developmental and odontogenic cysts day 4 Flashcards
Adenomatoid Odontogenic Tumor radio app
mixed density/ unilocular lucency
Adenomatoid Odontogenic Tumor demographic and location
- Teenagers - 75%
- Female - 2:1
- Maxilla - 2:1
- Anterior - 75%
dif dx
adenomatoid odontogenic tumor
OKC/OOC
dentigerous cyst
ameloblastic fibroma
odontogenic fibroma
why can adenomatoid odontogenic tumors present as mixed
there can be some calcification surrounding the tooth
dif dx?
adenomatoid odontogenic tumor likely (canine impacted=anterior)
ca epithelial odontogenic tumor
ameloblastic fibro-odontoma
Adenomatoid Odontogenic
Tumor histo
swirling pattern= zellbella pattern
pseudoducts present (one row of cells instead of two)=pathognomic
calcifications may be present as well
biopsy from ant. maxilla of teenage girl, impacted canine with a well defined luceny
Adenomatoid Odontogenic
Tumor
biopsy from ant. maxilla of teenage girl:
Adenomatoid Odontogenic
Tumor
Calcifying Epithelial Odontogenic Tumor demo and location
- Adults (Mean = 40 y)
- Posterior mandible - molar-ramus region
Calcifying Epithelial Odontogenic Tumor
recurrence and agression
- Recurrence, but less aggressive than ameloblastoma
what could this be (2)
calcifying epithelial odontogenic tumor
calcifying odontogenic cyst
calcifying epithelial odontogenic tumor radio
multilocular luceny with opacities present
dif dx? (2)
Calcifying Epithelial Odontogenic Tumor
ameloblastic fibro-odontoma
what could this be (4)
OKC (luceny is not mixed)
Ca epi odontogenic tumor
glandular odontogenic cyst
unicystic ameloblastoma
Calcifying Epithelial Odontogenic Tumor structure/histo
- A solid epithelial tumor (not cystic)
- Pink polygonal polyhedral epithelial cells
- Contains amyloid
- Concentric Liesegang ring calcifications
biopsy from 55 y/o man posterior man, unilocular lucency with some opacities
calcifying epithelial odontogenic tumor, pink polygonal polyhedral cells
Calcifying Epithelial Odontogenic Tumor, pink polygonal polyhedral cells
biopsy of a tumor from the posterior man of a 60 y/o male, radio app: well defined multilocular lucency with radio opacities
Calcifying Epithelial Odontogenic Tumor, pink polygonal polyhedral cells and amyloid (would app green with congo red stain)
biopsy from posterior man of 40 y/o man, presented as a multilocular mixed lucency
Calcifying Epithelial Odontogenic Tumor, pink polygonal polyhedral cells and liesing ring Ca
Odontogenic Myxoma derived from?
- Ectomesenchymal odontogenic neoplasm
Odontogenic Myxoma demo/location
- Young adults (Mean = 30 y)
- The mandible more commonly involved than the maxilla
Odontogenic Myxoma radio app
- A radiolucency, often multiolcular, may cross midline
Odontogenic Myxoma recurrence
- An unencapsulated lesion - recurrence is common
what other lesion (aside from odontogenic myxoma) crosses midline often
glandular odontogenic cyst
what could be the lesion in the posterior L man?
well defined multilocular radiolucency:
odontogenic myxoma
odontogenic fibroma
aneurysmal bone cyst
ameloblastoma
OKC
dif dx
odontogenic myxoma
glandular odontogenic cyst
ameloblastoma
OKC
odontogenic tumor tx
agressive removal due to recurrence
Odontogenic Myxoma histo
resembles?
dif term?
variable component?
- Resembles dental papilla, with stellate and spindled cells in a myxoid extracellular matrix
- Termed myxofibroma if there is increased collagen
- Odontogenic rests variable
which sides are what?
dental papilla on L and odonto myxoma on R
which sides are what?
dental papilla on L and odonto myxoma on R, myoxma may be less cellular and have more conn tissue
Odontogenic Fibroma types
- Central Odontogenic Fibroma: Simple type, World Health Organization (WHO) type
- Peripheral Odontogenic Fibroma
Odontogenic Fibroma demo
- Most common in adult females (2 : 1) (mean age = 40 y)
odontogenic fibromas often associated with?
- One-third of cases are associated with an unerupted tooth
odontogenic fibroma radio. app
where?
- Well-circumscribed unilocular or multilocular lucency of anterior maxilla and posterior mandible
- +/- radiopaque flecks
odontogenic fibroma location
often posterior mandible of anterior maxilla
odontogenic fibroma tx
Treatment by enucleation and vigorous curettage
Odontogenic Fibroma histo/types
- Mature, fibrous stroma with varying amounts of inactive odontogenic epithelium
- Epithelium-poor type - simple type
- Epithelium-rich type - complex type (WHO-type)
biopsy from posterior man of adult female, well defined multilocular luceny with opaque flecks.
associated with unerupted tooth.
diagnosis? tx?
simple type odontogenic fibroma, treatment by enucleation and vigorous curettage
biopsy from 45 y/o female anterior maxilla, presented as a well-defined multilocular lucency
odontogenic fibroma, more epithelium present=complex type
biopsy from 40 y/o adult female anterior maxilla presented as a unilocular lucency with opaque flecks
odontogenic fibroma with calcification present
what causes opacity flecks with odontogenic fibromas
calcifications
what causes opacity flecks with odontogenic fibromas
calcifications
can there be peripheral odontogenic fibromas?
yes, no radio app
what causes opacity flecks with odontogenic fibromas
calcifications
Cementoblastoma demo
- Neoplasm
- Young adults < 25 years
what causes opacity flecks with odontogenic fibromas
calcifications
Cementoblastoma most common location
- Mandibular first molar
Cementoblastoma results
- Pain, expansion, root destruction
Cementoblastoma tx and recurrence
- Does not recur after complete removal, tooth extracted as well
cementoblastoma
Ameloblastic Fibroma demo/presentation
- “Kiddie” tumor (Mean = 14.8 y)
- A painless swelling of posterior mandible
Ameloblastic Fibroma radio
- Well-circumscribed lucency, frequently associated with the crowns of impacted teeth
Ameloblastic Fibroma tx/recurrence
- Treatment by enucleation and curettage. May recur
dif dx
ameloblastic fibroma
dentigerous cyst
OKC
unicystic ameloblastoma
orthokeratinizing odontogenic cyst
dif dx
ameloblastic fibroma
dentigerous cyst
OKC
OOC
dif dx
ameloblastic fibroma
dentigerous cyst
OKC
unicystic ameloblastoma
orthokeratinizing odontogenic cyst
dif dx
OKC
OOC
ameloblastic fibroma
dentigerous cyst
unicystic ameloblastoma
Ameloblastic Fibroma histo
- Ectomesenchyme resembling dental papilla, hypercellular
- Epithelial strands and cords resembling dental lamina and enamel organ
anastomeses may form with epithelila strands
biopsy from the posterior man of a 14 y/o, presented as a unilocular lesion of an unerupted tooth.
diagnosis/tx?
ameloblastic fibroma, Treatment by enucleation. Recurrence is rare
Ameloblastic Fibro-Odontoma
demo
- A “kiddie” tumor (mean age = 8 to 12y)
Ameloblastic Fibro-Odontoma most frequent location
- Most frequent in posterior mandible
Ameloblastic Fibro- Odontoma radio
- A unilocular or multilocular mixed density lesion, often associated with the crown of an unerupted tooth
Ameloblastic Fibro-Odontoma occurance comapred to ameloblastic fibroma
- Less common than ameloblastic fibroma
Ameloblastic Fibro-Odontoma tx/recurrence
- Treatment by enucleation. Recurrence is rare
dif dx
ameloblastic fibro-odontoma
calcifying odontogenic cyst
calcifying epithelial odontogenic tumor
odontogenic fibroma
dif dx
ameloblastic fibro-odontoma
calcifying odontogenic cyst
calcifying epi odontogenic tumor
odontogenic fibroma
Ameloblastic Fibro-Odontoma histo
- Histologic features of ameloblastic fibroma, with the
presence of dentin and enamel
taken from post man as a multilocular mixed density, unerupted tooth
ameloblastic firbro-odontoma, dentin and enamel present
Odontoma demo? viewed as?
- Teenagers
- Viewed an a hamartoma
odontoma app
- Well-circumscribed, dif if complex (doesnt resemble anything) or compound (resembles mini teeth)
odontoma types and locations
- Compound - anterior maxilla
- Complex - posterior mandible
compound odontoma
complex odontoma
compound odontoma histo
would resemble mini teeth with organized dentin and enamel
complex odontoma histo
disorganized enamel and dentin
complex odontoma
what cysts are associated with odontomas
- 20% of Gorlin Cysts are associated with odontomas
Mixed Odontogenic Tumors histo compared
progression through odontogenesis
swirling pattern= zellbella pattern
pseudoducts present (one row of cells instead of two)=pathognomic
calcifications may be present as well
Adenomatoid Odontogenic
Tumor histo
- Adults (Mean = 40 y)
- Posterior mandible - molar-ramus region
Calcifying Epithelial Odontogenic Tumor demo and location
- Recurrence, but less aggressive than ameloblastoma
Calcifying Epithelial Odontogenic Tumor
recurrence and agression
multilocular luceny with opacities present
calcifying epithelial odontogenic tumor radio
- A solid epithelial tumor (not cystic)
- Pink polygonal polyhedral epithelial cells
- Contains amyloid
- Concentric Liesegang ring calcifications
Calcifying Epithelial Odontogenic Tumor structure/histo
- Ectomesenchymal odontogenic neoplasm
Odontogenic Myxoma derived from?
- Young adults (Mean = 30 y)
- The mandible more commonly involved than the maxilla
Odontogenic Myxoma demo/location
- Resembles dental papilla, with stellate and spindled cells in a myxoid extracellular matrix
- Odontogenic rests variable
Odontogenic Myxoma histo
- Most common in adult females (2 : 1) (mean age = 40 y)
Odontogenic Fibroma demo
- Well-circumscribed unilocular or multilocular lucency of anterior maxilla and posterior mandible
- +/- radiopaque flecks
odontogenic fibroma radio. app
often posterior mandible or anterior maxilla
odontogenic fibroma location
- Neoplasm
- Young adults < 25 years
Cementoblastoma demo
- “Kiddie” tumor (Mean = 14.8 y)
- A painless swelling of posterior mandible
Ameloblastic Fibroma demo/presentation
- Well-circumscribed lucency, frequently associated with the crowns of impacted teeth
Ameloblastic Fibroma radio
- Ectomesenchyme resembling dental papilla, hypercellular
- Epithelial strands and cords resembling dental lamina and enamel organ
anastomeses may form with epithelila strands
Ameloblastic Fibroma histo
- A unilocular or multilocular mixed density lesion, often associated with the crown of an unerupted tooth
Ameloblastic Fibro- Odontoma radio
- Histologic features of ameloblastic fibroma, with the
presence of dentin and enamel
Ameloblastic Fibro-Odontoma histo
- Teenagers
- Viewed an a hamartoma
Odontoma demo? viewed as?
- Well-circumscribed, dif if complex (doesnt resemble anything) or compound (resembles mini teeth)
odontoma app
would resemble mini teeth with organized dentin and enamel
compound odontoma histo
disorganized enamel and dentin
complex odontoma histo