A calcified epithelial odontogenic tumor with extension to the maxillary, ethmoid and sphenoid sinuses.

Calcified epithelial odontogenic tumor (CEOT) with extension to the maxillary, ethmoid and sphenoid sinuses is currently unreported. This extension poses a challenge for effective treatment, as CEOT is a benign neoplasm with contreversial potential aggressiveness. We report a case of CEOT that was previously misdiagnosed as an inverted papilloma. A segmental resection of the part of the tumor responsible for the symptoms was performed. Histology revealed polyhedral epithelial cells within an amorphous eosinophilic hyaline material containing round calcified structures and confirmed the diagnosis of CEOT. Postoperative CT Scan showed the partial resection of the tumoral process. A mixed radiolucent/radiopaque aspect of the remaining CEOT was clearly discernible. The patient was warned that due to the incomplete excision of the tumoral process, the risk of recurrence was significant and that a close clinical and radiological follow-up every 6 months was mandatory for a long time.

Radiologic-Pathologic correlation of Pindborg tumor of maxilla with extension to maxillary sinus, nasal cavity, and infraorbital margin: A case report.

Calcifying epithelial odontogenic tumor is a benign epithelial odontogenic tumor thought to originate from the stratum intermedium. Clear cell type, Langerhans cell/non-calcified type, and cystic/microcystic are the three recently recognized histological subtypes of CEOT in the 5th edition of the World Health Organization Classification of Head and Neck Tumors. Almost 350-400 cases of CEOT have been reported in literature, accounting for less than 1% of the reported cases of odontogenic tumors. We are reporting a case of Pindborg tumor of the maxilla with extension to the maxillary sinus, nasal cavity, and infraorbital margin, with an emphasis on radiographic and histopathologic presentation.

Epiphora and nasal blockage - An unusual presentation of Pindborg tumor: A case report and literature review.

Odontogenic tumors are silent ailments which can affect any individual. One such lesion is a calcifying epithelial odontogenic tumor (CEOT). It is a rare lesion with a locally aggressive nature. A 33-year-old male presented with nasal blockage and continuous flow of tears from the left eye for the past 7-8 months. Clinical examination revealed slightly protruded left eyeball and altered level of eyeballs with continuous watery discharge. Hess chart confirmed normal eye movements. Intraoral findings were not significant. The final diagnosis of CEOT was established based on the histopathological aspects. CEOT is mostly found in the third to fifth decade of life without gender predilection. Presenting symptoms and signs comprise painless expansile mass, although there are reports associated with pain, nasal obstruction, epistaxis, and proptosis. In this article, we would like to present a case of CEOT with epiphora and nasal blockage as the main and only presentation, an uncommon finding. Furthermore, discussing and posing a question of an adequate period of follow-up required to negate the presence of recurrence. One must stay vigilant enough not only to attest a singular symptom to the commonest ailment related to it but also to explore the possibility of the less known. Furthermore, we need to further research in depth to establish a certain duration after which the likeliness of recurrence is to the minimum.

Mandibular Radiolucencies: A Differential Diagnosis of a Rare Tumor.

The diagnosis and treatment of maxillofacial cystic lesions requires careful evaluation and correlation of the clinical presentation and radiological studies. The Pindborg tumor, also known as the calcifying epithelial odontogenic tumor, is a locally invasive benign neoplasm, with only around 300 cases being published to date. This study presents a new case of this already uncommon neoplasm, not associated with an impacted tooth, and describes the clinicopathological features of this rare entity, along with a review of other reported cases. Despite surgery having been recognized as the treatment of choice for the Pindborg tumor, no firm consensus exists concerning the extension of surgical resection.

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.

Pindborg Tumor-An Uncommon Odontogenic Tumor Detected by 68Ga-DOTATOC.

A 62-year-old-woman with a suspected Tumor-induced-osteomalacia (TIO), a rare neoplastic syndrome that results in renal phosphate wasting with hypophosphatemia, underwent 68Ga-DOTATOC PET/CT on the suspicion of a mesenchymal tumor producing Fibroblast growth factor 23 (FGF23). Imaging revealed a small osteolytic, somatostatin receptor (SSTR) positive lesion containing calcifications in the alveolar process of the maxilla. No other SSTR-positive focus was found. A biopsy was performed by an oral and maxillofacial surgeon that revealed a calcifying epithelial odontogenic tumor (Pindborg tumor). This case shows that epithelial odontogenic tumors as an uncommon benign tumor entity can also be SSTR-positive.

Pindborg tumor in early childhood: a rare tumor in the youngest patient reported to date.

Pindborg tumor is a benign expansile and slow growing odontogenic tumor that occurs mainly in adulthood. Limited management data exist for its treatment in young patients. We report the case of a 5-year-old patient and provide recommendations for the care of pediatric patients diagnosed with this rare odontogenic tumor.

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.

Calcifying epithelial odontogenic tumors (Pindborg tumor) of maxilla in pediatric patients.

The calcifying epithelial odontogenic tumor (CEOT) was first described by Pindborg as a distinct entity in 1955. Odontogenic tumors are derived from epithelial, ectomesenchymal, and/or mesenchymal elements that are or have been a part of the tooth-forming apparatus. Of all the odontogenic tumors, CEOT accounts for 1% of the cases. There is no sex predilection, with a 2:1 predilection for the mandible, mostly in the premolar/molar region. The CEOT typically presents clinically as an intraosseous, expansile, and painless mass that exhibits slow growth. It is often locally invasive. Most often, it is associated with an impacted tooth, is asymptomatic, and requires biopsy for diagnosis. Although most of these cases are primarily intraosseous, an extraosseous tumor is also known to occur, first observed by Pindborg in 1966. The lesions were surgically enucleated, and histopathological examination confirmed CEOT. The purpose of this article is to describe one additional case of both variants of CEOT.

A Rare Case of an Aggressive Clear Cell Variant of Calcifying Epithelial Odontogenic Tumor in the Posterior Maxilla.

A clear cell variant of calcifying epithelial odontogenic tumor is a rare benign odontogenic neoplasm, accounting for 33 cases described in the literature. In this article, we report a challenging example of clear cell variant of calcifying epithelial odontogenic tumor of the posterior maxilla in a 45-year-old female patient showing locally aggressive growth and recurrence. Microscopically, islands of polyhedral cells containing abundant cytoplasm, well-developed intercellular bridges blended with clear cells were observed. The nuclei were frequently pleomorphic and permeated by hyaline calcified material. Immunohistochemistry revealed positivity for pan-cytokeratin (AE1/AE3), cytokeratins (CK-14 and CK-19), Bcl-2, p53, and p63. The Ki-67 proliferative index was ~10%. As odontogenic tumors are rare, when a significant clear cell component is observed, the differential diagnosis with other lesions of the jaws with similar morphology, including other odontogenic tumors with prominent clear cell component, clear cell odontogenic carcinomas, and metastatic tumors, is difficult.

Synchronous Calcifying Epithelial Odontogenic Tumor: Case Report and Analysis of the 5 Cases in the Literature.

Calcifying epithelial odontogenic tumor (CEOT), or Pindborg tumor, is infrequent and accounts for less than 1% of all odontogenic tumors. It is benign and usually asymptomatic but displays locally infiltrative and expansile behavior. Synchronous lesions affecting the jaws are exceedingly rare. We present a case of synchronous CEOTs affecting the maxilla and mandible and describe the clinical, radiographic, histologic, and immunohistochemical features. We further review five cases previously described in the literature.

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.

Surgical management of a large calcifying epithelial odontogenic tumor in the maxilla: A case report.

INTRODUCTION: The calcifying epithelial odontogenic tumor (CEOT), also known as Pindborg tumor, is a locally invasive benign neoplasm. Histogenesis is controversial. PRESENTATION OF CASE: A 26-year-old male presented asymptomatic swelling on the right side of the face, with approximately six months of evolution. At intraoral examination, a hard nodule localized in the right posterior region of the maxilla, measuring approximately 5.0 x 3.0 cm was observed. The computed tomography images showed hypodense lesion with points of calcification associated with two non-erupted teeth. We suspect of odontogenic lesions. The final diagnosis of CEOT was established based on the histopathological aspects. DISCUSSION: This tumor is more frequent in adult men, usually develops in the posterior region of the mandible and may present clinical-pathological similarities with others odontogenic lesions. The radiological aspects observed in the CEOT are variable and depend on the time of evolution of the tumor. The histopathological examination is mandatory to establish the final diagnosis. CONCLUSION: Our case was treated with simple enucleation without signs of recurrence in five years of follow-up. Further studies are needed to understand the aetiology and the biological behaviour of this tumor.

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.

Calcifying epithelial odontogenic tumor: An updated analysis of 339 cases reported in the literature.

PURPOSE: The aim of this study was to integrate the available data published on calcifying epithelial odontogenic tumors (CEOT) into a comprehensive analysis of its clinical and radiologic features. MATERIALS AND METHODS: An electronic search was undertaken in May 2016. Eligibility criteria were publications having enough clinical, radiological and/or histological information to confirm definite diagnosis. RESULTS: A total of 362 lesions were found, 339 with enough information were analyzed. Variants clear cells (n = 33) and Langerhans cells (n = 10) were rarely described in the literature, as well as lesions with malignant transformation (n = 8). Central lesions (n = 264) were more prevalent than their peripheral counterparts (n = 24). A higher prevalence characterized the mandible, posterior region, and third and fourth decades. About 40% of the peripheral lesions showed signs of underlying bone erosion, and about half of the central ones showed signs of cortical bone perforation. Recurrence was found in all lesions (12.6%), peripheral lesions (18.8%), central lesions (11.6%), clear cell (10.7%), Langerhans cell (0%), and those with malignant transformation (42.9%). Excision or curettage was associated with the highest recurrence rate. None of the variables showed a statistically significant influence on the recurrence rate. CONCLUSIONS: The possible locally aggressive behavior of the lesions recommends a less conservative management than simple curettage. The clear cell variant shows similar demographic data and biological behavior compared to the non-variant lesions, suggesting that the presence of clear cells does not have an important clinical significance.

Pigmented Pindborg tumor of the maxilla: A case report.

The calcifying epithelial odontogenic tumor (CEOT), also known as the Pindborg tumor, is a benign locally invasive neoplasm. Common variants of CEOT include noncalcifying, Langerhans cell, bone and cementum forming and clear cell, which have a prognostic significance. Pigmented variants are known to occur in other odontogenic tumors. However, a definitive pigmented variant of CEOT has not been reported in literature so far. Here, we report the first case of pigmented Pindborg tumor arising from the maxilla in a young female. The pigment was demonstrated as melanin by staining and confirmed by immunohistochemistry. The pigmented variant of CEOT did not recur within 18 months postsurgery. Our report indicates that it is essential to recognize the pigmented variant. We discuss the common variants of CEOT and potential histogenesis of the pigmented variant. Further studies are required to reveal the histogenesis of melanocytes and their pathological significance in the odontogenic tumors.

Pindborg tumor.

Calcifying epithelial odontogenic tumor (CEOT), also known as Pindborg tumor, is a rare odontogenic epithelial neoplasm. So far, nearly 200 cases have been reported in the literature. We are reporting a case of CEOT in a 42-year-old male patient with painless bony swelling in the mandible. The clinical, radiographic, and histopathologic features are discussed with relevant references.