Mean = 40 y)
- Posterior mandible - molar-ramus region
- Recurrence, but less aggressive than ameloblastoma
Calcifying Epithelial
Odontogenic Tumor
Histo of _____:
• A solid epithelial tumor (not cystic)
• Pink polygonal polyhedral epithelial cells
• Contains amyloid
• Concentric Liesegang ring calcifications
Calcifying Epithelial
Odontogenic Tumor
______ is the soft tissue version of the CEOT that does not occur in bone
Peripheral CEOT
• Ectomesenchymal odontogenic neoplasm
• Young adults (Mean = 30 y)
• The mandible more commonly involved than the maxilla
• A radiolucency, often multiolcular, may cross midline
• An unencapsulated lesion - recurrence is common
-High recurrence
Odontogenic myxoma
histo of _____:
• Resembles dental papilla, with stellate and spindled cells in a
myxoid extracellular matrix
• Termed myxofibroma if there is increased collagen
• Odontogenic rests variable
Odontogenic myxoma
• Most common in adult females (2 : 1) (mean age = 40 y)
• Well-circumscribed unilocular or multilocular lucency of
anterior maxilla and posterior mandible
• +/- radiopaque flecks
• One-third of cases are associated with an unerupted tooth
• Treatment by enucleation and vigorous curettage
Odontogenic Fibroma
• Mature, fibrous stroma with varying amounts of inactive
odontogenic epithelium
• Epithelium-poor type - simple type
• Epithelium-rich type - complex type (WHO-type)
Odontogenic Fibroma
- Neoplasm
- Young adults < 25 years
- Mandibular first molar
- Pain, expansion, root destruction
- Does not recur after complete removal
Cementoblastoma
• “Kiddie” tumor (Mean = 14.8 y)
• A painless swelling of posterior mandible
• Well-circumscribed lucency, frequently associated with the
crowns of impacted teeth
• Treatment by enucleation and curettage. May recur
Ameloblastic Fibroma
Histo of ______:
• Ectomesenchyme resembling dental papilla
• Epithelial strands and cords resembling dental lamina and
enamel organ
Ameloblastic Fibroma
- A “kiddie” tumor (mean age = 8 to 12y)
- Most frequent in posterior mandible
- A unilocular or multilocular mixed density lesion, often associated with the crown of an unerupted tooth
- Less common than ameloblastic fibroma
- Treatment by enucleation. Recurrence is rare
Ameloblastic Fibro-
Odontoma
What separates Ameloblastic Fibro-
Odontoma from ameloblastic fibroma?
Ameloblastic Fibro-
Odontoma has mixed RO/ RL appearance
• Histologic features of ameloblastic fibroma, with the
presence of dentin and enamel
Ameloblastic Fibro-Odontoma
- Teenagers
- Viewed an a hamartoma
- Well-circumscribed
- Treated by enucleation
- No recurrence expected
- Compound - anterior maxilla
- Complex - posterior mandible
Odontoma
Which odontoma is seen in anterior maxilla and look like malformed mini teeth?
Compound odontoma
Which odontoma is mostly seen in posterior mandible that looks like a large portion of RO flecks together?
Complex odontoma
20% of ________ are associated with odontomas
Gorlin Cysts
(Mixed Epithelial and Mesenchymal Odontogenic Tumors)
Mimics early stage of odontogenesis
Ameloblastic fibroma
(Mixed Epithelial and Mesenchymal Odontogenic Tumors)
Mimics intermediate stage of odontogenesis
Ameloblastic fibro-odontoma
(Mixed Epithelial and Mesenchymal Odontogenic Tumors)
Mimics end stage of odontogenesis
Odontoma
