原文題目

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口腔病理科 On-Line KMU Student Bulletin

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原文題目(出處)： The peripheral adenomatoid odontogenic tumour: a case report. Oral Surg 2012;5: 45-8

原文作者姓名： L.M. Bowers , D.M. Cohen , A. Fetner & I. Bhattacharyya 通訊作者學校： Department of Oral and Maxillofacial Diagnostic Sciences,

Division of Oral Pathology, & Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL, USA

報告者姓名(組別)：許容齊 Intern I 組

報告日期： 101/05/08

內文：

I. Introduction

1. Adenomatoid odontogenic tomour( AOT) is a benign lesion of odontogenic origin

2. 3 clinical variants: follicular, extra-follicular, peripheral type

3. Peripheral odontogenic tumours (histological characteristics):

intraosseous counterparts but occur exclusively in the soft tissue II. Case report

1. An 11-year-old male presented for evaluation of a ‘red marginal lesion’ of 1 year’s duration.

i. 6 months prior to evaluation ii. Removed by electrosurgery iii. Returned 6 months later 2. Examination:

i. A firm erythematous, raised lesion ii. Facial gingiva associated with tooth 21 iii. Normal radiographic presentation

3. Diferentail diagnosis:

i. Epulis

ii. Pyogenic granuloma 4. Surgical flap:

i. Removed the tissue along with associated gingiva ii. Lesion was attached to the facial flap

iii. Not associated directly with the tooth

iv. Facial bone expansion was observed, no perforation was noted v. 7 mm root exposed from mesiofacial to distofacial line angle

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5. Histological examination:

i. Encapsulated lesion

ii. Proliferation cystic odontogenic epithelium iii. Well-ductal structures

iv. Scattered small calcospheritic masses

v. The histological ﬁndings were consistent with a well-encapsulated PAOT.

vi. The tissue appeared completely healed at 6 weeks III. Disscusson

1. WHO: defined AOT:

i. 1971: A tumour of odontogenic epithelium with duct-like structures and with varying degrees of inductive change in the connective tissue ii. 2005: composed of odontogenic epithelium in a variety of

histoarchitechtural patterns, embedded in a mature connective tissue stroma characterized by slow but progressive growth

2. Peripheral type:

i. Lowest frequency of 3types, 2.3% and 4.5 % of all AOT ii. Distinct male: female ratio, 1:2 ~ 1:14

iii. Lowest Mean Age of all AOT: 11.9 ~ 14 y/o iv. Area: most in anterior maxilla

3. Clinical appearance of PAOT:

i. Painless

ii. Slow-growing gingival swelling iii. May protrude associated teeth

iv. Bony defect may be associated with lesion

v. Radiographic appearance may reveal superficial erosion of bone 4. Histological features of AOT:

i. Cuboidal/ columnar cell of odontogenic epithelium ii. Nest/ rosette-like structures

1. Eosinophilic amorphous material (often) iii. Duct-like structure

1. Polarized away from space

2. Eosinophilic material/ cellular debris/ without content

3. convoluted cords in complicated patterns often show invaginations

4. dystrophic calcification(may be dentinoid/ cementum) 5. PAOT: like intraosseous lesion, usually solid, unencapsulated

i. This case: cystic component, relatively thick capsule 6. PAOT was proposed to be an erupted AOT

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i. Both peripheral and central components 7. AOT is rarely detected radiographically

8. Tx: excision; There have been no reports of recurrence of this lesion

題號題目

1 Which of the following is adenomatoid tumour most seen in?

(A) Anterior mandible (B) Anterior maxilla (C) Posterior mandible (D) Posterior maxilla 答案

(A )

出處：Oral and Maxillofacial Pathology 3 rd edition Ch 15 odontogenic cysts and tumors p.713, fig.15-84

題號題目

2 Which of the following about AOT is ture?

(A) Aggressive tumor

(B) Common in a patient over 30 y/o (C) Usually encapsuled

(D) Easily differentiate radiographically from the more common dentigerou cyst

答案 ( C)

出處：Oral and Maxillofacial Pathology 3 rd edition Ch 15 odontogenic cysts and tumors p.71