RESUMO
Objetivo: Presentar un caso clínico de un tumor odon- togénico epitelial calcificante (TOEC), así como una revisión de la literatura disponible sobre esta neoplasia para contribuir al análisis del mejor método de tratamiento de la patología. Caso clínico: Se presenta el caso de una paciente mujer de 35 años con un tumor odontogénico epitelial calcifican- te que recibió tratamiento de enucleación quirúrgica con una evolución favorable y seguimiento de 5 años por medio de evaluación clínica y radiológica. La elección terapéutica se basó en el resultado de un análisis exhaustivo de la literatura para determinar el mejor abordaje de la neoplasia (AU)
Aim: To present a clinical case of a calcifying epithelial odontogenic tumor (CEOT), as well as a review of the availa- ble literature on this neoplasia to contribute to the analysis of the best treatment method for the pathology. Clinical case: The case of a 35-year-old patient with a calcifying epithelial odontogenic tumor who received surgical enucleation treatment with a favorable evolution and 5-year follow-up through clinical and radiological evaluation is pre- sented. The therapeutic choice was based on the result of an exhaustive analysis of the literature to determine the best ap- proach to the neoplasia (AU))
Assuntos
Humanos , Feminino , Adulto , Neoplasias Mandibulares/cirurgia , Tumores Odontogênicos/classificação , Procedimentos Cirúrgicos Bucais/métodos , Biópsia/métodos , Tumores Odontogênicos/diagnóstico por imagem , SeguimentosRESUMO
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.
RESUMO
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.
Assuntos
Humanos , Feminino , Adulto , Dente Supranumerário/complicações , Neoplasias Maxilares/etiologia , Cisto Odontogênico Calcificante/etiologia , Dente Supranumerário/diagnóstico por imagem , Neoplasias Maxilares/patologia , Cisto Odontogênico Calcificante/patologiaRESUMO
A clear cell variant of calcifying epithelial odontogenic tumor is a rare benign odontogenic neoplasm, accounting for 33 cases described in the literature. In this article, we report a challenging example of clear cell variant of calcifying epithelial odontogenic tumor of the posterior maxilla in a 45-year-old female patient showing locally aggressive growth and recurrence. Microscopically, islands of polyhedral cells containing abundant cytoplasm, well-developed intercellular bridges blended with clear cells were observed. The nuclei were frequently pleomorphic and permeated by hyaline calcified material. Immunohistochemistry revealed positivity for pan-cytokeratin (AE1/AE3), cytokeratins (CK-14 and CK-19), Bcl-2, p53, and p63. The Ki-67 proliferative index was ~10%. As odontogenic tumors are rare, when a significant clear cell component is observed, the differential diagnosis with other lesions of the jaws with similar morphology, including other odontogenic tumors with prominent clear cell component, clear cell odontogenic carcinomas, and metastatic tumors, is difficult.
Assuntos
Neoplasias Maxilares/patologia , Tumores Odontogênicos/patologia , Neoplasias Cutâneas/patologia , Feminino , Humanos , Neoplasias Maxilares/diagnóstico , Pessoa de Meia-Idade , Tumores Odontogênicos/diagnóstico , Neoplasias Cutâneas/diagnósticoRESUMO
Calcifying epithelial odontogenic tumor (CEOT), or Pindborg tumor, is infrequent and accounts for less than 1% of all odontogenic tumors. It is benign and usually asymptomatic but displays locally infiltrative and expansile behavior. Synchronous lesions affecting the jaws are exceedingly rare. We present a case of synchronous CEOTs affecting the maxilla and mandible and describe the clinical, radiographic, histologic, and immunohistochemical features. We further review five cases previously described in the literature.
Assuntos
Neoplasias Mandibulares/patologia , Neoplasias Maxilares/patologia , Neoplasias Primárias Múltiplas/patologia , Tumores Odontogênicos/patologia , Neoplasias Cutâneas/patologia , Adulto , Feminino , HumanosRESUMO
RESUMEN: El Tumor Odontogénico Epitelial Calcificante (TOEC), también denominado Tumor de Pindborg, se define como una neoplasia benigna, caracterizada por la proliferación epitelial; presenta secreción de una proteína tipo amiloide con tendencia a la calcificación. Representa menos del 1% de los tumores odontogénicos. Reportamos un caso en paciente de 75 años con un TOEC en la región maxilar izquierda en relación a una pieza dentaria incluida. El caso no mostró sintomatología específica, sólo una expansión de corticales vestibular y palatina. El diagnóstico se confirmó histológicamente mediante biopsia incisional y extirpación quirúrgica de la lesión, mostrando una histomorfología clásica para este tipo de lesiones. Reportamos este caso para resaltar la edad de presentación inusual, especialmente su localización e ilustrar su abordaje terapéutico y seguimiento.
ABSTRACT: The Calcifying Epithelial Odontogenic Tumor (CEOT), also called Pindborg Tumor, is defined as a benign neoplasm, characterized by epithelial proliferation; secretion of an amyloid-like protein is present with a tendency to calcification. It represents less than 1% of odontogenic tumors. We report a case of a 75-year-old patient with a TOEC in the left maxillary region in relation to an included tooth. The case did not show specific symptomatology, only an expansion of vestibular and palatal corticals. The diagnosis was confirmed histologically by incisional biopsy and surgical removal of the lesion, showing a classic histomorphology for this type of lesions. We report this case to highlight the unusual age of presentation, especially its location and to illustrate its therapeutic approach and follow-up.
Assuntos
Humanos , Masculino , Idoso , Tumores Odontogênicos , Maxila , NeoplasiasRESUMO
INTRODUCTION: The calcifying epithelial odontogenic tumor (CEOT), also known as Pindborg tumor, is a locally invasive benign neoplasm. Histogenesis is controversial. PRESENTATION OF CASE: A 26-year-old male presented asymptomatic swelling on the right side of the face, with approximately six months of evolution. At intraoral examination, a hard nodule localized in the right posterior region of the maxilla, measuring approximately 5.0 x 3.0 cm was observed. The computed tomography images showed hypodense lesion with points of calcification associated with two non-erupted teeth. We suspect of odontogenic lesions. The final diagnosis of CEOT was established based on the histopathological aspects. DISCUSSION: This tumor is more frequent in adult men, usually develops in the posterior region of the mandible and may present clinical-pathological similarities with others odontogenic lesions. The radiological aspects observed in the CEOT are variable and depend on the time of evolution of the tumor. The histopathological examination is mandatory to establish the final diagnosis. CONCLUSION: Our case was treated with simple enucleation without signs of recurrence in five years of follow-up. Further studies are needed to understand the aetiology and the biological behaviour of this tumor.
RESUMO
OBJECTIVES: To analyse the occurrence of calcifying epithelial odontogenic tumours (CEOT) based on biopsy records from different Brazilian geographic regions and to contrast the data with a review of the literature. MATERIALS AND METHODS: A 2-step study was conducted. Step 1 consisted of a collaborative study of biopsies obtained from 1953 to 2017 at six Brazilian oral and maxillofacial pathology centres. Evaluation of 86,268 biopsy records was performed. Demographic and histopathological diagnosis data were assessed. In Step 2, a review of the literature of case reports and cases series of CEOT identified across five electronic databases was conducted. RESULTS: In the collaborative study, 32 cases of CEOT were evaluated. This figure represented 0.03% of the oral and maxillofacial lesions and 1.7% of all odontogenic tumours across the centres. Women in the fourth decade of life were more affected. CEOT occurred more in the mandible than in the maxilla (ratio 1.9:1). The review of the literature showed that Asian individuals were more affected by this neoplasm. CONCLUSIONS: Useful knowledge on the epidemiology, treatment and follow-up of CEOT has been provided. Demographic data and clinical features of the cases presented in this collaborative study were quite similar to those of studies reported worldwide.
Assuntos
Tumores Odontogênicos/diagnóstico , Neoplasias Cutâneas/diagnóstico , Brasil , Feminino , Humanos , Masculino , Mandíbula/patologia , Maxila/patologiaRESUMO
El tumor odontogénico epitelial calcificante o tumor de Pindborg es una neoplasia odontogénica benigna y poco frecuente que afecta predominantemente la mandíbula. El objetivo de este trabajo fue reportar y discutir un caso clínico de una mujer de 65 años de edad que presentaba un tumor de Pindborg en la zona de sínfisis mentoniana. El diagnóstico presuntivo se realizó según los hallazgos clínicos y radiográficos. Se efectuó una biopsia incisional que confirmó el diagnóstico. El tratamiento se basó en la resección completa de la masa tumoral con legrado óseo quirúrgico periférico. Para la prevención de la fractura patológica, se colocó una placa de reconstrucción y relleno óseo en la lodge posquirúrgica. A pesar del porcentaje de recidiva en casos reportados en la literatura, el tratamiento fue conservador y el control a distancia después de 6 años fue favorable (AU)
The calcifying epithelial odontogenic tumor (CEOT) or Pindborg tumor, is a rare benign but locally aggressive odontogenic neoplasm that affects the jaw. We report and discuss a case of a 65-year-old woman who presented a Pindborg tumor located in the mandibular symphysis region. The presumptive diagnosis was carried out by means of clinical and radiologic findings. The diagnosis was confirmed by the histological examination. Then, a resection of the entire mass was done, with osseous curettage. Reconstruction was achieved using a reconstruction plate system and bone void filler. Because of the risk of recurrence, the patient was followed closely. At the last follow-up examination 6 years after treatment the panoramic radiograph demonstrated that the cavity was almost completely ossified without any sign of CEOT recurrence (AU)
Assuntos
Humanos , Feminino , Idoso , Neoplasias Mandibulares , Tumores Odontogênicos , Procedimentos Cirúrgicos Bucais , Argentina , Biópsia , Seguimentos , Unidade Hospitalar de Odontologia , Diagnóstico DiferencialRESUMO
El tumor odontogénico epitelial calcificante es una neoplasia odontogénica benigna extremadamente rara. Representa aproximadamente el 1 por ciento de todos los tumores odontogénicos. Es localmente agresivo y presenta un 14 por ciento de recidiva. A pesar de ser una lesión benigna, se han publicado casos de malignización. En el siguiente artículo se presenta un caso clínico y se realiza una revisión bibliográfica, presentándose las características clínicas, radiológicas e histológicas de esta patología.(AU)
Assuntos
Humanos , Adulto , Feminino , Tumores Odontogênicos/classificação , Tumores Odontogênicos/patologia , Tumores Odontogênicos/diagnóstico por imagem , Neoplasias Maxilomandibulares/classificação , Procedimentos Cirúrgicos Bucais/métodos , Radiografia Panorâmica , Recidiva , Diagnóstico por Imagem/métodos , Técnicas Histológicas , Biópsia/métodosRESUMO
El tumor odontogénico epitelial calcificante es una neoplasia odontogénica benigna extremadamente rara. Representa aproximadamente el 1 por ciento de todos los tumores odontogénicos. Es localmente agresivo y presenta un 14 por ciento de recidiva. A pesar de ser una lesión benigna, se han publicado casos de malignización. En el siguiente artículo se presenta un caso clínico y se realiza una revisión bibliográfica, presentándose las características clínicas, radiológicas e histológicas de esta patología.
Assuntos
Humanos , Adulto , Feminino , Neoplasias Maxilomandibulares/classificação , Tumores Odontogênicos/classificação , Tumores Odontogênicos/patologia , Tumores Odontogênicos , Biópsia/métodos , Diagnóstico por Imagem/métodos , Técnicas Histológicas , Procedimentos Cirúrgicos Bucais/métodos , Radiografia Panorâmica , RecidivaRESUMO
El tumor de Pindborg es una neoplasia benigna, rara, con carácter invasivo local y tendencia a la recidiva, que representa entre el 0,17 y el 1,8 por ciento de todos los tumores odontogénicos, del cual tan solo se han publicado unos 200 casos, con una media de 4 casos nuevos por año en el mundo. Se presentó el caso de un hombre de 39 años de edad que acudió a la consulta de cirugía maxilofacial remitido de neurocirugía postraumatismo craneofacial, por presentar un aumento de volumen en el ángulo mandibular derecho. Se tuvo como objetivo publicar la existencia de esta infrecuente neoplasia por lo interesantes que resultan estos tumores por su evolución, dificultad en el diagnóstico, variantes de tratamiento y tendencia a la recidiva. Después de realizar exámenes de laboratorio, radiografías, tomografía axial computarizada y biopsia de fragmento óseo, se obtuvo extensión y diagnóstico de tumor de Pindborg en hemimandíbula derecha. Se realizó la técnica quirúrgica de hemimandibulectomía derecha y reconstrucción con injerto óseo de cresta ilíaca. La evolución del paciente fue satisfactoria(AU)
The Pindborg's tumor is a benign and uncommon neoplasm with a local invasive character and a trend to relapse accounting for the 0.17 and the 1.8 percent of all odontogenic tumors with only 200 cases published in the literature and a mean of four cases per year at world scale. This is the case of a man aged 39 came our consultation of Maxillofacial Surgery referred from Neurosurgery Service after a craniofacial trauma and an increase of volume in right mandibular angle with the aim to publish the existence of this uncommon neoplasm due to the interesting of this type of tumor by its evolution, difficulty for diagnosis, variants of treatment and trend to relapse. After carry out laboratory examinations, X-rays, axial tomography computerize and biopsy of bone fragment, it was possible the extension and diagnosis of Pindbog's tumor in right hemi-mandible. The right hemimandibulectomy is performed as surgical technique and the reconstruction using bone graft of iliac crest. Evolution of patient is satisfactory(AU)