Tumors of Odontogenic Epithelium

Question 1

Name three tumors of Odontogenic Epithelium.

Answer 1

Ameloblastoma
Adenomatoid Odontogenic Tumor (AOT)
Calcifying Epithelial Odontogenic Tumor (CEOT)

Question 2

What is an ameloblastoma?

Answer 2

benign but locally aggressive neoplasm of odontogenic epithelial origin that histologically resembles the ameloblasts of the enamel organ

Question 3

True or False: Enamel is produced by the lesional cells of an ameloblastoma.

Answer 3

False!

Question 4

True or False: The frequency of ameloblastoma equals the combined frequency of all other odontogenic tumors.

Answer 4

True

common of odontogenic tumors, yet still only 0.2% of oral pathology

Question 5

What is the average age at time of diagnosis for ameloblastoma?

Answer 5

33 years old

Question 6

Where do most ameloblastomas occur?

Answer 6

• in the mandible (molar-ramus region)

- some (20%) occur in association with an impacted tooth

Question 7

Ameloblastoma grows _____ with _____.

Answer 7

slowly
expansion/swelling

(posterior mandible:
no expansion = OKC, expansion = ameloblastoma)

Question 8

Ameloblastomas appear as a small radiolucency with well-defined borders, then become expansile and develop the ______ or _____ (multilocular) appearance.

Answer 8

soap bubble

honeycomb

Question 9

Several microscopic patterns have been seen with ameloblastoma but ______ or ______ are seen most often.

Answer 9

plexiform

follicular

Question 10

What is special about the nuclei in ameloblastomas?

Answer 10

nuclei are polarized AWAY from the basement membrane

Question 11

Loosely arranged polyhedral epithelial cells of ameloblastomas resemble _____ ______.

Answer 11

stellate reticulum

Question 12

What is the recommended treatment for ameloblastoma?

Answer 12

depends on the size and location
small = aggressive curettage or small en bloc resection
large = large en bloc or segmental resection with reconstruction

Question 13

True or False: Mandibular ameloblastomas should be treated more aggressively.

Answer 13

False: maxillary should be treated more aggressively due to their anatomic location

Question 14

With simple curettage, the recurrence rate of small ameloblastoma is ______%.

Answer 14

55-90%

Question 15

With marginal resection, recurrence rates are up to ____%.

Answer 15

15

Question 16

True or False: Ameloblastoma can be fatal.

Answer 16

True, maxillary lesions are more of a concern

Question 17

Yearly follow-up for ameloblastoma is should last ______ years; there is rare malignant transformation.

Answer 17

8 to 10 years

Question 18

A _______ ameloblastoma can look like many other gingival bumps.

Answer 18

peripheral

Question 19

Peripheral ameloblastoma is an aysmptomatic gingival mass in a _______-aged adult that includes _____tissues with little to no _____ involvement.

Answer 19

middle-aged
soft tissues
no bone

Question 20

What is the typical size for ameloblastoma?

Answer 20

less than 2 cm in diameter

Question 21

True or False: Peripheral ameloblastoma is an innocuous lesion that can easily be cured by local excision.

Answer 21

True

Question 22

What does AOT stand for?

Answer 22

Adenomatoid Odontogenic Tumor

Question 23

Adenomatoid Odontogenic Tumors arise from ______ or ______.

Answer 23

enamel organ

dental lamina rests

Question 24

True or False: AOT is more common in young patients under the age of 20 years.

Answer 24

True

Question 25

Does AOT have a sex predilection?

Answer 25

yes, more likely in females (2:1)

Question 26

The _____ maxilla is the most common location for AOT.

Answer 26

anterior

Question 27

____% of AOT are associated with anterior jaws, ____% are associated with an impacted tooth.

Answer 27

75%
75%
AOT FAM = female, anterior, maxilla

Question 28

How can an AOT be differentiated from a dentigerous cyst?

Answer 28

Radiograph:
AOT extends apically beyond the CEJ,
dentigerous stops at the CEJ

Question 29

AOT tumor cells form swirling spindle-cell nests that contain ________ structures of varying sizes.

Answer 29

duct-like

and sometimes foci of basophilic calcified material is also seen

Question 30

True or False: AOT is treated by enucleation with rare recurrence.

Answer 30

True

Question 31

True or False: The Pindborg Tumor is a rare odontogenic epithelial neoplasm.

Answer 31

True

Question 32

The histogenesis of a Pindborg Tumor (CEOT) is thought to be ______ _______.

Answer 32

stratum intermedium

STRaight PIN IN

Question 33

CEOT is more common in which area of the jaws?

Answer 33

Posterior mandible 57%

posterior maxilla 21%

Question 34

CEOT is often associated with _______ and is most often found in adults age _____ years.

Answer 34

impacted teeth

40 years old

Question 35

Radiographically, CEOT can appear as radiopaque flecks with ill- or well-defined borders. This appearance is known as “______”

Answer 35

driven snow

Question 36

CEOT epithelial cells may be associated with homogenous material that stains as ______ or calcifications within the _______ that forms lamellated structures.

Answer 36

amyloid

amyloid!

Question 37

What are the term used to describe “calcifications within amyloid” associated with CEOT?

Answer 37

Liesgang Rings

Question 38

What is the treament for CEOT?

Answer 38

Conservative Excision with 15% recurrence (radical excision therefore isn’t warranted)