RESUMEN
An 81-year-old male patient presented with a well-demarcated, unilocular radiolucent lesion in the right mandibular body, identified during a routine radiographic examination. Based on the clinical hypothesis of a residual cyst, enucleation with curettage was performed, and the specimen was submitted for histopathological analysis. Microscopically, the cystic lesion was predominantly lined by ameloblastomatous epithelium with numerous ghost cells and dentinoid. Additionally, other cystic cavities lined by stratified squamous epithelium with corrugated parakeratin were observed in the fibrous capsule. Based on these features, a final diagnosis of a calcifying odontogenic cyst with odontogenic keratocyst-like areas was established. No recurrence was observed over a 9-year follow-up period. The association of a calcifying odontogenic cyst with odontogenic keratocyst or odontogenic keratocyst-like areas is very rare. To date, this is the second case report in the literature presenting these findings.
Asunto(s)
Quiste Odontogénico Calcificado , Humanos , Masculino , Anciano de 80 o más Años , Quiste Odontogénico Calcificado/patología , Quiste Odontogénico Calcificado/diagnóstico , Enfermedades Mandibulares/patología , Enfermedades Mandibulares/diagnóstico , Quistes Odontogénicos/patologíaRESUMEN
Introdução: Os cistos e tumores odontogênicos são lesões que apresentam comportamento biológico heterogêneo e patogênese ainda não totalmente esclarecida. A Yes-associated protein (YAP) atua como um regulador transcricional de genes envolvidos na proliferação celular e na apoptose, participando da ativação de vias associadas ao crescimento cístico e à progressão neoplásica. Objetivo: Analisar a expressão imuno-histoquímica da proteína YAP e correlacioná-la com marcadores envolvidos na proliferação celular e na apoptose em lesões odontogênicas epiteliais benignas. Metodologia: A amostra consistiu de 95 casos de lesões odontogênicas - 25 cistos dentígeros (CDs), 30 CO não sindrômicos (COs), 30 AMB convencionais (AMB-Cs) e 10 AMB unicísticos (AMB-Us) -, além de 10 espécimes de folículo dentários (FD). Foi realizada coleta dos dados clinico-demográficos dos casos, bem como análise morfológica para melhor caracterização da amostra. Os cortes histológicos foram submetidos à técnica imuno-histoquímica através da utilização dos anticorpos YAP, ciclina D1, Ki-67 e Bcl-2, e a análise da expressão destes foi realizada quali-quantitativamente, mediante metodologia adaptada. Os dados coletados seguiram para análise descritiva e estatística (p ≤ 0,05). Resultados: Houve discreta predileção por mulheres (n = 55; 57,6%) e por indivíduos na faixa etária dos 21 aos 40 anos (n = 50; 47,6%), sendo a região posterior de mandíbula mais afetada (64%). A análise da imunoexpressão de YAP revelou maiores níveis de expressão em COs, especialmente nas camadas basal e parabasal, seguido dos AMB-Us e AMB-Cs, que demonstraram moderada imunorreatividade, predominantemente nas células periféricas. Além disso, houve diferenças significativas quanto à imunoexpressão de YAP entre os grupos analisados, com existência de correlações positivas e estatisticamente significativas entre YAP e ciclina D1 em CDs e AMB-Us, e entre YAP e Ki-67 em AMB-Us (p < 0,05). Todavia, entre a imunoexpressão YAP e Bcl-2, foi verificada ausência de correlação estatisticamente significativa. Conclusões: A YAP pode exercer influência sobre a proliferação celular do epitélio de cistos e tumores odontogênicos, auxiliando, assim, na progressão das diferentes lesões odontogênicas (AU).
Background: Odontogenic cysts and tumors present heterogeneous biological behavior, and their etiopathogenesis is not fully understood yet. Yes-associated protein (YAP) acts as a transcriptional regulator of genes involved in cell proliferation and apoptosis, activating pathways associated with cystic growth and neoplastic progression. Objective: To analyze the immunohistochemical expression of YAP protein and correlate it with markers involved in cell proliferation and apoptosis in benign epithelial odontogenic lesions. Methods: The sample consisted of 95 cases of odontogenic lesions - 25 dentigerous cysts (DCs), 30 non-syndromic odontogenic keratocyst (OKCs), 30 conventional AMB (C-AMBs), and 10 unicystic AMB (UAMBs) -, in addition to 10 specimens of dental follicles (DF). Clinicodemographic data collection was carried out, as well as morphological analysis for better characterization of the sample. The histological sections were submitted to the immunohistochemical technique using YAP, cyclin D1, Ki-67, and Bcl-2 antibodies, and their immunoexpression analysis was performed qualitatively and quantitatively, through an adapted methodology. The collected data were submitted for descriptive and statistical analysis (p ≤ 0.05). Results: There was a slight predilection for women (n = 55; 57.6%) and individuals aged between 21 and 40 years (n = 50; 47.6%), with the posterior region of the mandible as the most affected site (64%). Analysis of YAP immunoexpression revealed higher expression levels in OKCs, especially in the basal and parabasal layers, followed by U-AMBs and C-AMBs, which showed moderate immunoreactivity, predominantly in peripheral cells. In addition, there were significant differences in YAP immunoexpression between the analyzed groups, with positive and statistically significant correlations between YAP and cyclin D1 in DCs and U-AMBs, and between YAP and Ki-67 in U-AMBs (p < 0.05). However, between YAP and Bcl-2 immunoexpression, there was no statistically significant correlation. Conclusions: YAP may influence on the cell proliferation of odontogenic cysts and tumors epithelium, thus helping with the progression of the different odontogenic lesions (AU) .
Asunto(s)
Proliferación Celular , Proteínas Señalizadoras YAP/metabolismo , Proteínas Coactivadoras Transcripcionales con Motivo de Unión a PDZ/metabolismo , Quiste Dentígero/patología , Biomarcadores de Tumor , Registros Médicos , Estudios Retrospectivos , Interpretación Estadística de Datos , Apoptosis , Quiste Odontogénico Calcificado/patología , Estadísticas no Paramétricas , Proteínas Inhibidoras de la Diferenciación , Estudio Observacional , Hallazgos Morfológicos y MicroscópicosRESUMEN
The calcifying epithelial odontogenic tumor is a rare benign neoplasm that accounts for approximately 1% of all odontogenic tumors. Most of the cases occur in the posterior mandible, and a few involve the maxilla. Despite their relatively indolent biological behavior, tumors in the maxilla tend to grow fast. We report the case of a 33-year-old female patient exhibiting swelling in the right maxilla. An isodense area associated with an impacted supernumerary tooth was found on imaging examination. The histopathologic diagnosis was a calcifying epithelial odontogenic tumor. The treatment of choice was surgical removal of the lesion and associated dental elements. The patient has been followed up for 11 months and shows no signs of recurrence. Besides describing this case, we reviewed the literature on the association of calcifying epithelial odontogenic tumors with supernumerary teeth and found two case reports addressing this subject.
Asunto(s)
Humanos , Femenino , Adulto , Diente Supernumerario/complicaciones , Neoplasias Maxilares/etiología , Quiste Odontogénico Calcificado/etiología , Diente Supernumerario/diagnóstico por imagen , Neoplasias Maxilares/patología , Quiste Odontogénico Calcificado/patologíaRESUMEN
OBJECTIVES: To investigate the frequency of calcifying odontogenic cysts (COCs) that have been submitted for microscopic examination from representative geographic regions of Brazil and to compare it with literature data. MATERIALS AND METHODS: A retrospective study was conducted on biopsies obtained from 1953 to 2016 at 10 Brazilian oral and maxillofacial pathology centres. A total of 198,350 biopsy specimens were analysed. Demographic data and histopathological diagnosis were evaluated descriptively and statistically. In addition, a literature review of case series was carried out in four electronic databases. RESULTS: A total of 268 cases of COC were surveyed, representing 0.1% of the oral lesions at the centres studied. Female patients in their second decade of life and the maxilla were more affected. The mean lesion size of symptomatic individuals was larger than that of cases without symptoms (p = 0.026). The literature review showed a higher frequency in Asia and Europe, mainly affecting men in the third decade of life. CONCLUSIONS: COC is a rare lesion. Novel data on the clinicopathological features of 268 cases have been added to the literature. Data regarding gender and age of the Brazilian patients reported herein contrast with findings of case series and retrospective studies reported elsewhere.
Asunto(s)
Quiste Odontogénico Calcificado/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Quiste Odontogénico Calcificado/patología , Prevalencia , Estudios Retrospectivos , Factores Sexuales , Adulto JovenRESUMEN
Calcifying odontogenic cyst (COC) is a rare odontogenic cyst with ameloblastic epithelial lining containing clusters of ghost cells. COCs have been described in association with several odontogenic tumors, more commonly odontomas and rarely with dentigerous cyst (DC). In this article, we describe a case of COC associated with DC in a 15-year-old girl, who presented with a swelling on the right middle third of the face, producing facial asymmetry. Panoramic radiography showed a well-circumscribed, corticated, and unilocular radiolucency at the level of the right maxillary sinus, involving 2 unerupted premolars. The lesion was enucleated and histologically revealed a COC associated with DC, which presented mucous metaplasia. Immunohistochemical reactions were performed to better illustrate this rare synchronous occurrence of COC and DC, showing positivity for CK5, CK14, CK19, and p63 in both lesions. CK18 was negative in COC, and Bcl-2 was negative in DC. Periodic acid Schiff highlighted the mucous cells in the DC lining.
Asunto(s)
Biomarcadores de Tumor/análisis , Quiste Dentígero/complicaciones , Neoplasias Maxilares/patología , Quiste Odontogénico Calcificado/patología , Adolescente , Quiste Dentígero/diagnóstico por imagen , Quiste Dentígero/cirugía , Femenino , Humanos , Maxilar/diagnóstico por imagen , Maxilar/patología , Maxilar/cirugía , Neoplasias Maxilares/diagnóstico , Neoplasias Maxilares/etiología , Neoplasias Maxilares/cirugía , Quiste Odontogénico Calcificado/diagnóstico , Quiste Odontogénico Calcificado/etiología , Quiste Odontogénico Calcificado/cirugía , Radiografía Panorámica , Tomografía Computarizada por Rayos XRESUMEN
ABSTRACT: The appearance of mixed odontogenic tumors into the oral cavity is a rare event. It is considered that some mixed tumors are only a stage in the complete development of a hamartomatous formation such as ameloblastic fibroodontoma and odontoma. Both pathologies share in common cellular elements which at one point makes them indistinguishable from each other. We present the case of a 21 year old patient who showed a mandibular growth whose histological elements present characteristics of both pathologies. The treatment was surgical excision of the lesion. There were no complications or recurrences to periodic reevaluation.
RESUMEN: La aparición de tumores odontogénicos mixtos en la cavidad oral es un evento raro. Se considera que algunos tumores mixtos son solo una etapa en el desarrollo completo de una formación hamartomatosa como el fibro-odontoma ameloblástico y odontoma. Ambas patologías comparten elementos celulares comunes que en un punto los hacen indistinguibles entre sí. Presentamos el caso de un paciente de 21 años que mostró un crecimiento mandibular cuyos elementos histológicos presentan características de ambas patologías. El tratamiento fue la escisión quirúrgica de la lesión. No hubo complicaciones o recurrencias a la reevaluación periódica.
Asunto(s)
Humanos , Adulto Joven , Neoplasias Gingivales/patología , Odontoma/patología , Quiste Odontogénico Calcificado/patología , Neoplasias Gingivales/cirugía , Radiografía , Odontoma/cirugía , Quiste Odontogénico Calcificado/cirugía , FibroblastosRESUMEN
BACKGROUND: Pilomatrixoma, craniopharyngioma, and calcifying cystic odontogenic tumor are the main entities presenting ghost cells as an important histological feature, in spite their quite different clinical presentation; it seems that they share a common pathway in the formation of these cells. The aim of this study is to examine and compare the characteristics of ghost and other cells that form these lesions. METHODS: Forty-three cases including 21 pilomatrixomas, 14 craniopharyngiomas, and eight calcifying cystic odontogenic tumors were evaluated by immunohistochemistry for cytokeratins, CD138, ß-catenin, D2-40, Glut-1, FAS, CD10 and also by scanning electron microscopy. RESULTS: The CKs, CD138, ß-catenin, Glut-1, FAS, and CD10 were more often expressed by transitional cells of craniopharyngioma and calcifying cystic odontogenic tumor, compared with pilomatrixoma. Basaloid cells of pilomatrixoma showed strong positivity for CD138 and CD10. Differences on expression pattern were identified in transitional and basal cells, as ghost cells were negative for most antibodies used, except by low expression for cytokeratins. By scanning electron microscopy, the morphology of ghost cells were similar in their fibrillar cytoplasm, but their pattern varied from sheets in pilomatrixoma to small clusters in craniopharyngioma and calcifying cystic odontogenic tumor. CONCLUSIONS: Mechanisms involved in formation of ghost cells are unknown, but probably they follow different pathways as protein expression in the basal/transitional cells was not uniform in the three tumors studied.
Asunto(s)
Craneofaringioma/patología , Enfermedades del Cabello/patología , Neoplasias Maxilomandibulares/patología , Quiste Odontogénico Calcificado/patología , Tumores Odontogénicos/patología , Pilomatrixoma/patología , Neoplasias Hipofisarias/patología , Neoplasias Cutáneas/patología , Craneofaringioma/metabolismo , Craneofaringioma/ultraestructura , Células Epiteliales/patología , Transportador de Glucosa de Tipo 1/metabolismo , Enfermedades del Cabello/metabolismo , Humanos , Inmunohistoquímica , Neoplasias Maxilomandibulares/metabolismo , Neoplasias Maxilomandibulares/ultraestructura , Queratinas/metabolismo , Microscopía Electrónica de Rastreo , Neprilisina/metabolismo , Quiste Odontogénico Calcificado/metabolismo , Quiste Odontogénico Calcificado/ultraestructura , Tumores Odontogénicos/metabolismo , Tumores Odontogénicos/ultraestructura , Pilomatrixoma/metabolismo , Pilomatrixoma/ultraestructura , Neoplasias Hipofisarias/metabolismo , Neoplasias Hipofisarias/ultraestructura , Neoplasias Cutáneas/metabolismo , Neoplasias Cutáneas/ultraestructura , Sindecano-1/metabolismo , beta Catenina/metabolismo , Receptor fas/metabolismoRESUMEN
OBJECTIVE: Benign and malignant tumor cells can express altered adhesion properties, and these features can be associated with their proliferative and invasive characteristics. This study aimed to evaluate syndecan-1 and Ki-67 expression in ghost cell-containing odontogenic tumors. STUDY DESIGN: Clinical data were retrieved from laboratory records, and hematoxylin-eosin-stained slides and sections, labeled with monoclonal antibodies anti-syndecan-1 and anti-Ki-67 using the immunoperoxidase technique, were evaluated. RESULTS: Included were 21 central calcifying cystic odontogenic tumors (CCOTs) (4 associated with odontoma), 2 peripheral CCOTs, 1 dentinogenic ghost cell tumor, and 1 ghost cell odontogenic carcinoma (GCOC). Syndecan-1 was mainly expressed in cells resembling stellate reticulum and in stromal cells from the fibrous capsule. The mean Ki-67 labeling index was 4.1% (49.3% for GCOC), but it was not associated with syndecan-1 expression. CONCLUSIONS: Syndecan-1 is variably expressed in cells resembling the stellate reticulum, stromal cells, and basal cells and might be associated with the biology of these tumors.
Asunto(s)
Neoplasias Maxilomandibulares/metabolismo , Antígeno Ki-67/metabolismo , Quistes Odontogénicos/metabolismo , Tumores Odontogénicos/metabolismo , Sindecano-1/metabolismo , Adolescente , Adulto , Biomarcadores de Tumor/metabolismo , Quiste Dentígero/metabolismo , Quiste Dentígero/patología , Femenino , Humanos , Técnicas para Inmunoenzimas , Neoplasias Maxilomandibulares/patología , Masculino , Quiste Odontogénico Calcificado/metabolismo , Quiste Odontogénico Calcificado/patología , Quistes Odontogénicos/patología , Tumores Odontogénicos/patologíaRESUMEN
Calcifying cystic odontogenic tumors (CCOTs) are benign cystic lesions of odontogenic origin characterized by an ameloblastoma-like epithelium and the presence of a group of cells named ghost cells. The pattern of cytokeratin (Ck) expression on these lesions remains unclear and needs to be clarified. To this end, the expression of Ck6, Ck13, Ck14, Ck18, and Ck19 in the epithelium lining of 7 cases of CCOTs was evaluated by immunohistochemistry. For this, the epithelium lining was divided into 3 distinct regions: basal layer, suprabasal layer, and the compartment composed of ghost cells. In this study, 6 cases (85.7%) were classified as type 1 and 1 (14.3%) as type 4. All cases were negative for Ck13 and Ck18, despite the epithelial layer, as well as in the ghost cells. Ck6 was only positive in the ghost cells. Positivity for Ck14 and Ck19 was found in the basal and suprabasal layers, including the ghost cells. The results showing positivity for Ck14 and Ck19 in all of the analyzed cases reinforce CCOT as being of odontogenic origin, and the restricted expression of Ck6 in the ghost cells may be indicative that these cells suffer an altered differentiation into hair follicles in CCOTs.
Asunto(s)
Ameloblastoma/patología , Neoplasias Maxilomandibulares/patología , Queratinas/metabolismo , Quiste Odontogénico Calcificado/patología , Tumores Odontogénicos/patología , Adolescente , Adulto , Anciano , Ameloblastoma/metabolismo , Diferenciación Celular , Epitelio/metabolismo , Epitelio/patología , Femenino , Folículo Piloso/metabolismo , Folículo Piloso/patología , Humanos , Inmunohistoquímica , Neoplasias Maxilomandibulares/metabolismo , Masculino , Persona de Mediana Edad , Quiste Odontogénico Calcificado/metabolismo , Tumores Odontogénicos/metabolismo , Adulto JovenRESUMEN
The calcifying cystic odontogenic tumor or Gorlin cyst is an uncommon lesion with a variable clinical behavior and considerable histopathologic diversity. The authors report a case of calcifying cystic odontogenic tumor that was being treated as a maxillary sinus mucocele. The possibility of mimicking numerous odontogenic and nonodontogenic lesions makes the calcifying cystic odontogenic tumor difficult for a clinical diagnosis. The present case demonstrates that a specific knowledge in oral pathology is required to differentiate odontogenic lesions.
Asunto(s)
Neoplasias Maxilares/diagnóstico , Neoplasias Maxilares/cirugía , Quiste Odontogénico Calcificado/diagnóstico , Quiste Odontogénico Calcificado/cirugía , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias Maxilares/patología , Mucocele/diagnóstico , Quiste Odontogénico Calcificado/patología , Radiografía Panorámica , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Ameloblastomas and keratocystic odontogenic tumors (KOTs) are lesions that are characterized by locally invasive growth and cause extensive bone destruction. In addition, it is known that E-cadherin influences the adhesion of Langerhans cells (LCs) to keratinocytes. OBJECTIVE AND METHODS: The aim of this study was to investigate, using immunohistochemistry, the distribution of CD1a-positive cells in ameloblastomas and KOTs and their relationship with E-cadherin, in comparison to calcifying cystic odontogenic tumor (CCOT). RESULTS: The CD1a-positive LCs were observed in 11 ameloblastomas and KOTs. All of the cases of CCOT showed CD1a-positive LCs and a significant difference was found when this tumor was compared with ameloblastomas (P < 0.05, Mann-Whitney test). A statistically significant difference was also noted when comparing CD1a-positive LCs between CCOTs and KOTs (P < 0.05, Mann-Whitney test). Lower expression of E-cadherin in ameloblastomas (AMs) in relation to KOTs and CCOTs (P < 0.05, Fisher test) was observed. There was no correlation between E-cadherin and CD1a-positive LCs between all odontogenic tumors that were studied (P > 0.05, Spearman test). CONCLUSION: A quantitative difference of CD1a-positive cells between AMs and KOTs in comparison to CCOTs was observed. This permits to speculate that a depletion of CD1a-positive LCs might influence the local invasiveness of ameloblastomas and KOTs. Furthermore, it is suggested that E-cadherin mediates cell adhesion in these tumors.
Asunto(s)
Ameloblastoma/patología , Antígenos CD1/análisis , Cadherinas/análisis , Células de Langerhans/patología , Tumores Odontogénicos/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Adhesión Celular/fisiología , Recuento de Células , Forma de la Célula , Niño , Células Dendríticas/patología , Células Epiteliales/patología , Femenino , Humanos , Inmunohistoquímica , Queratinocitos/patología , Masculino , Neoplasias Mandibulares/patología , Neoplasias Maxilares/patología , Persona de Mediana Edad , Quiste Odontogénico Calcificado/patología , Adulto JovenRESUMEN
BACKGROUND: Initially described by Gorlin et al. in 1962, the calcifying cystic odontogenic tumor (CCOT) may be associated with unerupted teeth, ameloblastomas, adenomatoid odontogenic tumors, and, in many cases, with odontomas. It is rare in patients in the first decade of life, particularly involving deciduous teeth. Surgery is the treatment of choice, with low recurrence rates. CASE REPORT: We present a clinical case of CCOT associated with odontoma and a missing deciduous tooth in a 3-year-old female patient. The lesion was removed under general anesthesia. The patient has been followed up for 1 year, and no recurrence was found. This appears to be the first report in such a young age.
Asunto(s)
Neoplasias Primarias Múltiples/diagnóstico , Quiste Odontogénico Calcificado/diagnóstico , Odontoma/diagnóstico , Diente Primario , Preescolar , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias Primarias Múltiples/patología , Neoplasias Primarias Múltiples/cirugía , Quiste Odontogénico Calcificado/patología , Quiste Odontogénico Calcificado/cirugía , Odontoma/patología , Odontoma/cirugíaRESUMEN
OBJECTIVE: The objective of this preliminary study was to evaluate the expression of matrix metalloproteinases (MMPs), tissue inhibitors of metalloproteinases (TIMPs) and growth factors in keratocystic odontogenic tumors (KOTs). STUDY DESIGN: The expression of MMPs, TIMPs, growth factors, and the extracellular signal-regulated kinase (ERK) 1/2 signaling pathway were assessed by immunohistochemistry in 15 cases of KOT and 4 cases of calcifying cystic odontogenic tumor (CCOT). RESULTS: KOT samples expressed significantly higher amounts of MMPs, TIMPs, growth factors, epidermal growth factor receptor (EGFR), and ERK compared with CCOT samples, with the exception of MMP-2 and TIMP-1. CONCLUSIONS: MMP-9, TIMP-2, EGF and transforming growth factor α act together and likely regulate the proliferation and aggressiveness of KOT. ERK-1/2 serves as the transducer of signals generated by these proteins, which signal through the common receptor, EGFR. This process may be related to the increased proliferation and aggressiveness observed in KOT.
Asunto(s)
Receptores ErbB/metabolismo , Péptidos y Proteínas de Señalización Intercelular/metabolismo , Neoplasias Maxilomandibulares/metabolismo , Neoplasias Maxilomandibulares/patología , Metaloproteinasas de la Matriz/metabolismo , Quiste Odontogénico Calcificado/metabolismo , Quiste Odontogénico Calcificado/patología , Inhibidores Tisulares de Metaloproteinasas/metabolismo , Humanos , Técnicas para Inmunoenzimas , Estadísticas no ParamétricasRESUMEN
Screening for expression of amelogenesis-related proteins represents a powerful molecular approach to characterize odontogenic tumors and investigate their pathogenesis. In this study, we have examined the presence and distribution of odontogenic ameloblast-associated protein (ODAM), amelotin (AMTN), ameloblastin (AMBN), and amelogenin (AMEL) by immunohistochemistry in samples of adenomatoid odontogenic tumor (AOT), calcifying epithelial odontogenic tumor (CEOT), developing odontoma, ameloblastoma, calcifying cystic odontogenic tumor (CCOT), ameloblastic fibroma (AF), myxoma, odontogenic fibroma (OF), and reduced enamel epithelia (REE). Positive results were obtained in those tumors with epithelial component, except for AF, OF, and ameloblastoma. ODAM was found around mineralized structures (dystrophic calcifications) and CEOT's amyloid, whereas AMTN stained the eosinophilic material of AOTs. The CCOT transitory cells to ghost cells were strongly positive with all proteins except AMEL, and the REE as well as odontomas showed immunoexpression for ODAM, AMTN, AMBN, and AMEL similar to those found in normal rat tooth germs. Based on these results, some histopathogenetic theories were formulated.
Asunto(s)
Amelogenina/análisis , Proteínas de Unión al Calcio/análisis , Proteínas del Esmalte Dental/análisis , Tumores Odontogénicos/patología , Ameloblastoma/patología , Ameloblastos/patología , Amiloide/análisis , Animales , Membrana Basal/patología , Calcinosis/patología , Esmalte Dental/patología , Saco Dental/patología , Células Epiteliales/patología , Epitelio/patología , Hialina/química , Inmunohistoquímica , Quiste Odontogénico Calcificado/patología , Tumores Odontogénicos/etiología , Odontoma/patología , Ratas , Germen Dentario/patologíaRESUMEN
Hybrid odontogenic tumors are rare conditions that can affect the oral maxillofacial region and usually occur in adults as an asymptomatic swelling. Hybrid odontogenic tumors exclusively involving adenomatoid odontogenic tumor (AOT) and calcifying cystic odontogenic tumor (CCOT) are rare, with only 4 reported cases. In addition, there are only few studies describing the presence of abortive enamel in AOT and, to our knowledge, CCOT was not present in any of them. We described a rare case of AOT associated with CCOT and abortive enamel formation in a 2-year-old child, a condition not well described in the international literature. Secretory cell activity was assessed by periodic acid-Schiff and Congo red stains.
Asunto(s)
Neoplasias Maxilares/diagnóstico , Neoplasias Maxilares/cirugía , Quiste Odontogénico Calcificado/diagnóstico , Quiste Odontogénico Calcificado/cirugía , Preescolar , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias Maxilares/patología , Quiste Odontogénico Calcificado/patologíaRESUMEN
The peripheral calcifying odontogenic cyst (PCOC) accounts for less than 25% of the cases of calcifying odontogenic cysts and most commonly appears as a nodule on the gingiva. This paper aims to present both a case report of a PCOC located in the left vestibular maxilla as well as a review of the English-language literature. An 11-year-old female patient presented a swelling in the vestibular region of teeth 12 and 13. Periapical and panoramic radiographs demonstrated irregular calcification. Surgical excision was performed. Microscopic examination showed an odontogenic cystic lesion lined by ameloblastoma-like epithelium, containing numerous ghost cells. Areas of calcification associated with ghost cells could also be observed. The patient was diagnosed with PCOC. The patient has been disease-free for 36 months. The review of the cases of PCOC showed 44 well-defined cases. The mean age was of 49.4 years at the time of diagnosis. The reported cases appeared as a painless swelling, with a slight predilection for females, and were more frequently located in the anterior region of the maxilla or mandible. Surgical excision is the treatment of choice, and recurrence is rare.
Asunto(s)
Neoplasias Maxilares/patología , Quiste Odontogénico Calcificado/patología , Niño , Femenino , HumanosRESUMEN
AIMS: Ameloblastoma is an odontogenic neoplasm with local invasiveness and recurrence. We have previously suggested that growth factors and matrix metalloproteinases (MMPs) influence ameloblastoma invasiveness. The aim was to study expression of MMPs, tissue inhibitor of metalloproteinases (TIMPs) and growth factors in ameloblastoma. METHODS AND RESULTS: Thirteen cases of solid/multicystic ameloblastoma were examined. As a control, calcifying cystic odontogenic tumour (CCOT), a non-invasive odontogenic neoplasm with ameloblastomatous epithelium was also studied. Immunohistochemistry detected MMPs, TIMPs and growth factors in ameloblastoma and CCOT. The labelling index (LI) of MMP-9 and TIMP-2 was significantly higher in ameloblastoma compared with CCOT. The LI of epidermal growth factor (EGF), transforming growth factor (TGF)-alpha and epidermal growth factor receptor (EGFR) was also increased in ameloblastoma. This neoplasm showed greater expression of MMPs, TIMPs and growth factors compared with CCOT. We then analysed these molecules in ameloblastoma cells and stroma. Ameloblastoma cells exhibited increased LI of MMP-1, -2 and EGFR. We found a positive correlation between EGF and TIMP-1, and between TGF-alpha and TIMP-2. It is known that signals generated by growth factors are transduced by the ERK pathway. Ameloblastoma stroma exhibited the phosphorylated (activated) form of ERK. CONCLUSIONS: These results suggest an interplay involving growth factors MMPs and TIMPs that may contribute to ameloblastoma behaviour. Signals generated by this molecular network would be transduced by ERK 1/2 pathway.
Asunto(s)
Ameloblastoma/metabolismo , Ameloblastoma/patología , Péptidos y Proteínas de Señalización Intercelular/metabolismo , Neoplasias Maxilomandibulares/metabolismo , Neoplasias Maxilomandibulares/patología , Metaloproteinasas de la Matriz/metabolismo , Inhibidores Tisulares de Metaloproteinasas/metabolismo , Proliferación Celular , Factor de Crecimiento Epidérmico/metabolismo , Receptores ErbB/metabolismo , Humanos , Inmunohistoquímica , Sistema de Señalización de MAP Quinasas , Metaloproteinasa 1 de la Matriz/metabolismo , Metaloproteinasa 9 de la Matriz/metabolismo , Quiste Odontogénico Calcificado/metabolismo , Quiste Odontogénico Calcificado/patología , Células del Estroma/metabolismo , Células del Estroma/patología , Inhibidor Tisular de Metaloproteinasa-2/metabolismo , Factor de Crecimiento Transformador alfa/metabolismoRESUMEN
Ameloblastomatous epithelium containing clusters of ghost cells is the typical histopathology of calcifying cystic odontogenic tumor (CCOT). This paper aimed to assess keratins AE1-AE3, K7, K10/13, K14, K18, K19, vimentin, laminin, and collagen IV in 08 CCOTs to discuss their histopathogenesis. Similarity to the immunoprofile of the stratified squamous epithelium was seen in the with the basal layer expressing K14 and the upper cells expressing K10/13. When compared to the immunoprofile of the normal odontogenic epithelium, of odontogenic tumor epithelia and of the ghost cells described in the literature, it was possible to suggest that the CCOT epithelium differentiates towards squamous type.
Asunto(s)
Neoplasias Maxilomandibulares/metabolismo , Neoplasias Maxilomandibulares/patología , Queratinas/biosíntesis , Quiste Odontogénico Calcificado/metabolismo , Quiste Odontogénico Calcificado/patología , Diferenciación Celular , Transformación Celular Neoplásica , Colágeno Tipo IV/biosíntesis , Epitelio/metabolismo , Humanos , Inmunohistoquímica , Laminina/biosíntesis , Vimentina/biosíntesisRESUMEN
AIM: To report a case of calcifying odontogenic cyst (COC) that was suggestive of apical periodontitis adjacent to the roots of the maxillary incisor teeth. SUMMARY: Tooth 21 presented with clinical and radiographic signs of secondary infection, a post within the root canal and substantial internal tooth destruction; it was scheduled for endodontic surgery. Teeth 12 and 22 were root filled following the placement of a calcium hydroxide intracanal dressing for 21 days. Three attempts at root canal disinfection in tooth 11 were unsuccessful, and a persistent purulent drainage precluded completion of root canal treatment. Surgical enucleation of the periapical lesion was undertaken and the tissues submitted for histopathological examination. A diagnosis of COC was established based on the microscopic analysis. COC is an unusual benign lesion that represents 2% of all odontogenic lesions. Depending on the stage of development, it can mimic a large lesion associated with apical periodontitis and should therefore be considered in the differential diagnosis. In the case of COC, the definitive diagnosis can only be made with histopathological analysis. KEY LEARNING POINTS: Persistent apical periodontitis may be of nonendodontic origin. * Histological examination is essential to establish the cause of persistent apical periodontitis. * Calcifying odontogenic cyst can mimic apical periodontitis.