Tumors of Odontogenic Epithelium Flashcards
Name three tumors of Odontogenic Epithelium.
Ameloblastoma
Adenomatoid Odontogenic Tumor (AOT)
Calcifying Epithelial Odontogenic Tumor (CEOT)
What is an ameloblastoma?
benign but locally aggressive neoplasm of odontogenic epithelial origin that histologically resembles the ameloblasts of the enamel organ
True or False: Enamel is produced by the lesional cells of an ameloblastoma.
False!
True or False: The frequency of ameloblastoma equals the combined frequency of all other odontogenic tumors.
True
common of odontogenic tumors, yet still only 0.2% of oral pathology
What is the average age at time of diagnosis for ameloblastoma?
33 years old
Where do most ameloblastomas occur?
- in the mandible (molar-ramus region)
- some (20%) occur in association with an impacted tooth
Ameloblastoma grows _____ with _____.
slowly
expansion/swelling
(posterior mandible:
no expansion = OKC, expansion = ameloblastoma)
Ameloblastomas appear as a small radiolucency with well-defined borders, then become expansile and develop the ______ or _____ (multilocular) appearance.
soap bubble
honeycomb
Several microscopic patterns have been seen with ameloblastoma but ______ or ______ are seen most often.
plexiform
follicular
What is special about the nuclei in ameloblastomas?
nuclei are polarized AWAY from the basement membrane
Loosely arranged polyhedral epithelial cells of ameloblastomas resemble _____ ______.
stellate reticulum
What is the recommended treatment for ameloblastoma?
depends on the size and location
small = aggressive curettage or small en bloc resection
large = large en bloc or segmental resection with reconstruction
True or False: Mandibular ameloblastomas should be treated more aggressively.
False: maxillary should be treated more aggressively due to their anatomic location
With simple curettage, the recurrence rate of small ameloblastoma is ______%.
55-90%
With marginal resection, recurrence rates are up to ____%.
15
True or False: Ameloblastoma can be fatal.
True, maxillary lesions are more of a concern
Yearly follow-up for ameloblastoma is should last ______ years; there is rare malignant transformation.
8 to 10 years
A _______ ameloblastoma can look like many other gingival bumps.
peripheral
Peripheral ameloblastoma is an aysmptomatic gingival mass in a _______-aged adult that includes _____tissues with little to no _____ involvement.
middle-aged
soft tissues
no bone
What is the typical size for ameloblastoma?
less than 2 cm in diameter
True or False: Peripheral ameloblastoma is an innocuous lesion that can easily be cured by local excision.
True
What does AOT stand for?
Adenomatoid Odontogenic Tumor
Adenomatoid Odontogenic Tumors arise from ______ or ______.
enamel organ
dental lamina rests
True or False: AOT is more common in young patients under the age of 20 years.
True
Does AOT have a sex predilection?
yes, more likely in females (2:1)
The _____ maxilla is the most common location for AOT.
anterior
____% of AOT are associated with anterior jaws, ____% are associated with an impacted tooth.
75%
75%
AOT FAM = female, anterior, maxilla
How can an AOT be differentiated from a dentigerous cyst?
Radiograph:
AOT extends apically beyond the CEJ,
dentigerous stops at the CEJ
AOT tumor cells form swirling spindle-cell nests that contain ________ structures of varying sizes.
duct-like
and sometimes foci of basophilic calcified material is also seen
True or False: AOT is treated by enucleation with rare recurrence.
True
True or False: The Pindborg Tumor is a rare odontogenic epithelial neoplasm.
True
The histogenesis of a Pindborg Tumor (CEOT) is thought to be ______ _______.
stratum intermedium
STRaight PIN IN
CEOT is more common in which area of the jaws?
Posterior mandible 57%
posterior maxilla 21%
CEOT is often associated with _______ and is most often found in adults age _____ years.
impacted teeth
40 years old
Radiographically, CEOT can appear as radiopaque flecks with ill- or well-defined borders. This appearance is known as “______”
driven snow
CEOT epithelial cells may be associated with homogenous material that stains as ______ or calcifications within the _______ that forms lamellated structures.
amyloid
amyloid!
What are the term used to describe “calcifications within amyloid” associated with CEOT?
Liesgang Rings
What is the treament for CEOT?
Conservative Excision with 15% recurrence (radical excision therefore isn’t warranted)
