Prevalencia de carcinoma intraóseo primario derivado de quiste dentígero / Prevalence of primary intraosseous carcinoma derived from a dentigerous cyst

RESUMEN Introducción: La malignización de quiste dentígero a carcinoma intraóseo primario es infrecuente, poco documentada en la literatura. Corresponde del el 1 por ciento al 2,5 por ciento del total de tumores odontogénicos y es exclusiva de los huesos maxilares. Más común en hombres sobre 50 años de edad. Las características clínicas se asocian a edema, movilidad de piezas dentarias, parestesia, y la mayoría ocurre en ausencia de dolor, características que hacen difícil su diagnóstico y presentan un desafío para los patólogos. Objetivo: Revisar la prevalencia de carcinoma intraóseo primario derivados de quiste dentígero en los últimos 15 años publicados en PubMed Métodos: Se realizó una revisión de la literatura en un periodo que considera los últimos 15 años. Se consultó la base de datos PubMed utilizando los términos: "dentigerous cyst prevalence", "primary intraosseous squamous cell carcinoma", "dentigerous primary intraosseous squamous cell carcinoma". Se incluyeron artículos en inglés y español. De los 217 artículos, se suscribió a 39 para hacer el cruce de datos. Análisis e integración de los resultados: Para reconocer una enfermedad tan agresiva como el carcinoma intraóseo primario derivado de quiste dentígero hay que estudiar sus características clínicas, radiográficas y sintomatología. Su íntima relación con el quiste dentígero, el cual es el más prevalente de los quistes del desarrollo hace fundamental el profundo conocimiento de ambos. El carcinoma intraóseo primario se presenta como un desafío para los clínicos por su baja sintomatología y pobre sobrevida, con un total de 44 823 quistes odontogénicos estudiados, 9806 se diagnosticaron como quistes dentígeros, y 22 se malignizaron a carcinoma intraóseo primario, para un 0,32 por ciento del total. Conclusiones: La malignización de quiste dentígero a carcinoma intraóseo primario tiene una baja incidencia, pero se presenta silente haciendo difícil su diagnóstico precoz. Se recomienda biopsia de protocolo para cada caso de quiste dentígero y así evitar la baja sobrevida que produce el carcinoma intraóseo primario(AU)

ABSTRACT Introduction: Malignancy of dentigerous cyst into primary intraosseous carcinoma is infrequent and scantily documented in the literature. It represents 1 percent to 2.5 percent of the total odontogenic tumors and is exclusive of maxillary bones. It is more common among men aged around 50 years. Its clinical characteristics are edema, tooth mobility and paresthesia, and in most cases an absence of pain. These features hamper its diagnosis and pose a challenge to pathologists. Objective: Review the prevalence of primary intraosseous carcinoma derived from dentigerous cysts as published in PubMed in the last 15 years. Methods: A literature review was conducted of papers published in the last 15 years. The database PubMed was consulted using the following search terms: "dentigerous cyst prevalence", "primary intraosseous squamous cell carcinoma", "dentigerous primary intraosseous squamous cell carcinoma". The papers included were in English or Spanish. Of the 217 papers obtained, 39 were selected for data crossing. Data analysis and integration: Recognition of a condition as aggressive as primary intraosseous carcinoma derived from a dentigerous cyst requires examination of its clinical and radiographic characteristics as well as its symptoms. Its close relationship to dentigerous cyst, the most prevalent of developmental cysts, makes it necessary to gain an accurate and deep understanding of both. Primary intraosseous carcinoma poses a challenge to clinicians due to its low symptomatology and poor survival. Of the total 44 823 odontogenic cysts studied, 9 806 were diagnosed as dentigerous cysts and 22 maligned into primary intraosseous carcinoma, for 0.32 percent of the total. Conclusions: Malignation of a dentigerous cyst into primary intraosseous carcinoma has a low incidence and a silent presentation, which hampers its early diagnosis. Protocol biopsy is recommended for each case of dentigerous cyst to prevent the poor survival caused by primary intraosseous carcinoma(AU)

New WHO odontogenic tumor classification: impact on prevalence in a population

Abstract Objectives: This study approaches the history of reclassifications and redefinitions around the odontogenic keratocyst (OK), as proposed by the World Health Organization (WHO), and aims to understand the impact of those changes on the prevalence and epidemiology of odontogenic tumors (OTs). Methodology: Cases of OTs diagnosed in an Oral Pathology service between January 1996 and December 2016 were reviewed. Demographic data of patients such as age, gender and site of lesions were retrieved from their respective records. Results: Within the studied period, 7,805 microscopic reports were elaborated and 200 (2.56%) of these were diagnosed as OTs. Out of these 200, between 1996 and 2005, prior to the 2005 WHO classification, there were 41 (20.5%) OTs cases, being odontoma the most frequent (23; 56.09%), followed by ameloblastoma (8; 19.51%) and myxoma (03; 7.31%). Between 2006 and 2016, after the previous 2005 WHO classification there were 159 (79.5%) OTs, being odontogenic keratocystic tumor (KCOT) the most frequent (68; 42.76%), followed by odontoma (39; 24.52%) and ameloblastoma (21; 13.20%). Conclusions: As of today, the most recent WHO classification to be followed brings KCOT back to the cyst category, which will impact on the prevalence and epidemiology of OTs; thus, this study was able to identify a considerable increase (287.80%) in the prevalence of OTs when the 2005 WHO classification was utilized. Despite being an important academic exercise, classifying odontogenic lesions and determining whether to place the odontogenic keratocyst in a cyst or tumor category is crucial to establish the correct diagnosis and treatment to follow, whether by oral medicine or oral surgery specialist, or by the general practitioner.

A Thirteen-year Retrospective Analysis of 179 Odontogenic Tumours in a Nigerian Tertiary Healthcare Facility / Análisis retrospectivo de trece años de 179 tumores odontogénicos en un centro de salud terciaria nigeriana

ABSTRACT Background: Tumours of odontogenic origin (OTs) resulting from epithelial and mesenchymal elements that are part of the tooth-forming apparatus must be considered as a differential diagnosis when analysing jaw lesions. They may be cystic, myxomatous or sometimes have a mixture of cystic and solid areas. Objective: To analyse the OTs seen at the Maxillofacial Surgery Department, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria, between 2001 and 2013 based on the World Health Organization 's 2005 classification of OTs. Methods: A retrospective search and analysis was conducted of the medical records of all patients with a histopathologic diagnosis of orofacial tumours and tumour-like lesions seen at the Maxillofacial Surgery Department, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria, from 2001 to 2013. Results: Odontogenic tumours constituted 179 (15.3%) cases out of a total of 1170 orofacial tumours and tumour-like lesions seen within the study period. The 179 OTs were found in 101 (56.4%) males and 78 (43.6%) females, giving a male to female ratio of 1.3:1. The ages of the patients ranged from 12 to 88 years (mean, standard deviation: 33.31, 14.07 years). The lesions were predominantly benign (n = 176; 98.3%), with only three (1.7%) being malignant OTs. Conclusion: The distribution of OTs in this study compared well with that in previous reports from Nigeria.

RESUMEN Antecedentes: Los tumores de origen odontogénico (TO) como resultado de los elementos epiteliales y mesenquimales que son parte del aparato de formación de los dientes, se deben considerar como diagnosis diferencial a la hora de analizar lesiones maxilares. Pueden ser quísticos, mixomatosos, o constituidas a veces por una mezcla de áreas quísticas y sólidas. Objetivo: Analizar los TO vistos en el Departamento de Cirugía Maxilofacial del Hospital Docente Ahmadu Bello de Zaria, Nigeria, de 2001 a 2013, a partir de la clasificación de TO de la Organización Mundial de la Salud de 2005. Métodos: Se realizó una búsqueda y análisis retrospectivo de las historias clínicas de todos los pacientes con diagnóstico histopatológico de tumores orofaciales y lesiones tumorales observadas en el Departamento de Cirugía Maxilofacial del Hospital Docente Ahmadu Bello en Zaria, Nigeria, de 2001 a 2013. Resultados: Los tumores odontogénicos constituyeron 179 casos (15.3%) de un total de 1170 tumores orofaciales y lesiones tumorales vistas en el período de estudio. Los 179 TO fueron encontrados en 101 (56.4%) varones y 78 (43.6%) hembras, para un ratio varón-hembra de 1.3:1. Las edades de los pacientes variaron de 12 a 88 años (media, desviación estándar: 33.31, 14.07 años). Las lesiones fueron predominante benignas (n = 176; 98.3%), hallándose solamente tres TO malignos (1.7%). Conclusión: La distribución de TO en este estudio es comparable con la de los reportes anteriores en Nigeria.

Cáncer oromaxilofacial en niños: Parte II tumores odontogénicos y de glándulas salivales malignos / Maxillofacial cancer in children: Part II malignant odontogenic and salivary gland tumors

A nivel mundial, la información acerca de tumores malignos del territorio maxilofacial que afectan a niños es limitada. La mayoría de los resportes consiste principalmente en datos de la población adulta. Las neoplasias malignas originadas del aparato odontogénicos y glándulas salivales son lesiones que con cierta frecuencia pueden afectar a la población infantil. Los tumores odontogénicos malignos son entidades sumamente raras que, correspondiendo a menos del 5 % del total de tumores odontogénicos. Los sarcomas odontogénicos, si bien son poco frecuentes, corresponden a los tumores odontogénicos malignos más comunes en la infancia. Las neoplasias malignas de glándulas salivales corresponden al 35­60 % de los tumores de gándulas salivales en la infancia, siendo el más común de ellos el carcinoma mucoepidermoide. En general, el pronóstico de estas entidades es positivo sobre todo si es acompañado de un diagnóstico oportuno. A pesar de la baja frecuencia que presenta este grupo de patologías, no es menos cierto que es necesario saber con precisión cuales son los tejidos orales desde los cuales se pueden originar neoplasias malignas en los niños y tener una breve referencia diferencial entre ellos.

Globally, information about the maxillofacial malignant tumors affecting children is limited. Most reported data consists mainly of studies in the adult population. Malignant neoplasms arising from odontogenic apparatus and salivary glands are lesions that frequently can affect children. Malignant odontogenic tumors are extremely rare entities, corresponding to less than 5 % of all odontogenic tumors. Odontogenic sarcomas, although they are rare, correspond to the most common malignant odontogenic tumors in childhood. Malignant salivary gland neoplasms correspond to 35­60 % of tumors of salivary glands during childhood and the most common of these is mucoepidermoid carcinoma. In general, the prognosis of these entities is positive especially when there is a timely diagnosis. Despite the low frequency presented by this group of diseases, the fact remains that it is necessary to know precisely what the originating oral tissues are which can cause malignancies in children and have a brief reference differential between them.

Epithelial odontogenic tumors: analysis of 156 cases in a Brazilian population / Tumores odontogénicos epiteliales: análisis de 156 casos en una población brasileña

The objective of this study was to determine the distribution of epithelial odontogenic tumors diagnosed histologically in a period of 41 years in a Brazilian population according to age, gender, site affected and compare these data with previously reported studies from other countries. Data of epithelial odontogenic tumors diagnosed were collected from the files of the Oral Pathology Laboratory of Federal University of Rio Grande do Norte, Natal, RN, Brazil, and entered in a standardized form for later comparisons. Clini-cal features obtained from the patient records and microscope slides were reviewed according to the 1992 World Health Organization classification. A total 156 epithelial odontogenic tumor were reported. Of these, all of them were benign. Ameloblastoma was the most frequent type (85.9 %), followed by adenomatoid odontogenic tumor (10.9 %) and calcifying epithelial odontogenic tumor (3.2 %). The mean age of the patients was 38 years, with a wide range (11­80 years). The posterior region of mandible was the anatomic site most frequently affected by this disease, and no significant differences were found between sexes in the diagnosis of odontogenic tumors. A marked geographic variation in the relative incidences of various epithelial odontogenic tumors was found. It was particularly notable in ameloblastomas and adenomatoid odontogenic tumors, with the incidences observed in the present study being similar, sometimes different to earlier studies in others parts of the world.

El objetivo fue determinar la distribución de los tumores odontogénicos epiteliales diagnosticados histológicamente en un período de 41 años en una población brasileña según edad, sexo y la zona afectada y comparar estos datos con estudios anteriores de otros países. Los datos de los tumores odontogénicos epiteliales diagnosticados fueron obtenidos de los archivos del Laboratorio de Patología Oral de la Universidad Federal de Rio Grande do Norte, Natal, RN, Brasil, e introducidos en un formulario estandarizado para comparaciones futuras. Las características clínicas obtenidas a partir de los registros de los pacientes y los portaobjetos de microscopio fueron revisados de acuerdo a la clasificación de la Organización Mundial de la Salud 1992. Se informó de un total de 156 tumores epiteliales odontogénicas. De estos, todos eran benignos. Ameloblastoma fue el tipo más frecuente (85,9 %), seguido por el tumor odontogénico adenomatoide (10,9 %) y el tumor odontogénico epitelial calcificante (3,2 %). La edad media de los pacientes fue de 38 años, con un rango amplio (11­80 años). La región posterior de la mandíbula era el sitio anatómico más afectado por esta enfermedad, y no se encontraron diferencias significativas entre sexos en el diagnóstico de los tumores odontogénicos. Se encontró una marcada variación geográfica en las incidencias relativas de diversos tumores odontogénicos epiteliales. Fue particularmente notable en ameloblastomas y tumores odontogénicos adenomatoide, con las incidencias observadas en este estudio siendo a veces similares, y a veces diferentes de los estudios anteriores en otras partes del mundo.

The relevance of clinical and radiographic features of jaw lesions: A prospective study

Abstract The study was carried out in a Brazilian population and the aim was to describe the prevalence and the clinic-radiographical features of jaw lesions. In addition, a comparison between the main diagnosis hypothesis and final diagnosis was accessed. A prospective study which evaluated all patients with jaw lesions diagnosed in an Oral Diagnosis Center, between August 2013 and October 2014. A total of 450 patients were observed for the first time, and 130 had some type of jaw lesion. The mean age of the patients was 35.2 years ± 17.86. Among these, 71 were women (54.62%) and 87 were Caucasian (66.92%). The mandible was affected more frequently (71.43%) than the maxilla (28.57%). Swelling and pain were the most frequent clinical signs and symptoms and were observed in 60 (42.85%) and 38 (27.14%) cases, respectively. The panoramic x-ray was the main radiographic exam utilized (88.57%). Radiolucent lesions accounted for 89 cases (63.57%) and the unilocular form was present in 114 cases (81.43%). A total of 93 cases had histopathological analyses and the periapical cyst was the most frequent lesion. In the other 47 lesions, the diagnosis was conducted by clinical and radiographic management. Bone lesions were frequent, being noted on first visit in approximately 30% of patients; in 1/3 of the cases, the diagnoses were completed with a combination of clinical and radiographic exams.

Odontogenic Myxoma Involving the Maxilla: Case Report of a Rare Entity.

Odontogenic myxomas (OMs) are rare, benign, slow-growing tumors that may arise in the maxilla. They are known to have a female predilection and present as a painless mass commonly in the second or third decade of life, comprising 3-6% of all odontogenic tumors. They show a locally aggressive behavior, are radioresistant tumor and hence the need for early recognition and surgical resection. A high rate of recurrence has also been noted owing to its infiltrative pattern of growth and lack of capsule. Clinical and radiological aspects of maxillary OMs are not conclusive hence it is necessary to have a histopathological exam for the final diagnosis. We present a case of OM involving the maxilla in a 51-year-old female patient. The various histopathological differentials are also discussed.

Odontogenic tumors: a 14-year retrospective study in Santa Catarina, Brazil

Odontogenic tumors (OTs) are lesions that develop exclusively on maxillary bones, and form a heterogeneous group. They vary from hamartomatous lesions to benign and malign tumors. Although they are rarely observed in dentistry clinics, it is extremely important for the dentist to be aware of them. The aim of this study was to investigate the incidence of odontogenic tumors diagnosed in the population of Florianópolis, Santa Catarina, Brazil. Cases of odontogenic tumors were selected from the anatomopathological diagnostic services at Federal University of Santa Catarina from 1998 to 2011. Clinical data on these cases were collected from biopsy reports and patient files. Seventy-eight cases of odontogenic tumors were surveyed. Of these diagnoses, 51% were keratocystic odontogenic tumors (KCOTs); the remaining cases were mainly ameloblastomas and odontomas. The most frequently observed lesion in this retrospective study was KCOT (more than half of cases). Thus, this study shows that modifying the classification of the OTs altered the frequency of the lesions, possibly making KCOT the most common lesion observed in diagnostic services worldwide.

A review of 156 Odontogenic Tumours in Calabar; Nigeria

Background: Odontogenic tumours occur in our environment and because of late treatment; cause considerable disabilities. Objective: To review cases of odontogenic tumours in our centre in order to obtain a baseline data and subsequently compare the results with that obtained elsewhere. Patients and methods: Using hospital case files and register; we carried out a 15-year retrospective study of odontogenic tumours at the Dental and Maxillofacial Clinic; University of Calabar Teaching Hospital; Nigeria. The data documented include age; gender; duration of lesion; type of tumour; socio-economic class; type of surgery; and complaints during follow-up reviews. Results: Majority of the patients (n=49; 31.4) were in the third decade of life. There were 85 (54.5) males and 71 (45.5) females; giving male to female ratio of 1.2:1. There was a significant association between the type of odontogenic tumour and the age of occurrence (p=0.000). The longer the duration of symptoms before presentation; the larger the tumours (p=0.000). The benign odontogenic tumours were 151 (96.8); ameloblastoma (n=74; 47.4) being the commonest. Jaw resection (54.5) was the predominant treatment. Majority (58.0) of the complications following treatment were Facial deformity; malocclusion and impaired mastication. Conclusion: Majority of the patients was in the lower socio-economic class; presented late for treatment and a few with aesthetic and functional impairment returned for secondary surgery. The intervention of agencies of government and non-governmental organizations is required to assist these patients if we are to accomplish the core healthcare system values in our environment

Tumor odontogênico ceratocístico: levantamento de casos e revisão de literatura / Keratocystic odontogenic tumor: survey of cases and literature review

Introdução: O Tumor Odontogênico Ceratocístico (TOC) pode ser definido como um tumor intraósseo, benigno, de origem odontogênica. A incidência dessa lesão na mandibula é de 3 a 4 vezes maior que na maxila, com preferência pela região dos terceiros molares inferiores, no ângulo da madíbula, de onde se estende para o ramo ascentende. Em casos de lesões mais extensas, observa-se tumefação, drenagem ou dor associada, aumento de volume de tecidos moles e tecido ósseo, parestesia, mobilidade de dentes envolvidos pela lesão, bem como crescimento lento e deslocamento de peças dentárias. Objetivo e Metodologia: O objetivo deste trabalho foi realizar uma revisão da literatura e um levantamento de casos diagnosticados no Laboratóro de Patologia do Instituto de Ciências Biológicas da UPF a respeito do TOC. Resultados: No presente levantamento, foram encontrados 48 casos de TOC, com uma prevalencia do gênero feminino, na segunda e terceira década de vida. Um maior número de casos ocorreram na mandibula com preferencia pela região de terceiro molar inferior. Apresentavam em sua maioria lesões radiolúcidas uniloculares e o principal sinal clínico foi o de abaulamento. Conclusão: O que pode-se concluir através deste trabalho é que é fundamental para o sucesso do tratamento do Tumor Odontogênico Ceratocístico, o conhecimento por parte do Cirurgião Dentista de lesões tumorais de origem odontogênica , para que um correto e precoce diagnóstico seja executado, levando a melhor escolha do tratamento e, consequentemente um prognóstico favorável.

Introduction: The Keratocystic odontogenic tumor can be defined like an intraosseous tumor, benign, of odontogenic origin. The incidence of this lesion in the mandible and 3 to 4 times higher than in the maxilla, with a preference for the third molar region. In cases of more extensive lesions, there is swelling, drainage or pain associated, swelling of soft tissue and bone tissue, paresthesia, mobility of teeth involved by the injury, as well as slow growth and displacement of dental pieces. Objective and Methodology: The objective of this study was a literature review and a survey of cases diagnosed in the Pathology Lab of the Institute of Biological Sciences, UPF, about keratocystic odontogenic tumor. Result: In this survey, we found 48 cases of TOC, with a prevalence of females in second and third decade of life. A greater number of cases occurred in the jaw with a preference for the third molar region. Had mostly unilocular radiolucent lesions and was the main clinical sign of bulging. Conclusion: What can be concluded from this work is that it is essential for the successful treatment of odontogenic tumor keratocystic, knowledge by the Surgeon Dentist of odontogenic origin tumors, for a correct and early diagnosis is performed, taking the best choice of treatment and thus a favorable prognosis.

Quistes y tumores odontogénicos: revisión de 150 casos / Odontogenic cysts and tumors: a review of 150 cases

En el año 2005 la OMS realizó algunas modificaciones en la clasificación de quistes y tumores odontogénicos, por lo cual realizamos una revisión de los últimos 150 casos de quistes y tumores odontogénicos evaluados y operados en el Servicio de Odontología y Cirugía Bucomaxilofacial, cuyos diagnósticos histopatológicos fueron realizados en el Servidio de Anatomía Patológica de nuestro hospital, previo a mayo de 2005. Las muestras fueron nuevamente clasificadas, según las modificaciones impartidas por la OMS y se observaron las modificaciones estadísticas que de ello resultaron

Tumor odontogénico queratoquístico: presentación de un caso clínico y revisión de la bibliografía / Keratocystic odontogenic tumor: report of a clinical case and review of the literature

El tumor odontogénico queratoquístico (TOK) es una entidad patológica benigna de origen odontogénico con tendencia a la recidiva y controversial tratamiento. Cerca del 75 por ciento se presentan en zona de rama ascendente y cuerpo mandibular, mientras que en zona sinfisaria no alcanzan el 10 por ciento de los casos. Se presenta un caso clínico en zona sinfisaria con diagnóstico de TOQ. Se realiza el tratamiento y seguimiento a distancia, revisando las características clínicas y anatomopatológicas de la entidad.

Odontogenic keratocystic tumor: a clinical and histopathologic retrospective study based on the New WHO classification / Tumor odontogénico queratoquístico: estudio clínico e histopatológico retrospectivo basado en la nueva clasificación de la OMS

The aim was to review previous cases of Odontogenic Keratocyst or Keratocystic Odontogenic Tumor according to the new WHO classification. We used all cases diagnosed as Odontogenic Keratocyst or Keratocystic Odontogenic Tumor registered in the archives of the Pathologic Anatomy Laboratory of the Department of Pathology and Oral Diagnosis of the School of Dentistry of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil, which were collected from September, 1983 until September, 2008. The terms “Keratocyst” or “Keratocystic Odontogenic Tumor” were searched for and the following data were collected from the case files: age, sex, location of the lesion(s), and patients’ chief complaints. Hematoxilin and Eosin slides were reviewed according to the 2005 WHO criteria. The results found are in accordance with the literature. Due to its benign features, the Orthokeratinized Odontogenic Keratocyst found in our sample had its diagnosis changed to Orthokeratinized Odontogenic Cyst, as recommended by the WHO. Histopathologic exams are required for every bone lesion, in order to establish correct diagnosis. Because of its features, the Keratocystic Odontogenic Tumor must have more aggressive treatment, compared with odontogenic cysts, and long-term follow-up is mandatory.

El objetivo fue revisar los casos anteriores de queratoquiste odontogénico (QO) o tumor odontogénico queratoquístico (TOQ) de acuerdo con la nueva clasificación de la OMS. Fueron utilizados todos los casos diagnosticados como QO o TOQ registrados en los archivos del Laboratorio de Anatomía Patológica del Departamento de Patología y Diagnóstico Oral de la Facultad de Odontología de la Universidad Federal de Río de Janeiro, Rio de Janeiro, Brasil, registrados a partir de septiembre de 1983 hasta septiembre del 2008. Los términos "Queratoquiste" o "tumor queratoquistes odontogénicos" se buscaron y los siguientes datos se obtuvieron de los archivos del caso: edad, sexo, localización de la lesión (es), y quejas de los pacientes. Las muestras histológicas de hematoxilina y eosina fueron revisadas de acuerdo a los criterios de la OMS 2005. Los resultados encontrados estaban de acuerdo con la literatura. Debido a sus características benignas, el queratoquiste odontogénico ortoqueratinizado encontrado en nuestra muestra había cambiado su diagnóstico de quiste odontogénico ortoqueratinizado, según lo recomendado por la OMS. Los exámenes histopatológicos son necesarios para toda lesión ósea, con el fin de establecer el diagnóstico correcto. Debido a sus características, el TOQ debe tener un tratamiento más agresivo, en comparación con los quistes odontogénicos, donde un seguimiento a mediano y largo plazo es obligatorio.

Tumor de Pindborg relacionado con trauma facial / Pindborg's tumor in relationship with facial traumata

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)

Tumor odontógeno adenomatoide en región mandibular / Adenomatoid odontogenic tumor in mandibular region

El tumor odontogénico adenomatoide es un tumor poco frecuente derivado del epitelio odontontogénico, que contiene estructuras canaliculares con modificaciones inductivas de intensidad variable en el tejido conjuntivo. Es una lesión de crecimiento lento y poco invasiva pero que se puede asemejar a otras lesiones odontógenas de mayor agresividad como el quiste dentígero y el ameloblastoma entre otros. Su localización clásica (área de caninos superiores) nos orienta al diagnóstico y su patrón histológico ductiforme es muy propio de este tumor. Otros tumores que se encuentran dentro de este grupo son el fibroma ameloblástico, el odontoameloblastoma, el quiste odontógeno calcificante y los odontomas compuesto y complejo. Este grupo de lesiones puede o no tener formaciones de tejido duro dental dentro de ellos. Por esta razón, se presenta un paciente con este tipo de tumor, al que se le realizó estudio histopatológico, se revisó la literatura acerca de este tumor odontogénico benigno y sus características clínicas, radiográficas, tratamiento, así como los diagnósticos diferenciales que se deben tener en cuenta(AU)

The adenomatoid odontogenic tumor is an uncommon neoplasm derivative of the odontogenic epithelium containing canalicular structures with inductor modifications of variable intensity in the conjunctival tissue. It is a slow growth lesion and no much invasive but that may to be similar to other odontogenic lesions more aggressive including the dentigerous cyst and the ameloblastoma among others. Its classical location (upper canine area) guides us to diagnosis and its duct histological pattern is very typical of this tumor. Other tumors included in this group are the ameloblastic fibroma, the ameloblastic odontoma, the calcified odontogenic cyst and composed and complex odontomas. This group of lesions may or not to have formations of hard tissue inside. Thus, authors present the case of a patient presenting with this type of tumor making a histopathology study, a literature review on this benign odontogenic tumor and its clinical radiographic features, treatment, as well as the differential diagnoses to be into account(AU)

Ameloblastoma en población del noreste de Brasil: un estudio retrospectivo de 60 casos / Ameloblastoma present in a northeast Brazilian population: a retrospective study of 60 cases

El ameloblastoma es un tumor de epitelio odontogénico, caracterizado por la invasión local y aumento de la tasa de recidiva. Por esto se realizó este estudio descriptivo para determinar el comportamiento de los ameloblastomas en nuestro medio. Método: estudio retrospectivo de 17 años basado en los datos existentes de los archivos del Departamento Oral de Patología. Se analizaron los archivos de pacientes de enero de 1992 a mayo de 2009, con un diagnóstico definitivo de ameloblastoma. Fué recogida la información respecto al sexo, raza, presencia de síntomas, ubicación anatómica y extensión. Resultados: dentro de los 60 pacientes con ameloblastoma se observó, mayor incidencia en la tercera década de vida (28,3 por ciento). Las mujeres fueron más comprometidas que los hombres, con una proporción 1,22:1. La mayoría de lesiones fueron observadas en la raza blanca (51,7 por ciento). El sitio más habitual por la ocurrencia de tumor fue la mandíbula (85 por ciento). Los pacientes fueron sintomáticos en el 75 por ciento. La mayoría de pacientes presentaron lesiones de 3,5 a 6,0 centímetros de extensión (55 por ciento). Conclusiones: el ameloblastoma es mayormente observado en mujeres, en la tercera década de la vida y en la mandíbula. Las diferencias con otros estudios entre el sexo, la edad, raza, extensión, localización anatómica y los síntomas pueden ser atribuidos a las diferencias geográficas(AU)

The ameloblastoma is a tumor originated from odontogenic epithelium, characterized by local invasion and increased rates of recurrence. Methods: The 17-year retrospective study was based on existing data from the archives of Oral Pathology Department. Files of patients of January 1992-May 2009 with a definitive diagnostic of ameloblastoma were assessed. Information regarding gender, race, presence of symptoms, anatomic location and extent was documented. Results: Within the 60 patients with ameloblastoma observed, the age peak of tumor incidence was the third decade of life (28.3 percent). Females were more prominent than males, with a ratio 1.22:1. The majority of lesions were showed in Caucasians patients (51.7 percent). The most prevalent site for tumor occurrence was the mandible (85 percent). Symptomatic patients performed a total of 75 percent. The majority of patients had lesions from 3.5 to 6.0 cm of extension (55 percent). Conclusions: The ameloblastoma is more observed in females, in the third decade of life and in the mandible. The differences with other studies between gender, age, race, extent, anatomic location and symptoms can be attributed to geographic variations(AU)

[ clinicopathologic study of odontogenic cysts and tumors in an Iranian sample population]

Odontogenic cysts and tumors are lesions that are found exclusively in the mandible and maxilla. These lesions are one of the main causes of jaw destruction. But unfortunately only a few studies have been conducted in Iran on relative frequency of these lesions. The aim of this study was to determine the relative prevalence of odontogenic cysts and tumors in Kerman province along with age, sex and site of presentation over a 12-year period and to compare it with previous reports from different parts of the world. This research reviewed 1320 biopsies in a 10-years period. Data on factors such as age, sex and location of the lesions were extracted from pathology reports and analyzed by SPSS statistical software. Of 1320 specimens, 221 were diagnosed as odontogenic cysts and 25 biopsies were diagnosed as odontogenic tumors. Odontogenic cysts and tumors occurred most frequently in the first to second decades of life and most commonly in the mandible. Cysts were more common in men than women. Radicular cysts were the most common one [33.9%], followed by dentigerous cysts [21.7%] and odontogenic keratocyst [15.4%]. The most prevalent odontogenic tumor was ameloblastoma [41.4%], Our study provides demographic data on odontogenic cysts and tumors in Kerman province. Odontogenic cysts have a predilection for certain ages, sexes and sites. To determine the real relative frequency of odontogenic tumors, further studies should be conducted, especially in Iran, by experienced pathologists in the field of odontogenic tumors

Prevalência de cistos e tumores odontogênicos em pacientes atendidos na Fundação Assistencial da Paraíba: estudo retrospectivo / Prevalence of odontogenic cysts and tumors in patients treated at the Paraíba Health Assistance Foundation: a retrospective study

Avaliar a prevalência de cistos e tumores odontogênicos em pacientes atendidos na Fundação Assistencial da Paraíba (FAP). Foi realizado um estudo observacional, epidemiológico e retrospectivo, por meio da análise de 2.268 prontuários odontológicos de pacientes atendidos no período de janeiro de 1999 a dezembro de 2008. Os dados foram coletados por um único examinador e registrados em ficha específica, sendo analisadas as variáveis: gênero, faixa etária, tipo de lesão (cisto ou tumor) e localização (maxila ou mandíbula). A análise bivariada utilizou o teste do Qui-quadrado, sendo empregado um nível de significância de 5%. A prevalência de cistos e tumores foi de 1,9%, sendo verificada maior ocorrência no gênero feminino(62,8%) e na faixa etária de indivíduos acima de 51 anos (25,6%). A maxila foi a região mais atingida (60,5%). Não se observou diferença estatisticamente significante entre o gênero e o tipo de lesão (P=0,249) e entre a região envolvida e o tipo de lesão (p=0,190). Os cistos radiculares apicais foram os mais frequentes (51,7%), seguido dos cistos dentígeros (20,7%). Quanto à distribuição segundo o gênero, entre os homens houve predomínio do cisto dentígero, enquanto entre as mulheres a maior frequência foi de cisto radicular apical. Em relação aos tipos de tumores, os ameloblastomas (35,8%) e os odontomas (35,8%) foram os mais frequentes e as mulheres foram mais afetadas que os homens (78,6% versus 21,4%). Concluiu-se ser baixa a prevalência de cistos e tumores odontogênicos, sendo observada maior ocorrência no gênero feminino, em indivíduos acima de 51 anos e na região da maxila.

Estudo retrospectivo de tumores odontogênicos em dois centros de estudo no Brasil e três no México / Odontogenic tumours: a retrospective study in two center of diagnostic pathology

Os tumores odontogênicos compõem um grupo de lesões incomuns, porém interessantes, que se forma a partir dos tecidos que dão origem aos dentes. Esses tumores vêm sendo estudados há décadas por patologistas e cirurgiões que buscam entender seus mecanismos de formação e desenvolvimento, assim como desenvolver técnicas adequadas de tratamento. Inúmeras foram as tentativas realizadas até hoje para classificar esses tumores odontogênicos, sendo a última a nova Classificação de Tumores Odontogênicos da Organização Mundial da Saúde, publicada em 2005. Assim sendo, este trabalho teve por objetivo determinar a prevalência dos tumores odontogênicos diagnosticados nos Serviços de Anatomia Patológica das Faculdades de Odontologia de Bauru (USP) e de Araçatuba (UNESP) no Brasil, e das Faculdades de Odontologia da UNAM, da UAM-X e do Laboratório privado Peribact no México, compará-las e definir um perfil da ocorrência desses tumores nessas instituições e países seguindo essa nova classificação. Todos os casos diagnosticados como tumores e cistos odontogênicos passíveis de reanálise diagnóstica foram selecionados dos arquivos dessas instituições. Os dados demográficos e os aspectos clínicos de cada lesão foram obtidos a partir dos laudos e das fichas de requisição de exame anatomopatológico e as lâminas examinadas por um avaliador. Os resultados demonstraram que a inclusão do queratocisto no grupo de tumores provocou uma alteração significante na prevalência dessas lesões. O tumor odontogênico queratocístico foi a lesão mais prevalente, seguida pelo odontoma, ameloblastoma e mixoma no Brasil e no México. Quanto aos dados demográficos e localização, nossos achados corroboram com aqueles descritos na maior parte dos trabalhos realizados em todo o mundo, com diferenças pontuais em países como a China. Entretanto, a falta de maiores conhecimentos biomoleculares e genéticos dificulta a compreensão dessas diferenças.

Odontogenic tumors constitute a group of uncommon and particularly interesting lesions, arising from the odontogenic tissues. These tumors have been studied for decades by pathologists and surgeons seeking understand the mechanisms of formation and development, and trying to develop appropriate techniques of treatment. Many were the attempts made so far to classify these odontogenic tumors, the most recent being the new classification of odontogenic tumor of the World Health Organization, published in 2005. Therefore, this study aimed to determine the prevalence of odontogenic tumors diagnosed in five centers of diagnostic pathology: Laboratory of Oral Pathology, Faculty of Dentistry of Bauru USP; Laboratory of Oral Pathology, Faculty of Dentistry of Araçatuba UNESP, in Brazil; and Department of Oral Pathology, Faculty of Dentistry UNAM; Laboratory of Oral Pathology, Faculty of Dentistry of UAM-Xochimilco and Peribact Laboratory, a private laboratory of oral pathology, in Mexico; compare them and develop a profile of the occurrence of these tumors in these institutions and countries, following this new classification. All cases diagnosed as odontogenic cysts and tumors were selected for diagnostic review. The demographic and clinical features were obtained from the records when available. The cases were re-evaluated, and the diagnosis in each case was confirmed or modified when necessary. The results showed that the inclusion of keratocyst in the group of tumors caused a significant change in the prevalence of these lesions. The keratocyst odontogenic tumor was the most prevalent lesion, followed by odontoma, ameloblastoma and myxoma in Brazil and Mexico. Our findings corroborate with those reported arround the world, with occasional differences in countries, such as China. However, the lack of molecular and genetic knowledge precludes a better comprehension of these differences.

Ameloblastic Fibroma: Presentation and Management at two Nigerian Tertiary Hospitals

Background: Ameloblastic fibroma (AMF) is a relatively uncommon neoplasm of odontogenic origin. Aim: To appraise the prevalence; presentation and management of AMF in two major tertiary hospitals in Nigeria. Methods: Histopathology records of the Departments of Oral and Maxillofacial Surgery of the two hospitals were reviewed and histologically confirmed cases of AMF seen over a 23- year period were selected. The case records of the selected cases were retrieved and the presentation and management of the disease were analyzed and discussed. Results: Seventeen cases of histologically confirmed AMF were seen over the period under study. The age range was 10 - 63 years and mean age of occurrence was 27.1 + 16 years; there was no sex predilection but the mandible was the commonest site of occurrence. Most cases were treated by conservative excision but some cases had more extensive resection. No tumour recurrence was observed over an average follow up period of 2 years. Conclusion: AMF with a prevalence of 3.1in this study; remains a rare variety of odontogenic tumour and is amenable to conservative surgical excision preptrrrase. Large lesions may warrant more radical resection but recurrence is generally rare