Skip to main content
Free AccessCase report

Bilateral adenomatoid odontogenic tumour of the maxilla in a 2-year-old female—the report of a rare case and review of the literature

Published Online:https://doi.org/10.1259/dmfr/63978332

Abstract

Multifocal odontogenic lesions are uncommon and have only been observed in conditions associated with known genetic mutations. To the best of our knowledge, only two cases of multifocal adenomatoid odontogenic tumours (AOT) have previously been reported in the literature. In this study, we report the first case of a bilateral, separate AOT in the maxilla in the midline in a 2-year-old female. The patient presented with bilateral expansile masses in the maxilla on either side of the midline which had been present for 6 months. She was asymptomatic and had occasional difficulty in breathing. The tumour was diagnosed as AOT and was surgically enucleated along with the associated teeth. The patient recovered well and has been on recall for 5 years. The follow-up panoramic radiograph made a fortnight ago revealed evidence of three new radio-opaque lesions with an associated tooth in the region of the anterior mandible, the premolar region of the right maxilla and the molar region of the left maxilla. To acquire additional information about AOT, all reports regarding AOT cited in ‘PubMed’ from 1995 onward were reviewed and the incidence, clinical features, radiographic features and management of AOT are discussed in this study.

Introduction

Adenomatoid odontogenic tumour (AOT) is a slow-growing, well-circumscribed tumour representing 3–7% of all odontogenic tumours.1 Although the tumour is considered rare in the literature, Philipsen et al2 reported that the tumour ranks fourth among the odontogenic tumours. It was also known as adeno-ameloblastoma, ameloblastic adenomatoid tumour etc, but the World Health Organization (WHO) classification of 1971 adopted the term AOT, which was coined by Philipsen and Brin.3 In the latest edition of WHO classification of odontogenic tumours in 2005, AOT is classified into the first group of tumours (odontogenic epithelium without ectomesenchyme) instead of the second group (odontogenic epithelium with ectomesenchyme).4 Because of the absence of ectomesenchyme in immunohistochemical staining and dysplastic dentine, AOT is now considered the result of a metaplastic process rather than epithelial-ectomesenchyme interaction.4 Evidence suggests that follicular AOTs arise from the reduced enamel epithelium (REE) which lines the follicles of unerupted teeth.5 Crivelini et al6 detected the expression of Cytokeratin 14 in AOT, which is also expressed by REE, and concluded that AOT probably originates from REE.6 The origin of the extrafollicular variant is still not clear;5 however, Philipsen et al7 argued that all AOT variants show identical histology and therefore it points towards a common origin from the dental lamina or its remains.

AOT commonly affects the anterior portion of the jaws, especially the maxilla in females.1 Philipsen and Reichart et al8 reported that 64.3% of cases occur in the maxilla and commonly involve the canine tooth. In the mandible the involvement of the canine is more common;8 however, a few cases associated with the embedded third molars have been reported in the literature. Philipsen et al2 also reported that the involvement of all the four canines is 60.1% and the maxillary canine alone is 41.7%. AOT is commonly seen in the first and second decade of life and is usually asymptomatic.2 Clinically the patient may complain of an asymptomatic, slow-growing swelling or a missing tooth.1

Multifocal AOT is rare and this paper describes the case of a 6-month-old bilateral separate AOT of the anterior maxilla in the midline in a 2-year-old Indian female which was surgically enucleated along with the associated teeth. The patient recovered well and has been on recall for 5 years. The follow-up panoramic radiograph taken a fortnight ago revealed evidence of three new radio-opaque lesions with an associated tooth in the region of the anterior mandible, premolar region of the right maxilla and molar region of the left maxilla, which are yet to be diagnosed.

Case report

A 2-year-old Indian female presented with 6-month-old bilateral expansile masses in the maxilla to our hospital 5 years ago. The patient's mother first noticed a diffuse swelling in the right posterior region of the maxilla followed by involvement of the anterior and the left posterior regions of the maxilla. The swelling had been gradually increasing in size since then and was more pronounced on the right side. The patient had remained asymptomatic with occasional difficulty in breathing. The medical and dental histories were insignificant; the patient's older sister, aged about 9 years, was surgically treated for ameloblastic fibroma of the maxilla at the age of 2 years.

On examination, bilateral expansion of the maxilla was seen and was more pronounced on the right side, extending from the infraorbital rim to the corner of the mouth and laterally 3 cm and 2 cm on the right and the left sides (Figure 1). The skin over the swelling appeared normal with a smooth surface. A narrowing of the airway when breathing through the mouth was evident. On intraoral examination, two diffuse, bony hard swellings were seen in the maxilla on either side of the midpalatine raphe, extending from the incisor teeth to the distal aspect of teeth 55 and 65, with obliteration of the labial and the buccal vestibule bilaterally (Figure 1). The full set of deciduous teeth was seen with spacing and was firm and non-tender. The mucosa over the swelling appeared normal.

Figure 1
Figure 1

Bilateral expansile masses in the maxilla, which is more pronounced on the right side

The patient did not co-operate for a panoramic radiograph, but an occipitomental radiograph revealed obliteration of the maxillary sinus bilaterally. A CT scan revealed large, well-defined separate expansile mass lesions in both the maxillae, with the lesion on the right side larger than the left and comprising a calcified mass, displaced permanent teeth and fluid. Inferiorly the mass extended to the alveolar ridge; superiorly it extended to the floor of the orbit, resulting in bowing of the orbital floor, while medially the lesions were seen to abut each other inferiorly and the nasal septum superiorly. The right-sided lesion showed posterior cortical destruction with mild extension of the lesion into the soft tissues (Figures 2 and 3). Complete blood count, serum calcium and serum alkaline phosphotase levels were assessed and were well within the normal range. Incisional biopsy from both tumour masses revealed similar findings showing sheets of spindly fibroblastic cells with a few gland-like spaces containing hyaline eosinophilic material. The lining cells were tall and columnar and their nuclei were polarized away from the central lesion. Also seen scattered throughout the lesions were calcified and ossified structures, which were suggestive of AOT (Figure 4).

Figure 2
Figure 2

CT scan revealing the bilateral tumour mass with a calcification and associated tooth in the maxilla. The tumour on the right side measured 4.44 × 3.57 × 3.88 cm and tumour on the left side measured 3.51 × 2.90 × 3.02 cm

Figure 3
Figure 3

Sagittal CT scan revealing the large tumour mass with a calcification and a three-dimensional CT showing cortical destruction in the right maxilla

Figure 4
Figure 4

Histopathological picture revealing sheets of spindly fibroblastic cells

The diagnosis of AOT bilaterally involving the maxillae was made. The bilateral tumour was surgically enucleated along with the associated deciduous teeth and permanent tooth buds simultaneously under general anaesthesia. The patient recovered well within a week and has been on routine biannual clinical and radiographic follow-up for 5 years (Figure 5). The follow-up panoramic radiograph taken a fortnight ago revealed evidence of three new radio-opaque lesions associated with a developing tooth bud in the anterior mandible, the premolar region of the right maxilla and the molar region of the left maxilla (Figure 6). The lesions appear radio-opaque with a few radiolucent areas in between surrounded by a radiolucent rim and radio-opaque border, and are associated with developing tooth buds of 31 (20 × 10 mm), 14 (15 mm diameter) and 27 (15 × 10 mm). The patient is now on a monthly radiographic follow-up.

Figure 5
Figure 5

Fifth year follow-up pictures revealing missing anterior teeth from canine to canine in the maxilla and a normal appearing palate

Figure 6
Figure 6

Fifth year panoramic radiograph revealing a radio-opaque area with radiolucency in between, surrounded by a radiolucent rim and radio-opaque border which are associated with the tooth buds of 31 (20 × 10 mm), 14 (15 mm diameter) and 27 (15 × 10 mm)

Discussion

From 1995 onwards, 76 single cases of AOT (excluding case series of more than 5 cases) have been published in ‘PubMed’. The age range was 3–46 years; however, most of the cases reported were in the age group of 10–22 years with a female predominance. Very few cases have been reported in the age range of 1–10 years; the youngest patient was a 3-year-old female9 and another case was in a 4-year-old female,10 both of whom had peripheral AOTs. Most of the cases of AOT were predominantly found in the anterior maxilla, followed by the anterior mandible, and a few cases reported AOTs in the posterior mandible in the third molar region.

AOT is commonly seen in the age group 10–19 years.2 Philipsen and Reichart et al11 report that two-thirds of the cases are diagnosed in the second decade of life and more than half of the cases occur in the teens (13–19 years). The age range in our literature review was 3–46 years and the case reported here is in a 2-year-old female with central AOT, which to the best of our knowledge is the first case report of AOT in such a young child. There is a predilection of AOT in females (male-to-female ratio = 1:1.9),8 with reports of higher incidence in females in Asian populations, especially in Sri Lanka (male-to-female ratio = 1:3.2)12 and Japan (male-to-female ratio = 1:3).13

The literature review by the authors revealed cases of AOT arising/associated with dentigerous cyst, calcifying epithelial odontogenic tumour, calcifying odontogenic cyst, odontoma and unicystic ameloblastoma. There are a few reports of cases of adenoameloblastoma with dentinoid which has features of ameloblastoma and AOT (Table 1). Vargas et al28 reported two cases of a new odontogenic lesion for which they coined the term adenomatoid odontogenic hamartoma, following which a few cases have been reported (Table 1). These tumours are composed of mature hard and soft dental tissue, which resembles a developing tooth, and the interspersed remnants of odontogenic epithelium which form duct-like structures.

Table 1 Adenomatoid odontogenic tumours are thought to arise from/associated with as reported in the literature
TumoursCasesAuthors
Dentigerous cystTwoNonaka et al,14 Bravo et al15
Dental cystOneGracia-Pola Vallejo et al16
OdontomaTwoCudney et al,17 Martinez et al18
Adenoameloblastoma with dentinoidSixGhasemi-Moridani and Yazdi,19 Evans et al,20 Allen et al21
Calcifying epithelial odontogenic tumourTwoMosqueda-Taylor et al,22 Miyake et al23
Calcifying odontogenic cystThreePhillips et al,24 Buch et al,25 Zeitoun et al26
Unicystic ameloblastomaThreeJivan et al,5 Raubenheimer et al27
Adenomatoid odontogenic hamartomaThreeVargas et al,28 Otero et al29

Clinically the patient may present with a missing tooth, especially a canine or an asymptomatic slow growing swelling of the jaw bones.1 According to Philipsen et al,2 AOT appears in three clinical subtypes—follicular, extrafollicular and peripheral. The follicular and extrafollicular variants are both intrabony and account for approximately 97% of all AOTs, of which 73% are of a follicular type. The follicular type appears as a unilocular cystic radiolucency associated with an unerupted or impacted tooth and is diagnosed earlier in life (mean age 17 years) than the extrafollicular type (mean age 24 years).2 It is impossible to distinguish the follicular type of AOT from the dentigerous cyst radiographically.1 The radiolucency may sometimes extend apically along the root past the cementoenamel junction and this may help in distinguishing AOT from a dentigerous cyst.1 The extrafollicular type (24%) is a central lesion not associated with a tooth2 and may present as radiolucent lesions in the periapical region of the tooth mimicking a periapical cyst,30 or it may present as a periodontal intrabony defect31 or in the maxillary sinus.32 The peripheral type is seen as small sessile masses on the facia gingiva of the maxilla, which may mimic gingival epulis or fibroma.1 Displacement of neighbouring teeth owing to tumour expansion is much more common than root resorption.33 The peripheral lesion may show some erosion of the adjacent cortical bone.33 The central tumours produce a corticated radiolucency, sometimes with radio-opaque specks, and in 78% of the cases the radiolucency shows discrete foci and a flocculent pattern of scattered radio-opacities,34,35 which may mimic the radiographic picture of a calcifying epithelial odontogenic tumour or calcifying odontogenic cyst.

The lesions of AOT are small, seldom exceeding 3 cm in diameter, and are asymptomatic so are discovered during routine radiographic examination, but some larger lesions cause painless expansion of the bone.1 Tsaknis et al36 reported a case of massive AOT measuring 12 cm in an 11-year-old female, with seven impacted teeth and a pronounced area of radio-opaqueness. Takahashi et al37 have reported a gigantic AOT of the maxillary sinus and Geist et al38 have reported a case of unusually large AOT of the mandible which had caused expansion and resorption of the lower border of the mandible and displacement of the anterior teeth and extended across the midline. In the case reported here the tumour was bilateral and measured about 4 cm on the left side and 4.5 cm on the right side with a calcified mass, displaced permanent teeth and fluid. It had caused expansion of the maxilla, bowing of the orbital floor, posterior cortical destruction on the right side and also mild extension into the soft tissues.

Multifocal odontogenic lesions are uncommon with few case reports in the literature. Sedghizadeh et al39 have reported a case of a multifocal calcifying epithelial odontogenic tumour, Abrahao et al40 have reported a case of a recurrent bilateral gingival peripheral calcifying epithelial odontogenic tumour, Kamal et al41 have reported a case of multifocal peripheral odontogenic fibroma, Straith et al42 have reported a case of bilateral odontoma, Mills et al43 have reported a case of a squamous odontogenic tumour and there are a number of reports of multiple keratocystic odontogenic tumours in basal cell bifid rib syndrome in the literature.

Only two cases of multifocal AOTs have been reported in the literature to the best of our knowledge, and this is the first case of a bilateral, separate, multifocal, central AOT in the maxilla in the midline in a 2-year-old female. The follow-up radiographs have also revealed evidence of three new radio-opaque lesions with an associated tooth bud in the region of the anterior mandible, the premolar region of the right maxilla and the molar region of the left maxilla, which may represent new foci of AOT and are yet to be diagnosed. Larsson et al44 have reported a case of multifocal AOT of the jaw bone in a 12-year-old female who developed a dozen separate radiolucent lesions over a 5-year period. They were removed surgically along with about 20 associated tooth germs and unerupted malformed teeth. Bartake et al45 have reported a case of two AOTs of the left maxilla in the region of teeth 21–26 in a 14-year-old female which were found to be two separate, well-encapsulated masses separated by thin bony septae during enucleation. Otero et al29 have reported the first case of a bilateral adenomatoid odontogenic hamartoma in a 12-year-old female, wherein the lesions were well-circumscribed, unilocular radiolucent areas in the mandibular third molar region.

Microscopically an intracystic epithelial proliferation is composed of polyhedral to spindle cells.1 The pattern is typically lobular, although some areas may show a syncytial arrangement of cells.1 Rosettes and duct-like structures of columnar epithelial cells containing small amounts of eosinophilic material give the lesion its characteristic microscopic features, but may be scanty or even absent in a given lesion.1 Small deposits of calcified material are scattered over a background of odontogenic cells.1

AOT is a well-encapsulated tumour and is benign so it can be surgically enucleated easily from the bone along with the capsule.1 Recurrence of the tumour or aggressive behaviour are generally not the features of AOT, although Chuan-Xiang et al46 reported a case where recurrence appeared twice in a 36-year-old male over a 20-year period. Garg et al47 also reported the case of a 20-year-old female with large, aggressive AOT which caused resorption of roots and Takigami et al48 reported a similarly aggressive AOT which recurred four times and extended to the base of the skull. The above case reports describe recurrence of AOT with features of aggressiveness, root resorption and rapid growth, which is generally not the behaviour of AOT and the diagnoses in these cases can be questioned.

In the case reported here the large, bilateral, simultaneous occurrence of AOT in the midline of the maxilla in a 2-year-old child makes it a very rare presentation of this tumour. The patient recovered well after the enucleation and there has been no recurrence of the tumour until now. The latest follow-up radiographs have revealed evidence of three new radio-opaque lesions with an associated tooth bud in the region of the anterior mandible, the premolar region of the right maxilla and the molar region of the left maxilla which may represent new foci of AOT and are yet to be diagnosed.

References

  • 1 Neville BW, , Damm DD, , Allen CM, , Bouquet JE and . Oral and maxillofacial pathology, 2nd edn. WB Saunders: Philadelphia, PA; 2002. pp. 621–623. Google Scholar

  • 2 Philipsen HP, , Reichart PA, , Zhang KH, , Nikai H, , Yu QX and . Adenomatoid odontogenic tumour: biologic profile based on 499 cases. J Oral Pathol Med 1991;20:149–158. Crossref Medline ISIGoogle Scholar

  • 3 Philipsen HP, , Brin H and . The adenomatoid odontogenic tumour, ameloblastic adenomatoid tumour or adeno-ameloblastoma. Acta Pathol Microbiol Scand 1969;75:375–398. MedlineGoogle Scholar

  • 4 Jing W, , Xuan M, , Lin Y, , Wu L, , Liu L, , Zheng X, , et al.. Odontogenic tumours: a retrospective study of 1642 cases in a Chinese population. Int J Oral Maxillofac Surg 2007;36:20–25. Crossref Medline ISIGoogle Scholar

  • 5 Jivan V, , Altini M, , Meer S, , Mahomed F and . Adenomatoid odontogenic tumour (AOT) originating in a unicystic ameloblastoma: a case report. Head Neck Pathol 2007;1:146–149. Crossref MedlineGoogle Scholar

  • 6 Crivelini MM, , de Araujo VC, , de Sousa SO, , de Araujo NS and . Cytokeratins in epithelia of odontogenic neoplasms. Oral Dis 2003;9:1–6. Crossref Medline ISIGoogle Scholar

  • 7 Philipsen HP, , Samman N, , Ormiston IW, , Wu PC, , Reichart PA and . Variants of the adenomatoid odontogenic tumour with a note on tumour origin. J Oral Pathol Med 1992;21:348–352. Crossref Medline ISIGoogle Scholar

  • 8 Philipsen HP, , Reichart PA, , Siar CH, , Ng KH, , Lau SH, , Zhang X, , et al.. An updated clinical and epidemiological profile of the adenomatoid odontogenic tumour: a collaborative retrospective study. J Oral Pathol Med 2007;36:383–393. Crossref Medline ISIGoogle Scholar

  • 9 Kearns GJ, , Smith R and . Adenomatoid odontogenic tumour: an unusual cause of gingival swelling in a three year old patient. Br Dent J 1996;181:380–382. Crossref Medline ISIGoogle Scholar

  • 10 Unal T, , Cetingul E, , Gunbay T and . Peripheral adenomatoid odontogenic tumour: birth of a term. J Clin Pediatr Dent 1995;19:139–142. MedlineGoogle Scholar

  • 11 Philipsen HP, , Reichart PA and . Adenomatoid odontogenic tumour: facts and figures. Oral Oncol 1999;35:125–131. Crossref Medline ISIGoogle Scholar

  • 12 Nigam S, , Gupta SK, , Chaturvedi KU and . Adenomatoid odontogenic tumour – a rare cause of jaw swelling. Braz Dent J 2005;16:251–253. Crossref MedlineGoogle Scholar

  • 13 Sato D, , Matsuzaka K, , Yama M, , Kakizawa T, , Inoue T and . Adenomatoid odontogenic tumour arising from the mandibular molar region: a case report and review of literature. Bull Tokyo Dent Coll 2004;45:223–227. Crossref MedlineGoogle Scholar

  • 14 Nonaka CFW, , de Souza LB, , Quindere LB and . Adenomatoid odontogenic tumor associated with dentigerous cyst—unusual case report. Braz J Otorhinolaryngol 2007;73:129–131. 17505612 Crossref MedlineGoogle Scholar

  • 15 Bravo M, , White D, , Miles L, , Cotton R and . Adenomatoid odontogenic tumor mimicking a dentigerous cyst. Int J Pediatr Otorhinolaryngol 2005;69:1685–1688. Crossref Medline ISIGoogle Scholar

  • 16 Gracia-Pola Vallejo M, , Gonzalez Gracia M, , Lopez-Arranz JS, , Herrero Zapatero A and . Adenomatoid odontogenic tumor arising in a dental cyst:Report of an unusual case. J Clin Pediatr Dent 1998;23:55–58. MedlineGoogle Scholar

  • 17 Cudney N, , Persico J, , Cordell KG, , D’Silva NJ and . Adenomatoid odontogenic tumor developing in association with odontoma: report of a case. Quintessence Int 2008;39:693–697. 19107257 Medline ISIGoogle Scholar

  • 18 Martinez A, , Taylor AM, , Marchesani FL, , Brethauer U, , Spencer ML and . Adenomatoid odontogenic tumor concomitant with cystic complex odontoma: case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:e25–e29. Crossref MedlineGoogle Scholar

  • 19 Ghasemi-Mordani S, , Yazdi I and . Adenoid ameloblastoma with dentinoid: a case report. Arch Iranian Med 2008Jan;11(11):110–2. 18154432 Medline ISIGoogle Scholar

  • 20 Evans BL, , Carr RF, , Phillipe LJ and . Adenoid ameloblastoma with dentinoid: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:583–587. Crossref MedlineGoogle Scholar

  • 21 Allen CM, , Neville BW, , Hammond HL and . Adenomatoid dentinoma: report of four cases of unusual odontogenic lesion. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;86:313–317. Crossref MedlineGoogle Scholar

  • 22 Mosqueda-Taylor A, , Carlos-Bregni R, , Ledesma-Montes C, , Fillipi RZ, , de Almeida OP, , Vargas PA and . Calcifying epithelial odontogenic tumor like areas are common findings in adenomatoid odontogenic tumors and not a specific entity. Oral Oncol 2005;41:214–215. Crossref Medline ISIGoogle Scholar

  • 23 Miyake M, , Nagahata S, , Nishihara J, , Ohbayashi Y and . Combined adenomatoid odontogenic tumor and calcifying epithelial odontogenic tumor: report of case and ultrastructural study. J Oral Maxillofac Surg 1996;54:788–793. Crossref Medline ISIGoogle Scholar

  • 24 Philips MD, , Closmann JJ, , Baus MK, , Torske KR, , Williams SB and . Hybrid odontogenic tumor with features of ameloblastic fibro-odontoma, calcifying odontogenic cyst, and adenomatoid odontogenic tumor: a case report and review of literature. J Oral Maxillofac Surg 2010;68:470–474. Crossref Medline ISIGoogle Scholar

  • 25 Buch RS, , Coerdt W, , Wahlmann U and . Adenomatoid odontogenic tumor in calcifying odontogenic cyst. [In German.] Mund Kiefer Gesichtschir 2003;7:301–305. Crossref MedlineGoogle Scholar

  • 26 Zeitoun IM, , Dhanrajani PJ, , Adeyemi Mosandomi H and . Adenomatoid odontogenic tumor arising in calcifying odontogenic cyst. J Oral Maxillofac Surg 1996;54:634–637. Crossref Medline ISIGoogle Scholar

  • 27 Raubenheimer EJ, , Seeliger JE, , Van Heerden WF, , Dreyer AF and . Adenomatoid odontogenic tumor: a report of two large lesions. Dentomaxillofac Radiol 1991;20:43–45. LinkGoogle Scholar

  • 28 Vargas PA, , Carlos-Bregni R, , Mosqueda-Taylor A, , Cuairan-Ruidiaz V, , Lopes MA, , de Almeida OP and . Adenomatoid dentinoma or adenomatoid odontogenic hamartoma: what is the better term to denominate this uncommon odontogenic lesion. Oral Dis 2006;12:200–203. Crossref Medline ISIGoogle Scholar

  • 29 Otero D, , Simões M, , Antero S, , Lourenço S, , Niteroi RJ and . Bilateral adenomatoid odontogenic hamartoma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:e24–e26. Crossref MedlineGoogle Scholar

  • 30 Philipsen HP, , Srisuwan T, , Reichart PA, , Alcantara SP and . Adenomatoid odontogenic tumour mimicking a periapical cyst. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94:246–248. Crossref MedlineGoogle Scholar

  • 31 Blumenthal NM, , Mostofi R and . Repair of an intrabony decfect from an adenomatoid odontogenic tumour. J Periodontal 2000;71:1637–1640. Crossref Medline ISIGoogle Scholar

  • 32 Friedrich RE, , Scheuer HA, , Zustin J and . Adenomatoid odontogenic tumour (AOT) of maxillary sinus: case report with respect to immunohistochemical findings. In Vivo 2009;23:111–116. Medline ISIGoogle Scholar

  • 33 Handschel JGK, , Depprich RA, , Zimmermann AC, , Braunstein S, , Kübler NR and . Adenomatoid odontogenic tumour of the mandible: review of the literature and report of a rare case. Head Face Med 2005;1:3. Crossref MedlineGoogle Scholar

  • 34 Dare A, , Yamaguchi A, , Yoshiki S, , Okano T and . Limitation of panoramic radiography in diagnosing adenomatoid odontogenic tumours. Oral Surg Oral Med Oral Pathol 1994Jun;77(6):662–8. 8065735 Crossref Medline ISIGoogle Scholar

  • 35 Toida M, , Hyodo I, , Okuda T, , Tatematsu N and . Adenomatoid odontogenic tumour: report of two cases and survey of 126 cases in Japan. J Oral Maxillofac Surg 1990;48:404–408. Crossref Medline ISIGoogle Scholar

  • 36 Tsaknis PJ, , Carpenter WM, , Shade NL and . Odontogenic adenomatoid tumour: report of case and review of the literature. J Oral Surg 1977;35:146. MedlineGoogle Scholar

  • 37 Takahashi H, , Fujita S, , Shibata Y, , Yamaguchi A and . Adenomatoid odontogenic tumour: immunohistochemical demonstration of transferring, ferritin and alpha-one-antitrypsin. J Oral Pathol Med 2001;30:237–244. Crossref Medline ISIGoogle Scholar

  • 38 Geist SM, , Mallon HL and . Adenomatoid odontogenic tumour: report of an unusually large lesion in the mandible. J Oral Maxillofac Surg 1995;53:714–717. Crossref Medline ISIGoogle Scholar

  • 39 Sedghizadeh PP, , Wong D, , Shuler CF, , Linz V, , Kalmar JR, , Allen CM and . Multifocal calcifying epithelial odontogenic tumour. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104:e30–34. Crossref MedlineGoogle Scholar

  • 40 Abrahão AC, , Camisasca DR, , Bonelli BR, , Cabral MG, , Lourenço SQ, , Torres SR, , et al.. Recurrent bilateral gingival peripheral calcifying epithelial odontogenic tumour (Pindborg tumour): a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:e66–71. Crossref MedlineGoogle Scholar

  • 41 Kamal R, , Palaskar S, , Shetty VP, , Bhushan A and . Multifocal peripheral odontogenic fibroma. J Oral Maxillofac Pathol 2008;12:72–74. CrossrefGoogle Scholar

  • 42 Straith FE and . Bilateral odontoma: report of a case. Oral Surg Oral Med Oral Pathol l950Aug;3(8):1036–40. 15440073 Medline ISIGoogle Scholar

  • 43 Mills WP, , Davila MA, , Beuttnmuller EA, , Koudelka BM and . Squamous odontogenic tumour: report of a case with lesions in three quadrants. Oral Surg Oral Med Oral Pathol 1986Jun;61(6):557–63. 3459983 Crossref Medline ISIGoogle Scholar

  • 44 Larsson A, , Swartz K, , Heikinheimo K and . A case of multiple AOT-like jawbone lesions in a young patient – a new odontogenic entity? J Oral Pathol Med 2003;32:55–62. Crossref Medline ISIGoogle Scholar

  • 45 Bartake AR, , Punnya VA, , Sudeendra P, , Rekha K and . Two adenomatoid odontogenic tumours of the maxilla: a case report. Br J Oral Maxfac Surg 2009;47:638–640. Crossref Medline ISIGoogle Scholar

  • 46 Chuan-Xiang Z, , Yang G and . Adenomatoid odontogenic tumour: a report of a case with recurrence. J Oral Pathol Med 2007;36:440–443. Crossref Medline ISIGoogle Scholar

  • 47 Garg D, , Palaskar S, , Shetty VP, , Bhushan A and . Adenomatoid odontogenic tumour – hamartoma or true neoplasm: a case report. J Oral Sci 2009;51:155–159. Crossref MedlineGoogle Scholar

  • 48 Takigami M, , Uede T, , Imaizumi T, , Ohtaki M, , Tanabe S, , Hashi K, , et al.. A case of adenomatoid odontogenic tumour with intra-cranial extension. No Shinkei Geka 1988; 16:775–779 MedlineGoogle Scholar

Volume 41, Issue 4May 2012
Pages: 267-354

2012 The British Institute of Radiology


History

  • RevisedOctober 12,2010
  • ReceivedJuly 29,2010
  • AcceptedNovember 04,2010
  • Published onlineFebruary 13,2014

Metrics


Keywords