Jaw metastases.
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Adenocarcinoma, Mucinous↗
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The odontogenic adenomatoid tumor. A comprehensive study of twenty new cases.
Twenty new cases of odontogenic adenomatoid tumor are added to the literature, bringing the total number of reported cases to 152. The clinical, radiographic, and microscopic findings in these cases support the previously reported data for this lesion. The odontogenic adenomatoid tumor is a benign lesion which arises from residual odontogenic epithelium. It should be treated conservatively, as there is no indication that this lesion will recur. The histogenesis of this lesion, as well as the origin of the esinophilic droplet material, is discussed.
Adenoma↗
Keratinization in odontogenic tumors.
The potential of odontogenic epithelium to keratinize in the form of ghost cells is demonstrated in the histologic variants of a number of odontongic tumors. Although the cells lack keratohyaline granules, they do contain abundant tonofilaments and probably represent an altered form of keratin. The presence of this material in odontogenic tumors does not appear to alter clinical occurence or clinical behavior.
Adolescent↗
Odontogenic myxoma. A clinical and ultrastructural study.
The odontogenic myxoma is an uncommon neoplasm of the jaws that is believed to arise from the primitive, mesenchymal portion of the tooth germ. This study surveys nine cases of odontogenic myxoma of the jaws. Analysis of the clinical material revealed that the myxoma occurred most frequently in the posterior regions of the mandible and will recur if initial therapy is too conservative. The average age of the patients in this series was 26.5 years. Five cases involved females and four involved males. Electron microscope findings revealed that the tumor cells are probably responsible for the secretion of the myxomatous intercellular material of the neoplasm.
Adolescent↗
Multiple odontogenic tumors and other anomalies. An autosomal dominantly inherited syndrome.
The authors report the occurrence of multiple odontogenic tumors in a father, his two sons, and his daughter. These occurred soon after birth and recurred upon occasion, with imcomplete removal. Associated with the multiple odontomas is esophageal stenosis. The occurrence of hepatopathy of unknown origin and an increased susceptibility to infection appear to be other components in this syndrome. A similar case reported in the literature has been cited. Autosomal dominant inheritance is suggested.
Adolescent↗
Oral Kaposi's sarcoma.
A new case of primary oral Kaposi's sarcoma associated with immunosuppressive therapy is presented. The literature related to oral Kaposi's sarcoma is reviewed, and the pathogenesis of this condition is briefly discussed. There is a possiblity that early lesions of Kaposi's sarcoma may be misadiagnosed clinically and histopathologically as simple pyogenic granulomas.
Alveolar Process↗
Metastatic renal adenocarcinoma presenting as periapical pathosis in the maxilla.
A case is reported because of the infrequency with which tumors metastasize from the kidney to the maxilla. It is of special interest because it presented as a periapical pathosis associated with a nonvital tooth and emphasizes the value of routine histopathologic examination of tissue.
Adenocarcinoma↗
The odontogenic keratocyst. A clinicopathologic study of 312 cases. Part I. Clinical features.
An analysis was made of the clinical features of 312 acceptable cases of odontogenic keratocysts from the files of the Department of Oral Pathology, Indiana University School of Dentistry. A total of 5.1 per cent of the keratocysts were from patients with the basal-cell nevus syndrome and 5.8 per cent were from patients with multiple keratocysts but with no other features of the syndrome. There was a wide age range, with a peak incidence in the second and third decades of life. The mandible: maxilla ratio was 2:1, with the mandibular third molar area and ramus being the most common sites. Dentigerous cyst was the most frequent clinical as well as histologic diagnosis for the majority of the keratocysts in this study. The primordial cyst comprised the greatest percentage of keratocysts (44.4 per cent). A total of 50.3 per cent of the patients were symptomatic before seeking treatment, the most common finding being intraoral drainage and swelling. Their radiographic appearance was quite variable, although they frequently resembled ameloblastoma. These cysts may be very aggressive clinically. They have a relatively high recurrence rate, as previously reported in the literature, in comparison with other types of odontogenic cyst. The findings in this study support the theory that the histologic appearance of an odontogenic keratocyst may be assumed by any of the odontogenic or nonodontogenic cysts.
Adolescent↗
Meningioma presenting as an intraoral mass.
The following case report illustrates a rather rare oral lesion, an extracranial meningioma. In the dental office the lesion was seen on a periapical x-ray film as a multilocular radiolucency. The patient, however, could not be convinced of the necessity of biopsy until several years later when clinical expansion of the maxillary buccal plate was noted. Thereafter, clinical, radiographic, and histopathologic examination revealed a diffuse meningioma involving the maxillary sinus, the floor of the nose, and the maxillary gingiva. The patient has since refused complete surgical removal but remains alive and well 8 years after the lesion was first noted.
Aged↗
Metastatic melanoma of the maxilla presenting as a gingival swelling.
Malignant melanoma metastatic to the gingiva has been reported only once. We present a case in which the occurrence of melanoma in the gingiva followed extraction of a periapically "abscessed" tooth. Since the initial periapical mass may well have been a metastatic tumor, particularly in a patient undergoing therapy for disseminated malignant disease, the need for biopsy of such lesions is emphasized.
Adult↗
Extracondylar osteochondromas of the jaws.
A review of the literature and the addition of two new cases have revealed that according to a histologic criterion there are presently twenty reported cases of osteochondroma of the jaws located outside the condyles. Although most of the extracondylar lesions have occurred on the coronoid process, cases are now reported on the maxilla and the body of the mandible. The clinical features of these lesions are compared with those located in the condyle, and the radiographic and surgical approaches of the extracondylar lesions are discussed.
Age Factors↗
Squamous odontogenic tumorlike proliferations in odontogenic cysts.
Five cases of squamous odontogenic tumorlike proliferations occurring in the walls of odontogenic cysts are presented. These lesions showed no more aggressive potential than the cysts, if taken alone, in which they occurred. The lesions showed no tendency to develop into solid tumors and, on the basis of this limited series of cases, conservative surgery appears to be the treatment of choice.
Adult↗
An analysis of the interrelationship of the mixed odontogenic tumors--ameloblastic fibroma, ameloblastic fibro-odontoma, and the odontomas.
The mixed odontogenic tumors--ameloblastic fibroma, ameloblastic fibro-odontoma, and the odontomas--represent a group of lesions of which some are neoplastic and some are hamartomatous. Regarding data on age, sex distribution, and site of occurrence of the various lesions, it was concluded that the ameloblastic fibroma represents a separate entity that does not develop into a more differentiated odontogenic lesion and that the ameloblastic fibro-odontoma is an immature complex odontoma. Moreover, it was noted that the distribution according to site of the ameloblastic fibro-odontoma and complex odontoma was dependent on age, both lesions showing a more posteriorly located site of predilection with increasing age. Finally, it is supposed that age-related factors determine whether an aberrant development of the odontogenic tissues exhibits a hamartomatous or a neoplastic nature.
Adolescent↗
Variations in keratinizing odontogenic cysts and tumors.
Classification of keratinizing odontogenic cysts and tumors is not entirely satisfactory to the clinician and pathologist because many individual cases do not fit precisely into a particular category. This report describes the nature of some of these marginal lesions in order that similar cases may be diagnosed and treated correctly. Eight selected cases are described histologically, and their clinical behavior is discussed. It is concluded that the histopathologic appearance of the odontogenic epithelium in odontogenic cysts and tumors varies to a large extent and gives rise to a variety of keratinizing lesions. It is further concluded that some varieties are unique and, for the present, treatment of the rare lesions depends more on observed clinical behavior, with morphology having a lesser role in prognosis. It is important that clinicians as well as pathologists be aware of the wide variation of these keratinizing lesions so that the patient will receive optimum treatment.
Adult↗
Chondromyxoid fibroma of the maxilla. Electron microscopic findings and review of the literature.
A case of chondromyxoid fibroma of the anterior maxilla is presented. The light and electron microscopic appearances of this tumor are described. A review of chondromyxoid fibromas of the jaws is performed, with a discussion of the appropriate therapy.
Adult↗
Radiographic characteristics of central ossifying fibroma.
Sixty-four instances of histologically documented ossifying and/or cementifying fibromas were evaluated. Adequate radiographs were available in 43 of the cases. Most of these benign fibro-osseous neoplasms occurred in women, with a predilection for the third and fourth decades. Six distinct radiographic patterns could be identified: (1) radiolucent, superimposed over teeth or residing in edentulous regions (28%); (2) radiolucent with opaque foci, lying in edentulous areas or superimposed over teeth (42%); (3) radiolucent, interposed between contiguous teeth (5%); (4) radiolucent with opaque foci, interposed between contiguous teeth (9%); (5) multilocular expansile (7%); and (6) aggressively expansile with opacification (9%). All lesions exhibited well-defined margins. Root resorption was a feature in 11% of the sample, and root divergence occurred in 17% of the cases.
Adult↗
Ossifying fibroma: a clinicopathologic study of sixty-four cases.
Sixty-four cases of neoplastic benign fibro-osseous lesions are presented, with clinical and radiographic follow-up in 23 instances. A marked predilection for female patients was observed, with the majority or cases arising in the molar-premolar region of the mandible. Radiographically, these neoplasms are well demarcated and may be radiolucent, radiolucent with central opacification (target appearance), or multilocular radiolucent. A benign fibro-osseous histopathologic pattern is observed with osseous, cemental, and/or ovoid-curvoid calcified deposits. This feature, along with confinement to tooth-bearing regions, supports a periodontal ligament origin. It appears that the distinction between cementifying and ossifying variants is academic, as no behavioral differences exist. The recurrence rate following curettage was found to be 28%.
Adolescent↗