Maxillary dentigerous cyst showing squamous odontogenic tumor-like proliferation: surgical approach and literature review

Squamous odontogenic tumor (SOT) is a rare benign neoplasm of the jaw that likely arises from remnants of the dental lamina. It is a slow-growing lesion, with a radiolucent appearance in the central variant. Microscopically, SOT shows islands of squamous epithelium supported by fibrous stroma. In rare cases, squamous odontogenic tumor-like proliferation (SOT-LP) can be observed arising from odontogenic cysts (SOT-LPOC). Herein, we describe the case of a 42-year-old man who presented with discreet bleeding in the maxillary gingiva. Imaging revealed a well-defined, ovoid-shaped lesion with sclerotic margins involving tooth #18 in the intraosseous location. Fine needle aspiration supported the cystic nature of the lesion. After surgery, microscopy revealed a dentigerous cyst showing SOT-LP features. There was no recurrence after a 3-year follow-up. To the best of our knowledge, this is the first report of a dentigerous cyst showing SOT-LP features in the maxilla. Such cysts should be identified to avoid misdiagnosis, with the finding having therapeutic and prognostic implications.

Expresión del ki-67, p53, p16 y bcl-2 en Ameloblastomas / Expression of ki-67, p53, p16 and bcl-2 in Ameloblastomas

El objetivo de la presente investigación fue determinar la expresión de Ki-67, p53, p 16 y bcl-2 en Ameloblastoma Sólido y Uniquístico. El presente estudio fue retrospectivo de tipo clínico-patológico, experimental y correlacional. Se realizó análisis clínico-patológico de las variables: género, grupos de edad, diagnóstico histopatológico y localización anatómica y análisis inmunohistoquímico siguiendo protocolo estandarizado utilizando los marcadores Ki-67, p16, p53 y bcl-2 en el Laboratorio de Histopatología Bucal "Dr. Pedro Tinoco" de la Facultad de Odontología de la Universidad Central de Venezuela durante el período 2008-2013. De las biopsias bucomaxilofaciales se tomaron como muestra 34 casos diagnosticados histopatológicamente como Ameloblastoma Uniquístico (16 casos), Ameloblastoma Sólido (9 casos), y 9 casos como control con el diagnóstico de Tumor Odontogénico Queratoquístico. Se realizó análisis estadístico para correlación de variables a través de la prueba Kruskall-Wallis empleando Software estadístico SPSS®Versión N° 20 para sistema MAC OSX con un nivel de significancia del 99% (p<0,01). Se observó predominio del género masculino entre la segunda y tercera década de vida. Localización anatómica más frecuente en sector posterior mandibular, diagnóstico histopatológico más frecuente ameloblastoma uniquístico. El análisis inmunohistoquímico reveló al marcador Ki-67 como la más expresada, seguida por p53, bcl-2 y p16 indicando transformación neoplásica y proliferación asociado a tasa de recidiva Los marcadores utilizados son de utilidad para evaluar comportamiento biológico para sugerir tratamiento quirúrgico adecuado en cada caso.

The objective of this research was to determine the expression of Ki-67, p53, p16 and bcl-2 Solid and unicystic Ameloblastoma.This study was retrospective clinicopathological, experimental and correlational. Clinico-pathological analysis of the variables were: gender, age, anatomical site and histopathological diagnosis and immunohistochemical analysis using standardized protocol following the Ki-67, p16, p53 and bcl-2 markers in the Laboratory of Oral Histopathology "Dr. Pedro Tinoco "of the Faculty of Dentistry, Central University ofVenezuela during the period 2008-2013.The maxillofacial biopsies were sampled 34 cases diagnosed histopathologically as Ameloblastoma unicystic (16 cases), Ameloblastoma Solid (9 cases), and 9 cases as control diagnosis Odontogenic Tumor Queratoquístico statistical analysis for correlation of variables was performed through the Kruskal-Wallis test using SPSS statistical software version No. 20 MAC OSX system with a significance level of 99% (p <0.01).often males between the second and third decade of life was observed. Most frequent anatomical location in mandibular posterior, more frequent histopathological diagnosis unicystic ameloblastoma. Immunohistochemical analysis revealed the marcador Ki-67 as the expressed, followed by p53, bcl-2 and p16 indicating neoplastic transformation and proliferation associated with recurrence rate markers used are useful for assessing biological behavior to suggest appropriate surgical treatment in each case.

Prevalencia de ameloblastoma en una población peruana durante 13 años de evaluación / Prevalence of ameloblastoma in a peruvian population in 13 years of evaluation

Determinar la prevalencia de ameloblastoma en el Servicio de Cirugía de Cabeza y Cuello del Hospital Nacional Dos de Mayo, durante el periodo enero 1998 û julio 2012. Materiales y métodos. El diseño de investigación fue observacional, descriptivo, de tipo retrospectivo y transversal. La información fue recolectada de historias clínicas de pacientes con diagnóstico de ameloblastoma que se realizaron todo el tratamiento dentro del Hospital (preoperatorio, cirugía, posoperatorio y evolución). Resultados. Se determinó que el mayor número de casos se presentó durante la tercera década de vida, el sexo masculino predominó con un 90%, el sector más afectado fue el posterior mandibular con un 70 %, la resección tumoral en bloque fue el tipo de procedimiento más utilizado con un 40%, ningún caso reportó recidivas. Se determinó que el signo principal fue el incremento de volumen y dolor con un 80 y 50% respectivamente, el tamaño promedio del tumor estuvo comprendido entre 6 û 10 cm de longitud,solo el 10% de los casos fueron de evolución desfavorable. Conclusiones. Se encontró que el ameloblastoma es un tumor poco frecuente, se presenta, en promedio, un caso por año y está presente con mayor frecuencia en pacientes varones de raza mestiza entre 21 û 30 años procedentes de la costa peruana, este tumor mide en promedio 6-10 cm de largo por 1-5 cm de alto, estando ubicado con mayor frecuencia en la zona posterior mandíbular, siendo su cuadro clínico es el aumento de volumen seguido de dolor y movilidad dentaria...

To determine the prevalence of ameloblastoma at the Surgery Service of Head and Neck of the Dos de Mayo National Hospital during the period of January 1988-july 2012. Materials and methods. The research design of this study was retrospective. The information was collected from medical records with a diagnosis of ameloblastoma that were made throughout the treatment in the Hospital (Pre- surgery, surgery, post- surgery and evolution). Results. We found that the largest number of cases occurred during the third decade of life ,the male sex had a predominance of 90%, the sector most affected was the mandibular posterior area with 70%, tumor resection still block the most common type of procedure corresponding to 40%, no case reported recurrence . It was determined that the main sign was the increase in volume and pain occurring in 80% and 50% of cases respectively, the averagetumor size could be determined between 6 to 10 cm long, only 10% of cases were still unfavorable. Conclusions. We found that the ameloblastoma is a rare pathology, occurring in an average of 1 case per year, being present more frequently in male patients of mixed race between 21 to 30 years old from the Peruvian coast, we found this pathology average length 6-10 cm long and 1-5 cm high, being more frequently located in the posterior mandible, and its predominant clinical volume increase followed by pain and tooth mobility...

Expresión de p53 y Ki-76 en ameloblastomas acantosos / Expression of P53 and KI-67 in ameloblastomas acanthomatous

El Ameloblastoma Acantomatoso es una variante histopatológica donde la parte central de las células Epiteliales Odontogénicas sufren una metaplasia escamosa. Este cambio biológico podría darle a esta forma de ameloblastoma características de mayor agresividad y recidiva. El objetivo del presente trabajo fue determinar la expresión de las proteínas p53 y Ki-67 en ameloblastomas acantomatosos. Metodología: 12 especímenes diagnosticados histopatológicamente como ameloblastoma acantomatoso fueron examinados y la expresión de p53 y Ki-67 determinada inmunohistoquímicamente usando los anticuerpos anti-humanos clones DO-7 y MIB-1 respectivamente (DAKO®). La expresión de ambas proteínas fue evaluada mediante microscopio de luz y la intensidad y número de núcleos positivos semicuantificados y analizados mediante estadística descriptiva. Resultados: La expresión de p53 fue observada en el 50% de los casos tanto en las células basales como centrales de las islas tumorales. La expresión de Ki-67 fue observada en el 66,7% de los casos, en su mayoría tanto en las células basales como tumorales y en su totalidad de fuerte intensidad. Conclusiones: La expresión de p53 y Ki-67 en los ameloblastomas acantomatosos sugiere una proliferación celular acelerada y por ende una mayor capacidad de crecimiento. Estas proteínas podrían conformar una herramienta para la selección de tratamientos más radicales en ameloblastomas que las expresen

Acanthomatous Ameloblastoma is a histopathological variant where the central portions of odontogenic epithelial cells undergo squamous metaplasia. This biological change could confer more aggressive features and recurrence to the tumour. The aim of this study was to determine the expression of p53 and Ki-67 in acanthomatous ameloblastoma. Methods: 12 specimens histologically diagnosed as acanthomatous ameloblastomas were examined and the expression of p53 and Ki-67 determined immunohistochemically using anti-human antibody clone DO-7 and MIB-1 respectively (DAKO ®). The expression of both proteins was assessed by light microscopy and the intensity and number of positive cells semi-quantified and analyzed using descriptive statistics. Results: The expression of p53 was observed in 50% of the cases both in the basal cells as tumor central islands. The Ki-67 expression was observed in intensely in 66.7% of cases, mainly on basal cell as central. Conclusions: The expression of p53 and Ki-67 in acanthomatous ameloblastomas suggests accelerated cell proliferation and therefore increased capacity for growth. Expression of these proteins may constitute a tool for prognosis and treatment selection

Tumor odontogênico queratocístico: atualidades / Keratocyst odontogenic tumor: an update

O tumor odontogênico queratocístico (TOQ) é uma neoplasia benigna dos ossos gnáticos, que apresenta agressividade local e alta taxa de recorrência. O TOQ é uma lesão intra-óssea, invasiva e destrutiva dos maxilares que apresenta crescimento lento e infiltrativo sendo, geralmente, uma lesão assintomática. A radiografia e a tomografia computadorizada auxiliam no diagnóstico, sendo necessária a biópsia e análise histopatológica para diagnóstico definitivo. Entre as técnicas de tratamento estão a ressecção, a enucleação, a curetagem, a descompressão e a marsupialização. É de suma importância que o cirurgião conheça a neoplasia e a recente classificação da Organização Mundial da Saúde para que, após o diagnóstico, os tratamentos sejam adequadamente escolhidos. Este estudo visou abordar atualidades acerca do TOQ por meio da revisão da literatura.

The keratocystic odontogenic tumor (KOT) is a benign neoplastic lesion of the jaws, disclosing a high local aggressiveness and a high recurrence rate. The KOT is an asymptomatic slow growing tumor of the jaws with an infiltrative, invasive and destructive intraosseous behavior. Radiography and computed tomography images aid the diagnosis but biopsy and histopathology must be carried out to point a definitive diagnosis. The treatment is a surgical procedure. The techniques are resection, enucleation, curettage, decompression and marsupialization. It is paramount that the surgeon knows the lesion features after the recent World Health Organization remarks to perform the best treatment after diagnosis. This study aimed to address updates about KOT through a literature review.

Comportamiento clínico-patológico de odontomas / Clinical and pathological behaviour of odontomas

Introducción: los odontomas son considerados los tumores odontogénicos más comunes, generalmente detectados en exámenes radiográficos. El objetivo de este trabajo fue describir el comportamiento clínico patológico de los odontomas tratados en nuestro servicio en un período de 15 años. Métodos: se realizó un estudio descriptivo, transversal, entre enero de 1996 a diciembre del 2010, a partir de exámenes clínicos, radiográficos y anatomo-patológicos de las historias clínicas de los pacientes intervenidos quirúrgicamente en el Servicio de Cirugía Maxilofacial del Hospital Ciro Redondo García, de Artemisa. En 46 pacientes se estudiaron las variables edad, sexo, tamaño, localización del odontoma y clasificación: compuestos o complejos. Resultados: el sexo masculino representó 56,5 por ciento y 43,5 por ciento el femenino, el grupo etario de 15-29 años en ambos sexos representó 41,3 por ciento, 60,9 por ciento de los pacientes eran asintomáticos, 67,4 por ciento de los odontomas estaban localizados en el maxilar, el tamaño de 0 a 3 cm en el maxilar y la mandíbula representó 47,8 por ciento, y el odontoma compuesto apareció en 69,5 por ciento de los pacientes. Conclusiones: predominaron el sexo masculino y las edades de 15 a 29 años, la mayoría de los pacientes eran asintomáticos, los odontomas son de un tamaño de 0 a 3 cm, los más abundantes y el odontoma compuesto fue el más frecuente tanto en el maxilar como en la mandíbula(AU)

Introduction: Odontomas are considered as the most common odontogenic tumors, which are generally detected in X-rays. This paper was aimed at describing the clinical and pathological behavior of odontomes treated in our service for 15 years. Methods: A cross-sectional descriptive study was conducted from January 1996 to December 2010, based on clinical, radiographic and anatomic and pathological exams found in the medical histories of patients who were operated on at the maxillofacial surgery department of Ciro Redondo Garcia hospital in Artemisa. The variables age, sex, size, location of odontoma and classification into complex or compound were analyzed in 46 patients. Results: Males and females accounted for 56.5 percent and 43.5 percent of the study group; the 15-29 y age group prevailed in 41.3 percent of patients; 60.9 percent were asymptomatic; 67.4 percent of detected odontomas were located in the maxillary, the 0 to 3cm size in the maxillary and the jaw accounted for 47.8 percent whereas compound odontoma occured in 69.5 percent of patients. Conclusions: Males and 15-29 y ages predominated; most of patients were asymptomatic; the most abundant odontomas are 0 to 3cm long and the compound odontoma was the most frequent in both the maxillary and the jaw(AU)

Estudo imuno-histoquímico da presença de miofibroblastos e da expressão do fator transformador de crescimento-beta1, interferon gama, mataloproteinase de matriz 13 e indutor de metaloproteinases de matriz em lesões odontogênicas epiteliais / Immunohistochemical study of the presence of myofibroblasts and the expression of transforming growth factor-beta1, interferon gamma, mataloproteinase matrix 13 and matrix metalloproteinase inducer in odontogenic epithelial lesions

Os miofibroblastos são células que apresentam um fenótipo híbrido exibindo características morfológicas de fibroblastos e de células musculares lisas, sendo a aquisição de tal fenótipo denominada diferenciação, passando então a expressar a a-SMA, a qual é importante na identificação dessas células. Estudos têm sugerido que os miofibrobíastos apresentam relação com a agressividade de diversas lesões e que o seu processo de diferenciação estaria relacionado à expressão do TGF-pl e do IFN-y atuando, respectivamente, no estímulo e na inibição dessa diferenciação. O objetivo deste trabalho foi investigar o papel dos miofibroblastos em lesões odontogênicas epiteliais, relacionando-os à agressividade das lesões e analisar por meio da imuno-histoquímica. a expressão do TGF-pl e IFN-y no processo de diferenciação, além da análise da MMP-13 que é ativada por miofibroblastos e do indutor de metaloproteinases de matriz (EMMPRIN) como precursor desta MMP. A amostra foi constituída por 20 ameloblastomas sólidos, 10 ameloblastomas unicfsticos, 20 ceratocistos odontogênicos e 20 tumores odontogênícos adenomatóides. Para a avaliação dos miofibroblastos, foram quantificadas as células imunorreativas ao anticorpo a-SMA presentes no tecido conjuntivo, próximo ao tecido epitelial. As expressões de TGF-pl, IFN-y, MMP-13 e EMMPRIN, foram avaliadas no componente epitelial e no conjuntivo, estabelecendo-se o percentual de imunorreatividade e atribuindo-se escores de 0 a 4. A análise dos miofibroblastos evidenciou maior concentração nos ameloblastomas sólidos (média de 30,55), seguido pelos ceratocistos odontogênicos (22,50), ameloblastomas unicísticos (20,80) e tumores odontogênicos adenomatóides (19,15) com valor de p= 0,001. Não foi encontrada correlação significativa entre TGF-pl e IFN-y no processo de diferenciação dos miofibroblastos, bem como na relação entre a quantidade de miofibroblastos e a expressão da MMP-13. Constatou-se, correlação estatística entre MMP-13 e TGF-pi (r= 0,087; p= 0,011) além de significante correlação entre MMP-13 e IFN-y (r=0,348; p=0,003). Entre EMMPRÍN e MMP-13 verificou-se significância (r= 0,474; p<0,001) assim como entre EMMPRIN e IFN-y (r=0,393; p=0,001). A maior quantidade de miofibroblastos evidenciada nos ameloblastomas sólidos, ceratocistos odontogênicos e ameloblastomas unicísticos sugere que estas células podem ser um dos fatores responsáveis para um comportamento biológico mais agressivo destas lesões, embora a população de miofibroblastos não tenha apresentado correlação com TGF- -pi, IFN-y ,MMP-13 e EMMPRIN. Quanto a correlação evidenciada entre MMP-13 e TGF-pl, isto pode sugerir um papel indutor do TGF-pl para a expressão da MMP-13, assim como os resultados deste estudo reforçam a relação bem estabelecida do EMMPRIN como indutor da MMP-13. Constatou-se também relação entre EMMPRIN e IFN-y assim como entre MMP-13 e IFN-y sugerindo, dessa forma, um sinergismo na ação anti-fibrótica desses marcadores.

Myofibroblasts are cells that exhibit a hybrid phenotype, sharing the morphoíogical characteristics of fibroblasts and smooth muscle cells, which is acquired during a process called differentiation. These cells then start to express a-SMA, a marker that can be used for their identification. Studies suggest that myofibroblasts are related to the aggressiveness of different tumors and that TGF-pl and IFN-y play a role in myofibroblast differentiation, stimulating or inhibiting this differentiation, respectively. The objective of this study was to investigate the role of myofibroblasts in epithelial odontogenic tumors, correlating the presence of these cells with the aggressiveness of the tumor. Immunohistochemistry was used to evaluate the expression of TGF-pl and IFN-y in myofibroblast differentiation, as well as the expression of MMP-13, which is activated by myofibroblasts, and of EMMPRIN (extracellular matrix metalloproteinase inducer) as a precursor of this MMP. The sample consisted of 20 solid ameloblastomas, 10 unicystic ameloblastomas, 20 odontogenic keratocysts, and 20 adenomatoid odontogenic tumors. For evaluation of myofibroblasts, anti-a-SMA-immunoreactive cells were quantified in connective tissue close to the epithelium. Immunoexpression of TGF-pl, IFN-y, MMP-13 and EMMPRIN was evaluaíed in the epithelial and connective tissue components, attributing scores of 0 to 4. The results showed a higher concentration of myofibroblasts in solid ameloblastomas (mean of 30.55), followed by odontogenic keratocysts (22.50), unicystic ameloblastomas (20.80), and adenomatoid odontogenic tumors (19.15) (p=0.00). No significant correlation between TGF-pl and IFN-y was observed during the process of myofibroblast differentiation. There was also no correlation between the quantity of myofibroblasts and MMP-13 expression. Significant correlations were found between MMP-13 and TGF-pi (r=0.087; p=0.01 1), between MMP-13 and ÍFN-y (r=0.348; p=0.003), as well as between EMMPRIN and MMP-13 (r=0.474; /xO.001) and between EMMPRIN and IFN-y (r=0.393; p=0.00). The higher quantity of myofibroblasts observed in solid ameloblastomas, odontogenic keratocysts and unicystic ameloblastomas suggests that these cells are one of the factors responsible for the more aggressive biological behavior of these tumors, although the myofibroblast population was not correlated with TGF-01, IFN-y, MMP-13 or EMMPRIN. The correlation between MMP-13 and TGF-pl suggests that the latter induces the expression of this metalloproteinase. The present results also support the well-established role of EMMPRIN as an inducer of MMP-13. Furthermore, the relationship between EMMPRIN and IFN-y and between MMP-13 and IFN-y suggests synergism in the antifibrotic effect of these markers.

Tumor odontogenico queratoquistico: tratamiento conservador con injerto autologo combinado con plasma rico en plaquetas / Queratoquistico odontogenic tumor: conservative treatment combined with autologous platelet rich plasma

Muchos autores consideran que el origen del tumor Odontogénico Queratoquístico, es la lámina dental, otros autores lo asocian al órgano del esmalte. Éste es el segundo tumor odontogénico más común, considerado el más agresivo y con el mayor porcentaje de recidiva. En la década de los años 90, algunos investigadores propusieron entre las alternativas de tratamiento del tumor, el utilizar como coadyuvante en la reparación y cicatrización ósea, el gel de plasma rico en plaquetas más injertos óseos; con el objetivo de promover una maduración más rápida y una cicatrización óptima de los defectos óseos producto del curetaje. Se reporta un caso clínico de un paciente de sexo femenino, 35 años de edad, el cual es remitido, por presentar lesión radiolúcida extensa en zona de mentón, que compromete órganos dentarios 35 y 45. Se realiza punción aspirativa, obteniendo un contenido seroso con trazos sanguinolentos, que en conjunto con la biopsia incisional confirman el diagnóstico de tumor odontogénico queratoquístico. Se decidió realizar enucleación y curetaje óseo amplio del lecho quirúrgico, colocación de injerto heterólogo y autólogo, este último, obtenido de rama ascendente mandibular, combinado con gel de plasma rico en plaquetas con fines de regeneración ósea, posteriormente controles clínicos y radiográficos durante un año.

Many authors believe that the origin of the keratocysts Odontogenic Tumor is the dental lamina, others authors associate it with the enamel organ. This is the second most common odontogenic tumor, considered the most aggressive, with the highest rate of recurrence. During the 90´s, some researchers suggested the alternative treatment of the Tumor, using as an adjunct in the repair and bone healing, the gel of plasma rich in platelets plus bone grafts, to promote a more rapid maturation and an optimal healing of bone defects of the product curettage. It is reported a case of a female patient, 35 years old, which is transmitted by introducing large radiolucent lesion in the chin area, involving from tooth 35 to 45 in extension. Puncture aspiration is performed, obtaining a substance with serous bloody strokes, which together with the incisional biopsy confirmed the diagnosis of Tumor Odontogenic Keratocysts. It was decided to perform enucleation and bone curettage comprehensive surgical placement of autologous and heterologous graft, this latter obtained from the mandibular ramus, gel combined with platelet-rich plasma for bone regeneration, clinical and radiographic controls after one year.

Tumor odontogénico de células escamosas asociado a un quiste residual / Squamous cell odontogenic tumor associated to a residual cyst

El tumor odontogénico de células escamosas (TOCE) es una neoplasia sumamente infrecuente, derivada de restos de la lámina dental o restos de Malassez. Esta lesión denota una expresividad variable. Se presenta el caso de una mujer de 72 años con un aumento de volumen asintomático en el lado izquierdo del maxilar inferior con diagnóstico presuntivo de quiste residual y diagnóstico histopatológico de TOCE. Se discute y actualiza su presentación clínica, radiográfica y su tratamiento y se actualiza la información sobre la patología.

Adenomatoid odontogenic tumor expanding the maxilla and shifting the dental midline: a case report

Adenomatoid odontogenic tumor [AOT] is a benign, non-invasive lesion with slow but progressive growth. Three variants of AOT were reported in the literature: follicular, extrafollicular, and peripheral. This report illustrates a unusual ease of AOT causing shifting of the dental midline. Orthopantomogram and CT Scan radiographs revealed a well circumscribed unilocular radiolucency located in the area of the left maxillary lateral incisor, canine and first premolar. The radiolucency was not associated with an impacted tooth or any calcification. Biopsy was performed and microscopic examination revealed the presence of an AOT. The patient has been followed-up for one year without recurrence

Recurrent ameloblastoma after 33 years of hemimandibulectomy: case report

Ameloblastomas are benign odontogenic tumors that exhibit a local malign behavior. Case report: A recurrence of an ameloblastoma occurring after 33 years of emimandibulectomy in a 69-year-old woman is reported. The tumor arose as a painless mass. Clinical exam showed a lesion placed in the right third molar region. The right mandible was absent from the bicuspid area to the condyle in radiography and computed tomography. After excision, microscopic features diagnosed an ameloblastoma. The patient is under close follow-up and shows no recurrence or metastasis. Conclusion: Despite the radical initial treatment, the tumor showed an uncommon behavior and recurred.

A clinical case of peripheral ameloblastoma

The peripheral ameloblastoma (PA) is a rare, benign, extraosseous odontogenic soft tissue tumour that is confined to the gingiva or alveolar mucosa. The PA presents the same histological characteristics of intraosseous ameloblastoma, although it is less aggressive than this classical subtype. We report a clinical case of PA of the alveolar mucosa in the right posterior maxilla, highlighting the importance of histological examination to the diagnosis.

Squamous odontogenic tumor: a case report and review of literatures

A squamous odontogenic tumor (SOT) is an epithelial originated benign tumor. It has been rarely reported and most was intramural type. We observed a case of SOT in the mandible. It was associated with the odontogenic cyst. It was shown positive to pancytokeratin and p53. Considering that the case was free from recurrence for 5 years after surgery, p53 positive did not seem to be related to the prognosis of the disease.

Tumor marrom do hiperparatireoidismo dos maxilares / Hyperparathyroidism brown tumor of the jaws

O tumor marrom do hiperparatiroidismo é uma doença óssea metabólica podendo acometer todo o esqueleto, inclusive os ossos maxilares. O objetivo deste trabalho é de ressaltar a importância desta doença no diagnóstico diferencial das lesões do complexo máxilo-mandibular e realizar uma revisão da literatura quanto à sua etiologia, características clínicas e radiográficas e tratamento.

Tumor odontogênico adenomatóide: relato de caso clínico / Adenomatoid odontogenic tumor: report of case

O tumor odontogênico adenomatóide é uma lesão benigna, não invasiva, de crescimento lento, porém progressivo. Apresenta predileção pela região anterior de maxila e por mulheres jovens. Geralmente apresenta - se assintomático e não excede 3 cm em seu maior diâmetro. Normalmente está associado com um canino incluso sendo que molares e incisivos laterais não erupcionados raramente são envolvidos. Propusemos relatar um caso de tumor odontogênico adenomatóide associado a um incisivo lateral em uma adolescente de 14 anos assim como revisar os aspectos clínicos, radiográficos, biológicos e tratamento do tumor odontogênico adenomatóide

Simultaneous occurrence of an odontogenic keratocyst and squamous odontogenic tumor in the mandible : a case report and immunohistochemical study

A squamous odontogenic tumor (SOT) is rare disease and it is believed to originate from epithelial rests of Malassez of the periodontal membrane. Neither sex nor site predilection in either jaw has been established. Some lesion can be shown in juxtaposition in tooth roots. Although most lesions remain smaller than 2 cm, our cases involved a half of left mandibular ramus. The exact pathogenesis is still unknown. We report a case of SOT including the results of immunohistochemical study of pancytokeratin and p53.

Tratamento cirúrgico de mixoma odontogênico com enxerto ósseo autógeno: relato de dois casos / Surgical treatment of odontogenic myxoma with autogenous graft: report of two cases

Tumor odontogênico de origem mesodérmica, com comportamento benigno, embora localmente invasivo e recidivante, o mixoma odontogênico acomete com maior freqüência a mandíbula de adolescentes, com leve predominância no sexo feminino. Clinicamente se manifesta como uma expansão óssea lenta e indolor; radiograficamente observa-se uma imagem radiolúcida de contorno indefinido multi ou unilocular, comumente associada a um dente incluso. O tratamento é cirúrgico e a recidivafreqüente. Acompanhamento pós-operatório de longo prazo é necessário e, no caso de recidiva, nova intervenção cirúrgica, mais radical, deve ser executada. Foram relatados dois casos de mixomas em que foram necessárias novas intervenções cirúrgicas para tratamento de recidivas e a utilização de enxerto ósseo autógeno na reconstrução das áreas lesadas.