Pindborg tumor associated with a supernumerary tooth: a case report

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.

A case report of maxillary calcifying epithelial odontogenic tumor in a teenage girl

Objective@#To report the case of a rare benign odontogenic tumor in an adolescent girl which was successfully managed by complete excision and curettage of underlying bone. @*Methods@#Design: Case Report. Setting: Tertiary National University Hospital. Patient: One. @*Result@#A 15-year-old girl with a 3-year history of a large Calcifying Epithelial Odontogenic Tumor (Pindborg Tumor) atypically occurring in the posterior maxillary alveolar ridge and compressing the maxillary antrum underwent tumor excision via gingivobuccal approach and curettage of the emaining mucosa in the cavity in consideration of her patient’s aesthetic concerns. No recurrence has been observed two years post-op and she remains asymptomatic on regular follow-up. @*Conclusion@#A calcifying epithelial odontogenic tumor can be managed conservatively with close follow-up to monitor recurrence.

Tumor Odontogénico Epitelial Calcificante maxilar superior: reporte de un caso / Calcifying Epithelial Odontogenic Tumor in upper maxillary: a case report

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.

Tumor infrecuente de los maxilares, tumor de Pindborg: presentación de un caso clínico / Infrequent tumor of the jaws, Pindborg tumor: report of a clinical case

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)

Pindborg tumor: Pathology with special stains

Odontogenic tumors constitute a wide spectrum of lesions ranging from malignant and benign neoplasms to dental hamartomas, all derived from the epithelial and ectomesenchymal remnants of the tooth forming apparatus. Calcifying epithelial odontogenic tumor (CEOT) is an uncommon, benign epithelial odontogenic tumor first described by Pindborg in 1956. It is a universally accepted eponym for this neoplasm. Pindborg tumor or CEOT is a locally aggressive neoplasm that accounts for 1% of the total odontogenic tumors, with recurrence in 14% of cases. The etiology of this tumor remains an enigma to the clinician. Pindborg suggested that the tumor arises from the remnants of reduced enamel epithelium of an unerupted tooth. Recent studies in literature report that the tumor arises from stratum intermedium. We report a case of Pindborg tumor in a 22-year-old male patient in the left mandibular posterior region. Radiographically, a well-defined radiolucency was associated with unerupted mandibular second molar which was displaced to the inferior border of the mandible. Along with routine haematoxylin and eosin stains, this case reports histopathological findings using Congo red stain and modified Gallegos stain.

Immediate Prosthetic Rehabilitation of Surgically Enucleated Pindborg tumour: A case report.

Treatment of patients with maxillofacial defects is one of the most challenging tasks. Prosthetic reconstruction of maxillomandibular defects may be achieved with the help of removable and fixed prosthesis to restore the lost form, function and speech. The purpose of this article is to describes a case of CEOT (Calcifying Epithelial Odontogenic Tumor) in left mandibular body region managed with a treatment obturator, which allowed closure of the defect by secondary healing through granulation tissue maturation and associated bone fill. A 19 guage wire was used to stabilize the appliance, and provide retentive properties. The obturator allowed decrease in size of defect and enhanced comfort and overall wellbeing of the patient.

Tumor odontogénico epitelial calcificante de maxilar superior: reporte de un caso / Calcifying epithelial odontogenic tumor of the upper jaw: report of a case

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.

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)

Calcifying epithelial odontogenic tumor (CEOT) in palate: report of a case

A calcifying epithelial odontogenic tumor (CEOT) was first described as a separate entity in 1955 by Pindborg, and has since been referred to as Pindborg tumor. CEOT is characterized by the presence of squamous-cell proliferation, calcification and amyloid deposits, and accounts for only 1% of all odontogenic tumors. CEOT is a benign, though occasional locally invasive, slow-growing neoplasm. It is located either intraosseously or extraosseously, and is usually associated with an unerupted permanent tooth. A 24 year-old female visited our clinic, presenting with a palatal swelling and intra-oral ulcer. After an incisional biopsy, the lesion was confirmed to be odontogenic tumor. A tumor resection and reconstruction surgery with tongue flap were performed.

Mixed odontogenic tumor: Ameloblastoma and calcifying epithelial odontogenic tumor.

Odontogenic tumors constitute a group of heterogeneous disease derived from epithelial, mesenchymal and/or ectomesenchymal elements. Ameloblastoma is the best known and the most frequent form of odontogenic tumors. Calcifying epithelial odontogenic tumor (CEOT), known as Pindborg tumor, is locally invasive lesion which has a characteristic amiloid deposition. Here a case of a peripheral ameloblastoma associated with CEOT is presented with clinical and morphological features.

Pindborg Tumor in an Adolescent- An Atypical Presentation.

Calcifying epithelial odontogenic tumor (Pindborg tumor), is a rare benign odontogenic neoplasm representing about 0.4-3% of all odontogenic tumors. This tumor more frequently affects adults in an age range of 20- 60 years, with a peak incidence in the 5th decade of life. Calcifying epithelial odontogenic tumour has a much lower recurrence rate than ameloblastoma and malignant transformation with metastasis is rare.

Pindborg Tumor on Hard Palate / 대한이비인후과학회지

Pindborg tumor occurs rarely, with a frequency ranging from 0.17% to 1.8% of all odontogenic tumor. It typically presents as a painless asymptomatic expansile mass, but it can result in mechanical effects. The treatment of Pindborg tumor in the past has varied, ranging from enucleation or curettage, to hemimandiblectomy or hemimaxillectomy. We experienced a case of Pindborg tumor treated by marsupialization with sufficient results. But since recurrence has been reported from 10% to 14%, we plan on close observation over at least 5 years.