Mandibular extrafollicular adenomatoid odontogenic tumor
Keywords:
adenomatoid odontogenic tumor, extrafollicular, mandible, periapical cyst.Abstract
Introduction: adenomatoid odontogenic tumor is a benign odontogenic tumor composed of odontogenic epithelium with mature fibrous stroma without ectomesenchymal involvement. It represents between 2 % and 7 % of these tumors. More than 90 % appear before age 30, with three clinical variants: follicular, extrafollicular and peripheral. Its clinical-radiographic aspect may vary, and it may be confused with other cystic or neoplastic lesions of the oral cavity, hence the need for an anatomo-pathological diagnosis.
Objective: present a case of mandibular extrafollicular adenomatoid odontogenic tumor.
Case presentation: afemale 12-year-old patient presents with asymptomatic left mandibular gum swelling, with no pathological antecedents of interest and an imprecise time of evolution. Physical examination found a round 1.5 cm swelling displacing the left mandibular gum between the lateral incisor and the canine. Radiography revealed a unilocular radiolucent lesion between teeth 42 and 43 expanding the cortical bone. The teeth involved showed no pulpal vitality. Upon reaching a clinical diagnosis of periapical cyst, surgical excision was performed and a sample was submitted to the Anatomical Pathology laboratory. The anatomo-pathological diagnosis was extrafollicular adenomatoid odontogenic tumor.
Conclusions: though more common in the maxilla, adenomatoid odontogenic tumors may also occur in the mandible. Clinical and radiological features may be similar to those of other odontogenic lesions, such as dentigerous cysts, other neoplasms and periapical inflammatory lesions; therefore, the final diagnosis should be provided by anatomo-pathological evaluation.
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