Cases reported "Odontogenic Tumors"

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1/14. Ameloblastic fibro-odontoma: report of case with light and electron microscopic observations.

    A case of a large ameloblastic fibro-odontoma has been reported. Its clinical behavior was discussed and descriptions of its characteristics under the light and electron microscope were presented. As a special entity, with a prognosis that permits conservation of peripheral bone margins, this lesion should be understood by all clinicians who manage odontogenic tumors. Within the group of odontogenic tumors, the combined observations of light and electron microscopy may introduce additional criteria for more refined classification.
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2/14. Benign cementoblastoma: a case report.

    The case of a 23-year-old with a benign cementoblastoma is presented. The clinicopathologic features, treatment and prognosis are discussed and a brief review of the literature is presented. Although this neoplasm is rare, the dental practitioner should be aware of the clinical features that will lead to its early diagnosis and treatment.
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3/14. Ameloblastic fibrosarcoma: report of a case. Immunohistochemical study and review of the literature.

    Ameloblastic fibrosarcoma is a rare malignant odontogenic tumour characterized by a benign epithelial component within a malignant fibrous stroma. Its behaviour is relatively benign, with absence of metastatic disease, and the prognosis is reported to be good. It is a paradoxical neoplasm with "sarcomatous" morphological and immunohistochemical patterns but with a favourable clinical course. We report a new case of this tumour in a mandibular ramus of a 31-years-old male patient, that was surgically excised and treated with adjuvant chemotherapy and radiotherapy. Five years later the patient is free of disease. The growth potential of ameloblastic fibrosarcoma is evaluated and compared with a related lesion, the ameloblastic fibroma. The sarcomatous mesenchymal component of ameloblastic fibrosarcoma is positive to Ki67, PCNA and p53, in front of the negativity of ameloblastic fibroma.
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4/14. Primary intraosseous carcinoma associated with impacted third molar of the mandible: review of the literature and report of a new case.

    This study investigated the clincopathologic features of primary intraosseous carcinoma (PIOC) related to the third molar of the mandible. Six cases (5 from the literature and 1 new case; mean patient age 73 years) of PIOC associated with completely impacted lower third molar were analyzed. For comparison, 8 cases of PIOC presenting after extraction of the lower third molar were also evaluated, with a significantly lower mean patient age of 56 years. Most lesions were deceptively similar to those related to the lateral type of dentigerous cyst, and half of the impacted cases revealed an asymptomatic fracture of the mandible. In all patients except for the present case, metastasis had not been recorded. Surprisingly, no patients are known to have died of PIOC. In our experience the prognosis of PIOC associated with a completely impacted third molar is much better than commonly believed, although the number of cases involved is too small to make a general conclusion. However, delay in establishing the correct diagnosis followed by extraction without awareness of the carcinoma is know to adversely affect the prognosis.
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5/14. Central odontogenic fibroma: a case report.

    OBJECTIVE: The aim of this case report was to analyze clinical and histological features of a central odontogenic fibroma followed up for 6 years after surgical excision. methods: A 26-year old Caucasian female was referred, reporting a painless gingival swelling in the buccal area of the maxillary right canine. There were no other symptoms and no recent history of pain. Her medical history was non-contributory. Radiographic evaluation showed the presence of a radiolucent area with well-defined margins. The lesion was surgically removed and histologically analysed. RESULTS: Histologic analysis showed a cellular fibroblastic tissue characterized by interwoven bundles of collagen densely packed and absence of odontogenic epithelium. The surgical site was monitored for 6 years after surgery with no signs of recurrence. CONCLUSION: The central odontogenic fibroma here reported displayed a prominent quantity of collagen and absence of odontogenic epithelium. The surgically removed lesion had a favourable prognosis and no recurrence for the 6 year follow-up period.
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6/14. Cystic variant of calcifying epithelial odontogenic tumor.

    Calcifying epithelial odontogenic tumor (CEOT) is a benign, locally aggressive odontogenic neoplasm characterized by sheets and nests of epithelial cells with deeply eosinophilic or occasionally clear cytoplasm, calcifications, and eosinophilic amorphous material that stains positive for amyloid. Although many cases of CEOT are associated with impacted teeth and occasionally appear radiographically as dentigerous cysts, a true cystic variant has not been previously reported. We report a 15-year-old white male with a large cystic maxillary lesion that filled most of the left maxillary sinus. It deformed the medial wall, the inferior orbital floor, and caused narrowing of the left inferior meatus. Histologically, the cystic lining showed characteristics of CEOT. An intraluminal component that featured histologic characteristics of CEOT was identified during surgery. The lesion was enucleated and the postsurgical course of the patient was uneventful. Because follow-up has been for less than 1 year, a meaningful long-term prognosis cannot be determined at present. However, the patient has not reported any symptoms or signs of recurrence during the follow-up period.
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7/14. Primary intraosseous squamous carcinoma. Report of two cases.

    Two cases of primary intraosseous squamous carcinoma (PIOSC) are reported. One PIOSC is in the mandible of a 24-year-old man and appears to be a keratinizing PIOSC arising de novo. The other PIOSC presented in the edentulous maxilla of a 56-year-old man and was diagnosed as a PIOSC arising from an odontogenic cyst. The 2nd tumor subsequently metastasized to a cervical lymph node. Previous reports have noted a favorable prognosis for PIOC arising in odontogenic cysts, and only 3 other instances of metastases of a PIOSC in an odontogenic cyst have been documented.
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8/14. Cementoblastoma: review of the literature and report of a case in a 7 year-old girl.

    Cementoblastoma is a very rare tumour of mesenchymal odontogenic origin. It usually affects adolescents and young adults, the youngest patient ever reported being 8 years-old. It is treated by enucleation and has an excellent prognosis. We review the world literature on the subject and present a case of cementoblastoma in a 7 year-old girl.
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9/14. Primary intraosseous carcinoma of the mandible.

    The case of a 58-year-old man with a large primary intraosseous carcinoma (PIOC) of the mandible is presented. The tumour is rare, and the prognosis is usually poor. There are no specific histological characteristics of PIOC. Staining for basement membrane laminin could be a valuable aid in the differential diagnosis between PIOC and tumours of ameloblastoma origin.
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10/14. Variations in keratinizing odontogenic cysts and tumors.

    classification of keratinizing odontogenic cysts and tumors is not entirely satisfactory to the clinician and pathologist because many individual cases do not fit precisely into a particular category. This report describes the nature of some of these marginal lesions in order that similar cases may be diagnosed and treated correctly. Eight selected cases are described histologically, and their clinical behavior is discussed. It is concluded that the histopathologic appearance of the odontogenic epithelium in odontogenic cysts and tumors varies to a large extent and gives rise to a variety of keratinizing lesions. It is further concluded that some varieties are unique and, for the present, treatment of the rare lesions depends more on observed clinical behavior, with morphology having a lesser role in prognosis. It is important that clinicians as well as pathologists be aware of the wide variation of these keratinizing lesions so that the patient will receive optimum treatment.
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