Calcifying Epithelial Odontogenic Tumour - A Diagnostic Challenge

ABSTRACT

Introduction/Aims: Calcifying epithelial odontogenic tumour (CEOT) or Pindborg's tumour is a rare, benign, slow-growing dental neoplasm which is locally aggressive and can invade dentoalveolar bone with possible displacement of teeth and soft tissue. We present a case of CEOT, which was initially managed as cemento-osseous dysplasia (COD). Material(s) and Method(s) A 52-year-old Afro-Caribbean female presented with a two-month history of a left anterior maxillary swelling and examination revealed a firm, buccal mass from upper left central incisor to first premolar. Plain radiograph and computed tomography (CT) imaging revealed a dense calcified body with a lucent capsule measuring 19 x 24 x 23 mm causing displacement of adjacent teeth and expansion of the maxillary cortex, and concluded the diagnosis of COD. Biopsy was offered to the patient but she was reluctant to proceed, so she was managed conservatively according to the radiological diagnosis. Results/Statistics During the 18-month surveillance period, the patient developed signs of infection of her anterior left maxilla and COD. CT scans showed a slight increase in the tumour size and surgical excision was postponed due to COVID-19 pandemic and resolution after oral antibiotics. After another 12 months, a biopsy of the bony mass was carried out due to overlying mucosal erythematous and nodular changes. The histology confirmed CEOT. Conclusions/Clinical Relevance Radiological diagnosis is often helpful and tissue biopsy is key when adverse signs are detected. Clinicians should be aware of CEOT as a differential diagnosis for any slow-growing bony lesion which appears mixed radiolucent and radiopaque on imaging. Copyright © 2022