bromochloroacetic-acid and Mandibular-Neoplasms

Ameloblastic carcinoma is a malignant odontogenic neoplasm that has been reported only rarely in veterinary species. A 16-y-old Arabian crossbred mare was presented for evaluation of a hard mass on the body of the mandible, with evidence of osteolysis on radiographs. Incisional biopsies revealed an invasive neoplasm comprised of spindloid epithelial cells with a high mitotic count and partial dual cytokeratin-vimentin immunoreactivity. The horse was euthanized because of rapid tumor progression 3 mo after presentation. Postmortem evaluation revealed partial obliteration of the mandible by a large, firm-to-hard, tan, locally destructive and invasive mass with no gross or histologic evidence of metastasis. Postmortem histology revealed a poorly differentiated epithelial neoplasm with variably prominent features suggestive of odontogenic histogenesis: a plexiform ribbon architecture, infrequent basilar palisading with antibasilar nuclei, rare basilar cytoplasmic clearing, subepithelial matrix hyalinization, and partial dual cytokeratin-vimentin immunoreactivity. Features of malignancy included regions of necrosis, pronounced cellular atypia, a high mitotic count, extensive tissue invasion and local tissue destruction, and extension of neoplastic cells beyond the margins of the mandibular bone. Collectively, these features are most consistent with mandibular ameloblastic carcinoma. Including our case described here, ameloblastic carcinoma has been reported in only 5 horses. The microscopic features reported most consistently are dual cytokeratin-vimentin immunoreactivity, a high mitotic count, and basilar palisading. Ameloblastic carcinoma should be considered as a differential diagnosis for rapidly growing, locally invasive masses arising from the dentate jaw of horses.

Topics: Ameloblastoma; Animals; Carcinoma; Female; Horse Diseases; Horses; Keratins; Mandibular Neoplasms; Odontogenic Tumors; Vimentin

Keratocystic odontogenic tumor is an intraosseous benign tumor of epithelial origin that can appear as a unicystic or multicystic lesion. It is characterized most significantly by its high recurrence rate. This is why surgical removal is the chosen therapeutic approach in most cases. However, while surgery may be the safest technique to prevent recidivism, it may also result in numerous complications with large tumors. A number of authors have suggested a more conservative treatment for large keratocystic odontogenic tumors. The case examined in this article is that of a 48-year-old male patient who presented with a five-month swelling on the left side of his face, located in the mandibular area.

Topics: Anti-Infective Agents, Local; Chlorhexidine; Humans; Keratins; Male; Mandibular Neoplasms; Middle Aged; Odontogenic Cysts; Odontogenic Tumors; Therapeutic Irrigation

We present an uncommon case (female patient aged 59 years) of the clear-cell variant of calcifying epithelial odontogenic tumor (CEOT) (also known as Pindborg tumor) in the mandible. The clinical characteristics and probable origins of the clear tumor cells of previously reported cases of clear-cell variant of intraosseous CEOT are also summarized and discussed.

Topics: Biopsy; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Keratins; Mandibular Neoplasms; Middle Aged; Odontogenic Tumors; Radiography, Panoramic; Skin Neoplasms

Topics: Amyloid; Cell Nucleus; Collagen; Cytoplasm; Diagnosis, Differential; ErbB Receptors; Female; Follow-Up Studies; Humans; Immunohistochemistry; Keratins; Ki-67 Antigen; Mandibular Neoplasms; Membrane Proteins; Microscopy, Electron, Transmission; Middle Aged; Odontogenic Tumors; Proto-Oncogene Proteins c-bcl-2; Radiography, Panoramic; Skin Neoplasms; Tomography, X-Ray Computed; Tumor Suppressor Protein p53; Vimentin

To investigate for the first time the immunohistochemical and mutational status of β-catenin in a mandibular case of adenomatoid odontogenic tumor (AOT) and to review the immunohistochemical expression data of various markers (cytokeratins, metalloproteinases, etc) in such a lesion.. A case of follicular-type AOT in a young male patient was analyzed in regard to the immunohistochemical expression of β-catenin and mutations of the β-catenin gene (CTNNB1). Its expression is altered in some odontogenic tumors.. We found a strong cytoplasmic expression of β-catenin, but no molecular anomaly within the exon 3 of CTNNB1. β-catenin is considered to play a role in cell differentiation processes.. Our results were consistent with previous findings in ameloblastoma and malignant odontogenic tumors. However, β-catenin alterations had not been explored in AOT so far. Further studies are necessary to understand the specific regulation of β-catenin in the AOT pathogenesis.

Topics: Adenoma; Adolescent; beta Catenin; Cadherins; DNA Mutational Analysis; Extracellular Matrix Proteins; Humans; Keratins; Male; Mandibular Neoplasms; Matrix Metalloproteinases; Odontogenic Tumors

The aim of this review is to evaluate the principal clinical and conventional radiographic features of non-syndromic keratocystic odontogenic tumour (KCOT) by systematic review (SR), and to compare the frequencies between four global groups.. The databases searched were the PubMed interface of Medline and LILACS. Only those reports of KCOTs that occurred in a series of consecutive cases, in the reporting authors' caseload, were considered.. 51 reports, of 49 series of cases, were included in the SR. 11 SR-included series were in languages other than English. KCOTs affected males more frequently and were three times more prevalent in the mandible. Although the mean age at first presentation was 37 years, the largest proportion of cases first presented in the third decade. The main symptom was swelling. Over a third were found incidentally. Nearly two-thirds displayed buccolingual expansion. Over a quarter of cases recurred. Only a quarter of all SR-included reported series of cases included details of at least one radiological feature. The East Asian global group presented significantly as well-defined, even corticated, multilocular radiolucencies with buccolingual expansion. The KCOTs affecting the Western global group significantly displayed an association with unerupted teeth.. Long-term follow-up of large series that would have revealed detailed radiographic description and long-term outcomes of non-syndromic KCOT was lacking.

Topics: Africa South of the Sahara; Asia, Eastern; Chi-Square Distribution; Ethnicity; Europe; Humans; Keratins; Latin America; Mandibular Neoplasms; Maxillary Neoplasms; Neoplasm Recurrence, Local; Odontogenic Tumors; Radiography; Sex Ratio; United States

Topics: Ameloblastoma; Carcinosarcoma; Chemotherapy, Adjuvant; Child; Diagnosis, Differential; Fatal Outcome; Female; Follow-Up Studies; Humans; Keratins; Mandibular Neoplasms; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Radiotherapy, Adjuvant; Vimentin

We herein describe a rare case of a 48-year-old woman with both ossifying fibroma (OF) and keratocystic odontogenic tumor (KCOT) in the mandible. CT images showed a 15 × 15 × 20-mm radiolucent-radiopaque lesion with bucco-lingual bony expansion in the left first premolar equivalent area of the mandible, and a 15 × 40 × 35-mm well-defined unilocular radiolucent lesion in the left side of the mandible, extending from the distal side of the distal root of the left second molar to the left mandibular ramus. A biopsy of the radiolucent-radiopaque lesion and fenestration surgery of the radiolucent lesion were performed. Histopathologic examination revealed a fibro-osseous lesion (FOL) and a KCOT, respectively. CT was useful in diagnosing the radiolucent-radiopaque lesion as OF and for detecting the 3-dimensional bone expansion and the contents in the lumen of the KCOT.

Topics: Bicuspid; Biopsy; Connective Tissue; Contrast Media; Dental Cementum; Epithelium; Female; Follow-Up Studies; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Keratins; Mandibular Neoplasms; Middle Aged; Molar; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Odontogenic Tumors; Radiographic Image Enhancement; Radiography, Panoramic; Tomography, X-Ray Computed

Ewing's sarcoma (ES) is a malignancy primarily affecting bone tissue that is commonly diagnosed in adolescents and young adults. Its occurrence in the head and neck region is unusual and generally involves the mandible and maxilla. An extensive review of the literature shows only few cases of the oral ES in patients under the age of 5. This paper reports a rare case of ES of the mandible in a 4-year-old girl, which had been previously misdiagnosed and treated as a dental abscess. In the clinical examination, a hard immobile expansive mass of 5 cm in diameter was observed on the left side of the mandible. Radiographic examination revealed a radiolucent lesion with ill-defined borders and wide vestibular bone plate destruction. Microscopically, the tumor was composed by monotonous small round cells that exhibited immunoreactivity for CD99, vimentin and pancytokeratin. The patient was subjected to multiagent chemotherapy with ifosfamide, carboplatin, etoposide, vincristine, cyclophosfamide and doxorrubycin (VAC/ICE regimen). However, after the first chemotherapeutic cycle, the patient died due to disseminated infection. This case elucidates the importance of professional knowledge of the relevant aspects of malignant lesions such as ES.

Topics: 12E7 Antigen; Abscess; Antigens, CD; Antineoplastic Combined Chemotherapy Protocols; Cell Adhesion Molecules; Child, Preschool; Diagnostic Errors; Fatal Outcome; Female; Humans; Keratins; Mandibular Neoplasms; Sarcoma, Ewing; Tomography, X-Ray Computed; Tooth Diseases; Vimentin

Dentinogenic ghost cell tumor (DGCT) is a rare neoplasm, representing 1.9% to 2.1% of all odontogenic tumors. Few cases of DGCT have been reported and only 11 show no bone involvement. A rare case of peripheral DGCT is reported, located in the anterior mandible of a 45-year-old man. The patient presented a slow painless growth in the canine region of an edentulous mandible. Radiographically, no bone involvement was registered. The lesion was enucleated and microscopically characterized by islands of epithelial cells showing ameloblastomalike features in fibrous tissue. Dysplasic dentin and ghost cells were frequently observed. Areas showing a connection between tumor cells and the overlying mucosa were also identified. Immunohistochemical analysis demonstrated positivity for pan-cytokeratin, cytokeratin-14, and 2 neural markers. Denditric cells (Langerhans cells and melanocytes) were identified inside tumoral islands. A rare case of peripheral DGCT is reported, with immunohistochemical analysis and a review of the English literature.

Topics: Dental Arch; Dentin; Dentin Dysplasia; Humans; Jaw, Edentulous; Keratin-14; Keratins; Langerhans Cells; Male; Mandibular Neoplasms; Melanocytes; Middle Aged; Odontogenic Tumors; S100 Proteins

Peripheral odontogenic fibroma is a rare lesion that arises on the gingiva and can clinically mimic a variety of reactive lesions, benign neoplasms, and metastases. We describe a symptomatic lesion arising on the mandibular gingiva of a 58-year-old female with no history of trauma or dental disease in the area. An excisional biopsy showed the lesional stroma to contain numerous polyhedral granular cells with occasional interspersed islands of inactive odontogenic epithelium. We believe this to represent the fourth case of peripheral granular cell odontogenic fibroma to be reported in detail in the literature.

Topics: Female; Fibroma; Gingival Neoplasms; Granular Cell Tumor; Humans; Keratins; Mandibular Neoplasms; Middle Aged; Odontogenic Tumors

The clear cell odontogenic carcinoma (CCOC) is a rare, locally infiltrative neoplasm with a marked tendency for local recurrence and regional lymph node metastasis. The first description in 1985 included three cases of destructive jaw lesions. The entity was described as a clear cell odontogenic tumour in the previous WHO classification due to the fact that rarity of the lesion restricting pathologists to understand the spectrum of the degree of malignancy. These tumours have a peak incidence in the 5th-7th decades. CCOC tends to occur more frequently in the mandible, with a female predilection. The most striking histological feature is of large islands and strands of uniform cells with round or ovoid nuclei and clear cytoplasm. Presently we describe a case of clear cell odontogenic carcinoma in a 52-year-old female who presented with a bony-hard lump in the left body of the mandible. The patient is free of any recurrence after 2 years of follow-up.

Topics: Adenocarcinoma, Clear Cell; Cell Nucleus; Cytoplasm; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Keratins; Mandibular Neoplasms; Middle Aged; Mucin-1; Odontogenic Tumors

Keratoameloblastoma is an extremely rare variant of ameloblastoma, and a review of the English language literature yields only several documented cases of ketatoameloblastoma. This paper reports a keratoameloblastoma showing unique histological architecture. The patient was a 76-year-old Japanese man with a multilocular radiolucent lesion of the mandible extending from the left canine to the second molar area. Microscopically, the lesion was characterized by multicystic spaces lined by papillary projections of proliferating odontogenic epithelium with extensive surface parakeratinization in a lamellar accumulation of keratin. In addition, "hair-like" extensions of keratin were frequently found. There was no ghost cell type keratinization. Histological features of the odontogenic epithelium were similar to those of conventinal ameloblastoma. An additional prominent feature of the present ameloblastoma was formation of hard tissue in continuation, in part, of the accumulated keratin in the fibrous tissue. These hard tissues showed a woven bone- or cellular cementum-like appearance and were not in contact with odontogenic epithelium. The present case was finally diagnosed as "keratoa meloblastoma," although such a type of keratoameloblastoma has not been documented previously in the spectrum of ameloblastoma.

Topics: Aged; Ameloblastoma; Humans; Keratins; Male; Mandibular Neoplasms; Radiography

The neoplastic variant of calcifying odontogenic cyst has various designations, and its malignant counterpart has been reported as aggressive epithelial odontogenic ghost cell tumor or odontogenic ghost cell carcinoma. We present a case of odontogenic ghost cell carcinoma with reference to the relation between the ghost cells and apoptosis. A 33-year-old man complained of a mandibular mass. The mass occupied the entire right side of the mandible with destruction of both buccal and lingual bone. The mass also infiltrated into submandibular and sublingual spaces. Histologically, the mass was composed of a solid proliferation of hyperchromatic and pleomorphic epithelial cells with abnormal mitoses. Islands of ghost cells were frequently admixed with nucleated cells, and there were foci of ameloblastic differentiation. Immunohistochemical stains for cytokeratins, involucrin, and apoptosis-related proteins such as Bcl-2, Bcl-X(L), and Bax were done. Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling (TUNEL) assay was also performed. The nucleated cells adjacent to the ghost cells expressed cytokeratins and involucrin, but the ghost cells had no reaction. Bcl-2 was negative. Both Bcl-X(L) and Bax were demonstrated in the nucleated cells adjacent to the ghost cells. The ghost cells exhibited Bax protein. Some nucleated cells adjacent to the ghost cells were positive with TUNEL assay. The above results indicate that ghost cells undergo abnormal terminal differentiation as an apoptotic process.

Topics: Adult; Apoptosis; Cell Differentiation; Cell Nucleus; DNA, Neoplasm; Humans; Immunohistochemistry; In Situ Nick-End Labeling; Keratins; Male; Mandibular Neoplasms; Odontogenic Tumors; Terminology as Topic

Topics: Adolescent; Female; Granuloma, Giant Cell; Humans; Immunohistochemistry; Keratins; Mandible; Mandibular Diseases; Mandibular Neoplasms; Odontogenic Tumors

Topics: Adult; Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; Humans; Keratins; Male; Mandibular Diseases; Mandibular Neoplasms; Neoplasm Invasiveness; Odontogenic Cysts

The aim of this article is to present a case of primary neuroendocrine tumor (typical carcinoid) of the mandible that occurred in a 46-year-old black woman who was seropositive for the human immunodeficiency virus. Radiologically the lesion presented as a poorly circumscribed honeycomb radiolucency that extended from tooth 21 to the ascending ramus. Histologically the tumor cells were variously arranged in small islands, trabeculae, follicles, and slitlike spaces lined by a single layer of palisaded low-columnar cells. The follicles contained an eosinophilic colloid-like substance. Immunocytochemical staining showed diffuse, intense positivity for MAK 6, pancytokeratin, S-100, and neuron-specific enolase and focal, intense, positive staining for chromogranin A. Electron microscopy showed the presence of interdigitating cell membranes, rudimentary cell attachments, and varying numbers of membrane-bound dense core granules. Special investigations failed to reveal a primary tumor, and no metastases were found. Urine and hematologic assessment did not show any evidence of functional activity. The tumor was resected, and no recurrence or spread has been seen for 2 years. Origin from foregut-derived, immature, and functionally uncommitted endocrine cells is presumed.

Topics: Carcinoid Tumor; Cell Lineage; Cell Membrane; Chromogranin A; Chromogranins; Colloids; Cytoplasmic Granules; Eosinophils; Female; HIV Seropositivity; Humans; Immunohistochemistry; Intracellular Membranes; Keratins; Mandibular Neoplasms; Microscopy, Electron; Middle Aged; Phosphopyruvate Hydratase; Radiography; S100 Proteins

A rare case of clear cell odontogenic carcinoma was investigated using histochemical and immunohistochemical methods. The tumor occurred in the anterior mandible of a 69-year-old Japanese man. Histologically, the tumor was composed mostly of large clear cells and squamous cells. Columnar-shaped cells with basophilic nuclei polarized away from the basement membrane were observed at the periphery of the tumor foci. The tumor cells had aggressively invaded muscle and perineural tissues. The tumor cells were positive for PAS staining. Immunohistochemically, tumor cells reacted positively to keratin, cytokeratin19, epithelial membrane antigen, and S-100 protein. The tumor was diagnosed as a clear cell odontogenic carcinoma. Its characteristics are discussed in term of its histopathological, histochemical and immunohistochemical features.

Topics: Aged; Basement Membrane; Cell Nucleus; Coloring Agents; Facial Muscles; Histocytochemistry; Humans; Immunohistochemistry; Keratins; Male; Mandibular Neoplasms; Mandibular Nerve; Mucin-1; Neoplasm Invasiveness; Odontogenic Tumors; S100 Proteins

Six cases of squamous cell carcinoma arising in the head and neck of patients infected with the human immunodeficiency virus are described. This article reports the first two cases of primary intraosseous squamous cell carcinoma associated with infection with human immunodeficiency virus. Clinical presentation, results of imaging studies, histologic characteristics, therapies applied, and the clinical follow-up are described in detail for each of the six cases. These data are evaluated through a review of the current literature.

Topics: Acquired Immunodeficiency Syndrome; Adult; Biomarkers, Tumor; Carcinoma, Squamous Cell; CD4-CD8 Ratio; Female; Head and Neck Neoplasms; HIV Infections; Humans; Immunocompromised Host; Keratins; Male; Mandibular Neoplasms; Middle Aged; Mouth Neoplasms

The histologic classification for odontogenic carcinomas is still under revision; thus, the differentiation between the terms "malignant ameloblastoma" and "ameloblastic carcinoma" has not been definitely stated. Nevertheless, it is recommended to reserve the former for those lesions that, in spite of an apparently innocuous histology, have given origin to metastatic growths, and to apply the latter for those ameloblastomas in which there is histologic evidence of malignancy in the primary, recurrent or metastatic lesions. A case of an ameloblastic carcinoma in the mandible is presented. Histologically, it was characterized by areas with features of a typical ameloblastoma and areas with anaplastic appearances.

Topics: Ameloblastoma; Carcinoma; Cell Nucleolus; Cell Nucleus; Collagen; Cytoplasm; Humans; Keratins; Male; Mandibular Neoplasms; Middle Aged; Neoplasm Recurrence, Local

To investigate the clinical features, pathologic manifestations, and biologic behaviors of a variant of ameloblastoma with basal cell features (AM-BC).. Following retrospective review of the clinical and pathological data of six cases of AM-BC, we described their histological and immunohistochemical (IHC) features and discussed the biologic behaviors, prognoses, pathogenesis, and clinical relevance of AM-BC. Direct sequencing of polymerase chain reaction products was also performed in all cases.. The six cases of AM-BC involved four women and two men, aged 22-82 years. Four lesions occurred in the maxilla and two in the mandible. Histologically, the basal cells tended to be arranged as unequally sized follicles, strands, or cords of odontogenic epithelium in the connective tissue stroma. Little or no stellate reticulum was present in the central portion of the nest. Expression of CKs was consistent with other histological variants of ameloblastoma (AM), but AM-BC had significantly higher p53 and Ki-67 (p < 0.05) labeling indices than other histological variants of AM. Two patients had BRAF gene mutations.. Ameloblastoma with basal cell features is a very rare variant of AM. Our study showed the differences and relationships that exist between AM-BC and other variants of AM, which could enhance understanding of AM-BC.

Topics: Adult; Aged, 80 and over; Ameloblastoma; Female; Humans; Immunohistochemistry; Keratins; Ki-67 Antigen; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Mutation; Proto-Oncogene Proteins B-raf; Proto-Oncogene Proteins p21(ras); Retrospective Studies; Smoothened Receptor; Tumor Suppressor Protein p53; Young Adult

Myoepithelial carcinomas are quite infrequent neoplasms and coupled with their diverse morphological appearance are interesting as far as diagnosis and management is concerned. They account for less than 1% of all salivary gland tumors. The variable morphologic appearance of myoepithelial carcinoma leads to a wide differential diagnosis, including primary salivary gland tumors and metastatic tumors. The prognosis of these tumors is not fair as they are locally aggressive and approximately one third of the patients die of the pathology. We report a case of clear cell variant of myoepithelial carcinoma in an unusual location, i.e. the upper lip. The treatment carried out was wide surgical resection. The patient was followed up for 2 years and was symptom free. The clear cell variant of myoepithelial carcinoma is extremely rare and only about 51 cases of this variant affecting the salivary glands have been reported worldwide so far.

Topics: Actins; Calcium-Binding Proteins; Calponins; Female; Humans; Keratins; Lip Neoplasms; Mandibular Neoplasms; Microfilament Proteins; Middle Aged; Myoepithelioma; Neoplasm Invasiveness; Neprilysin; Sarcoma, Clear Cell

Keratoameloblastoma is an extremely rare odontogenic tumor, as only 18 cases have been reported in the literature.. The authors report a case of keratoameloblastoma in a 32-year-old woman and review the literature concerning the clinical features, radiological appearance, histopathological findings and treatment options.. Keratoameloblastoma is a rare tumor observed more frequently in males (sex ratio: 3:1) characterized by extensive keratin production in odontogenic islets and fibrous stroma.

Topics: Adult; Ameloblastoma; Diagnosis, Differential; Female; Humans; Keratins; Mandibular Neoplasms; Plastic Surgery Procedures; Radiography, Panoramic; Treatment Outcome

Synovial sarcoma (SS) is extremely rare in the jaws, and only 8 cases have been reported worldwide. The specific aims of this study were to report 15 cases of primary intraosseous SS (PISS) and analyze the histologic features and outcome-related prognostic factors.. Data from patients diagnosed with PISS from 2004 to 2013 were collected in this retrospective study. Patient characteristics (primary location, histologic subtype, tumor size, and surgical margin) were defined as predictor variables. Local recurrence and tumor-related death were outcome variables. The association of tumor-related outcomes with patient characteristics was analyzed using Kaplan-Meier and Cox regression statistics. Other clinical and pathologic characteristics were summarized as a third category of variables for further analysis.. This study examined 15 cases (women, n = 10; men, n = 5) with a mean age at diagnosis of 35 years. There was no imbalance in the distribution of primary SS locations (maxilla, n = 7; mandible, n = 8). Six patients (40%) developed local recurrence and 4 patients (26.7%) had a tumor-related death. The 5-year local recurrence-free survival (LRFS) and overall survival rates were 57% and 69.1%, respectively. The strong statistical association of surgical margin with 5-year LRFS rate was shown by univariate (P = .01) and multivariate (hazard ratio = 7.598; P = .028) analyses.. PISS is extremely rare in the jaw. Immunohistochemical analysis played an important role in the diagnosis of PISS. The surgical margin showed a strong association with local recurrence. Thus, ideal surgical margins should be achieved during surgery to obtain better local control.

Topics: 12E7 Antigen; Adolescent; Adult; Antigens, CD; Cause of Death; Cell Adhesion Molecules; Female; Humans; Immunohistochemistry; Keratins; Lymphatic Metastasis; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Mucin-1; Neck Dissection; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Plastic Surgery Procedures; Prognosis; Proto-Oncogene Proteins c-bcl-2; Retrospective Studies; Sarcoma, Synovial; Survival Rate; Vimentin; Young Adult

Topics: Biopsy; Diagnosis, Differential; Epithelium; Follow-Up Studies; Humans; Keratins; Male; Mandibular Diseases; Mandibular Neoplasms; Middle Aged; Odontogenic Cysts; Odontogenic Tumors; Radiography, Panoramic

There is increasing evidence that overexpression of cyclooxygenase-2 (COX-2) plays an important role in tumour growth and spread of tumours by interfering with cell proliferation, cellular adhesion, immune surveillance, apoptosis, and angiogenesis. COX-2 levels are increased in various tumours. In this study, the expression of COX-2 in 116 specimens of keratocystic odontogenic tumours (KCOT) has been analyzed. KCOT is a benign neoplasm of odontogenic origin with an occasionally aggressive behavior leading to high recurrence rates. Formalin-fixed, paraffin-embedded blocks were sectioned and used for hematoxylin-eosin (H&E) staining and incubated with an anti-COX-2 monoclonal antibody for immunohistochemical examination. Detection of the COX-2 antibody was performed with the EnVision kit. Cellular staining pattern for COX-2 was cytoplasmatic, and the staining intensities were semi-quantitatively evaluated as follows: negative (-), mild (±) or strong (+). Mild to strong expression of COX-2 was observed in 83 (71.6%) cases; 34 (29.3%) of which were mild positive and 49 (42.2%) were strong positive. COX-2 stain was detected mainly in the epithelial lining. The expression of COX-2 in KCOT and the current knowledge of the role played by COX-2 in tumorigenesis further strengthen the current concept that the KCOT should be regarded as a neoplasm. Furthermore, the multitude of markers known to be overexpressed in KCOTs is suggestive of what could be called a 'network addiction' pattern, rather than a pathological mechanism dependant on a specific activated/suppressed gene, thus explaining its aggressive behavior.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Chi-Square Distribution; Child; Cyclooxygenase 2; Female; Humans; Keratins; Male; Mandibular Neoplasms; Middle Aged; Neoplasm Invasiveness; Odontogenic Tumors; Retrospective Studies; Statistics, Nonparametric; Young Adult

The aim of this study was to describe the clinicopathologic and immunohistochemical characteristics of 14 cases of central odontogenic fibroma (COF), and the ultrastructural features of 2 of them.. Collaborative retrospective study based on the records of 4 oral pathology diagnostic services in Latin America based on the current World Health Organization classification.. There were 7 male and 7 female patients (mean age 31.8 years). Eight tumors occurred in the maxilla and 6 in the mandible. Thirteen cases were epithelium-rich and 1 epithelium-poor COF. Three were classified as hybrid COF with giant cell lesion. Mean size of the hybrid lesions were larger than pure COF (3.8 vs. 2.4 cm). Odontogenic epithelial islands were immunoreactive for cytokeratin (CK) AE1/AE3, CK5, CK14, CK19, and 34BE12 and negative for CK1 and CK18. Langerhans cells positive for S-100 and CD1a were found within the epithelial islands in 6/6 tested cases. CD68 was expressed in the giant cells of the hybrid lesions and in a few mononuclear cells of 2 cases of COF. Ki-67 index was <1% in all cases. In 6 tumors (42.8%), there were small globular eosinophilic droplets within the epithelial islands, which were positive for collagen type IV, and 9/13 cases (69.2%) were focally positive for smooth muscle actin. In addition to fibroblasts, myofibroblastic differentiation was found in the 2 cases studied ultrastructurally.. Immunohistochemistry was useful to confirm the presence of epithelium and to exclude other central fibrous tumors. COF also contains a variable number of mast cells, Langerhans cells, and myofibroblasts, and further studies are needed to better understand the participation of these cells in COF histogenesis.

Topics: Adolescent; Adult; Epithelium; Female; Fibroma; Humans; Immunohistochemistry; Keratins; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Odontogenic Tumors; Retrospective Studies; Ultrasonography; Young Adult

Adenomatoid odontogenic tumour (AOT) is a benign tumour of odontogenic origin. The differential diagnosis of AOT is crucial in terms of surgical management. The 23-year old male patient presented in this case study was referred to the maxillofacial surgery clinic due to the incidental radiological finding of a large osteolytic lesion of the anterior mandible with a retained permanent canine at the base of the bone. Ultrasound imaging revealed the anterior surface of the tooth inside the lesion, indicating extreme thinning of the maintained cortical bone and liquid filling of the cystic lesion. Surgery revealed a bone defect with a deformed, incomplete tooth inside a granulation-like soft tissue. The tooth was extracted and the soft tissues were excavated. Healing was uneventful. Radiographic and physical investigations during long-term follow-up demonstrated complete bone remodeling. Some areas of the tumour were alpha-smooth-muscle-actin positive, indicating a myoepithelial differentiation. Differential diagnosis of AOT to other odontogenic tumours, such as ameloblastoma, is crucial for therapy. Exact morphological diagnosis avoids extensive ablative surgery.

Topics: Actins; Adult; Bone Remodeling; Cell Differentiation; Cell Membrane; Epithelium; Humans; Immunohistochemistry; Keratins; Male; Mandibular Neoplasms; Muscle, Smooth; Odontogenic Tumors

Nevoid basal cell carcinoma syndrome (NBCCS) is a rare autosomal dominant disorder characterized by developmental abnormalities and a predisposition to cancers. Although multiple jaw tumors, such as keratocystic odontogenic tumors (KCOTs), are one of the most frequent complications in NBCCS, the molecular mechanism for how KCOTs develop in NBCCS is poorly understood. A 15-year-old girl with 2 jaw tumors was diagnosed as NBCCS according to the clinical criteria. The pathologic findings indicated that the 2 tumors were consistent with KCOTs. A PTCH1 mutation, c.1472delT, was detected in her peripheral blood as well as in the 2 tumors. Interestingly, an additional PTCH1 mutation, c.264_265insAATA, that was not present in the peripheral blood, was found in the maxillary tumor but not the mandibular tumor. The Ki-67 labeling index was significantly higher in the maxillary KCOT (17.7%) than in the mandibular KCOT (14.3%). These findings indicate distinct molecular mechanisms of tumorigenesis in these KCOTs.

Topics: Adolescent; Basal Cell Nevus Syndrome; Cyclin D1; DNA Mutational Analysis; Female; Humans; Immunohistochemistry; Keratins; Ki-67 Antigen; Mandibular Neoplasms; Maxillary Neoplasms; Odontogenic Tumors; Patched Receptors; Patched-1 Receptor; Receptors, Cell Surface

Topics: Carcinoma, Squamous Cell; Diagnosis, Differential; Female; Gingival Neoplasms; HIV Infections; Humans; Keratins; Mandibular Neoplasms; Middle Aged

Topics: Adult; Diagnosis, Differential; Follow-Up Studies; Humans; Infant; Keratins; Male; Mandibular Neoplasms; Melanoma; Neuroblastoma; Neuroectodermal Tumor, Melanotic; Rhabdomyosarcoma, Embryonal; Synaptophysin

Primary intraosseous salivary gland tumors of the mandible are rare, with mucopidermoid carcinoma being the most frequent, followed by adenoid cystic carcinoma (ACC). We present a case of a central ACC involving the mandible of a 46-year-old man. He presented an indurated swelling on the vestibular aspect of the left mandibular body and ipsilateral paraesthesia of the lower lip. A panoramic radiography revealed a large radiolucent area, with irregular margins, involving the body and ramus of the left mandible, and CT scan confirmed that the lesion was confined within the mandibular bone. The histopathological features were of an ACC. CT scan also revealed multiple nodular lesions in both lungs suggestive of metastases. The patient was surgically treated by hemi-mandibulectomy. The patient is well with no evidences of recurrences in the mandible. The present case shows that the clinical and immunohistochemical profile of primary intraosseous ACC is similar to what is found in ACC involving the salivary glands.

Topics: beta Catenin; Cadherins; Carcinoma, Adenoid Cystic; Humans; Keratins; Male; Mandible; Mandibular Neoplasms; Middle Aged; Radiography; Treatment Outcome; Vimentin

Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor associated with aggressive clinical behavior, metastasis, and low survival. We report a case of CCOC affecting the mandible of a 39-year-old man. The tumor presented a biphasic pattern composed of clear cell nests intermingled with eosinophilic cells and separated by collagenous stroma. Immunoreactivity to cytokeratin (CK), specifically AE1/AE3 and CK 8, 14, 18, and 19 was found, as well as to epithelial membrane antigen (EMA). The tumor cells were negative for S100 protein, CK 13, vimentin, smooth muscle actin, laminin and type IV collagen. Low labeling indices for the proliferation markers Ki-67 and proliferating cell nuclear antigen and to p53 protein might predict a favorable prognosis for the lesion. A surgical resection was performed, followed by adjuvant radiotherapy. A 2-year follow-up has shown no signs of recurrence. The significance of histochemical and immunohistochemical resources in the correct diagnosis of CCOC is analyzed.

Topics: Adenocarcinoma, Clear Cell; Adult; Humans; Keratins; Male; Mandibular Neoplasms; Mucin-1; Odontogenic Tumors

Ghost cell odontogenic carcinoma is a rare neoplastic variant of calcifying odontogenic cyst, with aggressive growth characteristics. A painful swelling in the jaws with local paraesthesia is the most common symptom. Although it often causes irregular destruction of the adjacent bone, immunohistochemical expression of tartrate-resistant acid phosphatase (TRAP) and vitronectin receptor has not previously been described in this carcinoma.. This article describes a ghost cell odontogenic carcinoma affecting the mandible of a 55-year-old man. The patient was treated by segmental mandibulectomy and there was no evidence of recurrence or metastasis for 1.8 years. Cytological features including the immunohistochemical expression of TRAP and vitronectin receptor were studied.. Specimens revealed varying sized islands of anucleate cell clusters with homogenous, pale eosinophilic cytoplasm, so called ghost cells, admixed with sheets of tumour. TRAP and vitronectin receptor were detected in the ghost cells, but they were not expressed in the tumour cells. Our findings suggest that some of the cytokines produced by ghost cells may play important roles in causing extensive bone resorption in the ghost cell odontogenic carcinoma.

Topics: Acid Phosphatase; Biomarkers, Tumor; Bone Resorption; Cytoplasm; Follow-Up Studies; Humans; Immunohistochemistry; Integrin alphaVbeta3; Isoenzymes; Keratins; Male; Mandibular Neoplasms; Middle Aged; Odontogenic Cyst, Calcifying; Osteoclasts; Tartrate-Resistant Acid Phosphatase

To investigate the clinicopathological characteristics and biologic behaviour of epithelioid hemangioendothelioma in the oral cavity.. The clinical features and pathological findings of nine cases with intraoral epithelioid hemangioendothelioma were reviewed, including immunohistochemistry study.. This series comprised seven males and two females aged 6-53 years (mean 28 years). The sites of the tumour included the tongue (n = 4), lip (n = 1), the gingiva and alveoli of the maxilla (n = 1), the gingiva and alveoli of the mandible (n = 1), buccal mucosa (n = 1), and the floor of the mouth (n = 1). A painless solitary mass was the most common presentation and was found in eight cases. On pathology, the tumour grew in short strands, cords or nests of polygonal to slightly spindled epithelioid cells in fibro-myxoid stroma, with formation of intracytoplasmic lumina. Tumour cells were immunoreactive to CD34, FVIIIRAg, and vimentin. Focal-positive cytokeration were observed in three cases. Immunoreactivity for S-100 protein, epithelial membrane antigen (EMA) and human herpesvirus (HHV)-8 was negative in all cases. Two cases recurred after surgical excision, but no patient developed local or distant metastasis.. Wide local excision with long-term follow-up seems to be the treatment of choice for intraoral epithelioid hemangioendothelioma because of their unpredictable biological behaviour and recurrence potential.

Topics: Adolescent; Adult; Antigens, CD34; Child; Female; Gingival Neoplasms; Hemangioendothelioma, Epithelioid; Herpesvirus 8, Human; Humans; Keratins; Lip Neoplasms; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Mouth Floor; Mouth Mucosa; Mouth Neoplasms; Mucin-1; Neoplasm Recurrence, Local; Retrospective Studies; S100 Proteins; Tongue Neoplasms; Vimentin; von Willebrand Factor

Although it has been reported that ghost cells are present in odontomas, the generation mechanism of these cells is unclear. To evaluate the presence of ghost cells and involvement of the Wnt signaling pathway, we examined the expression of hard keratins, beta-catenin and Lef-1 in odontomas.. Sixty-nine cases of odontoma were examined immunohistochemically with the use of antibodies against human hair proteins, beta-catenin and Lef-1.. Expression of hard keratins was found only in the cytoplasm of ghost cells in 46 (66.7%) of the 69 odontomas. Compound odontomas (78.8%) showed a higher incidence of ghost cells than complex odontomas (29.4%). Histopathologically, ghost cells were found within odontogenic epithelium adjacent to immature enamel and in the centre of Liesegang-ring-like calcified materials. Expression of beta-catenin and Lef-1 was observed in the cytoplasm and nucleus of odontogenic epithelial cells adjacent to the ghost cells in immature odontomas.. These findings suggest that odontoma is a hard keratin-expressing tumor-like lesion, and that the Wnt signaling pathway may be involved in the formation of ghost cells in odontomas.

Topics: Adolescent; Adult; Aged; beta Catenin; Cell Nucleus; Child; Child, Preschool; Cytoplasm; Dental Enamel; Epithelium; Female; Humans; Keratins; Lymphoid Enhancer-Binding Factor 1; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Odontoma; Signal Transduction; Wnt Proteins

The term synovial sarcoma was first proposed for the histologically well defined entity by Knox in 1936. The name was proposed due to the fact that at least the cases reported in the early part showed some resemblance of the tumour to normal synovial tissue histologically. Thereafter, tumours have been diagnosed from areas without synovial tissue. The diagnosis of monophasic tumours can be difficult and immunostains appear to be a good diagnostic tool in those cases. The occurrence in the mandible is extremely rare. This is a case of synovial sarcoma arising in the condyle involving most of the ramus. The tumour was diagnosed as synovial sarcoma with predominant spindle cell component by correlation of histopathology with immunostains (cytokeratin, epithelial membrane antigen, actin and desmin). The patient has been treated with surgery and radiotherapy.

Topics: Actins; Adult; Desmin; Female; Follow-Up Studies; Humans; Keratins; Mandibular Condyle; Mandibular Neoplasms; Mucin-1; Sarcoma, Synovial

The case describes a 38-year-old woman presenting a multilocular radiolucency affecting the entire right half of the lower jaw, with an unerupted third molar displaced to the region of the coronoid process. The histological study showed the presence of fibroblasts, focally with pleomorphic nuclei, dense collagen and an odontogenic epithelium with dystrophic calcifications. A cyst with an important inflammatory infiltrate was, moreover, observed.

Topics: Adult; Female; Fibroma; Humans; Keratins; Mandibular Neoplasms; Membrane Proteins; Odontogenic Tumors; Radiography; Recurrence; Sex Distribution

Three cell systems (MINT1/2/3) derived from a melanotic neuroectodermal tumor of infancy (MNTI) arising in the mandible of a 1-month-old newborn boy have been established, and their cytological natures have been characterized. The cells had immunopositivities for pan-keratin, vimentin, neuron-specific enolase, S-100 protein and melanoma-associated antigen (HMB-45). These immunohistochemical phenotypes were basically the same as those observed in tissue sections, in which, synaptophysin, myelin basic protein, c-myc gene products, carcinoembryonic antigen, and epithelial membrane antigen were also immunolocalized in tumor cells. Karyotyping analyzes revealed that the chromosome numbers of the three cell systems ranged from 60 to 67 with 3n ploidies, and that there were many structural aberrations, such as del(11)(q13), del(22)(q13), add(2)(p11), add(7)(q22), extra copies for chromosomes 1, 2, 3, 5, 7, 9, 10, 11, 12, 16, 20, and 22, der(9)t(9;13)(p13;q12)add(9)(q34), and der(13;21)(q10;q10), which were shared by the three cell systems, while der(19)t(11;19)(q13;p13) was found in MINT1 and MINT3. When stimulated by endothelin-3 and vitamin D(3), the cells had spinous cell shapes with immunopositivities for HMB-45, neurofilament protein and glial fibrillary acidic protein, which indicated more neural differentiation. The established cell systems will be useful for further investigation on the molecular and genetic basis of MNTI to understand its pathogenesis, which is largely unknown.

Topics: Animals; Antigens, Neoplasm; Carcinoembryonic Antigen; Cell Differentiation; Cell Line, Tumor; Cholecalciferol; Chromosome Aberrations; Endothelin-3; Female; Fluorescent Antibody Technique; Humans; Immunohistochemistry; Infant, Newborn; Karyotyping; Keratins; Male; Mandibular Neoplasms; Melanoma-Specific Antigens; Mice; Mice, Inbred BALB C; Mice, Nude; Mucin-1; Myelin Basic Protein; Neoplasm Proteins; Neoplasm Transplantation; Neoplasms, Experimental; Neuroectodermal Tumor, Melanotic; Phosphopyruvate Hydratase; Proto-Oncogene Proteins c-myc; S100 Proteins; Transplantation, Heterologous; Vimentin

Adenomatoid Odontogenic Tumour (AOT) is a relatively uncommon odontogenic lesion and few studies describing its cytokeratin profile have been reported in the English-language literature. Thirty-nine cases of AOT from three Oral Diagnosis services (Brazil, Mexico and Guatemala) were studied, considering their clinical, radiographic, and histological features and immunohistochemical expression of cytokeratins (AE1/AE3, 34betaE12, CK1, CK5, CK6, CK7, CK8, CK10, CK13, CK14, CK16, CK18, and CK19), vimentin and Ki-67. Sixty five percent of cases affected women, anterior maxilla was the preferred site and radiographically most cases showed unilocular radiolucency with well defined sclerotic borders. Calcifying epithelial odontogenic tumour (CEOT)-like areas were found in 36 out of 39 cases, and 10 cases showed positivity for Congo red in polarized light. All cases were positive for AE1/AE3, 34betaE12, CK5, CK14 and CK19. CEOT-like areas were negative for CK 19. Vimentin was also expressed in 27 cases and this profile may indicate the existence of a variable phenotype in certain areas of the tumour. There were no recurrences after surgical treatment, and this can be related to the low proliferative activity observed in all cases with Ki-67 marker.

Topics: Adolescent; Adult; Biomarkers, Tumor; Child; Child, Preschool; Female; Humans; Keratins; Male; Mandibular Neoplasms; Maxillary Neoplasms; Odontogenic Tumors

A rare case of mucinous adenocarcinoma with neuroendocrine differentiation of the mandibular ramus is presented. The patient, an 80-year-old man, was referred to our hospital with chief complaint of swelling and pain in the left buccal mucosa. CT and MRI examination showed an osteolytic tumor mass occupying the upper region of the left mandibular ramus. Macroscopically, the excised tumor was a relatively well-defined, solid mass with diffuse bone resorption, measuring 3 cm x 3.2 cm x 3 cm. Microscopical examination showed that the tumor forming glandular structures with abundant mucous production and high cellular atypia. Immunohistochemical studies demonstrated the positive reactivities for pan-keratin, cytokeratin 7, vimentin,alpha-amylase, alpha-smooth muscle actin, neuron-specific enolase, glial fibrillary acid protein, calcitonin, and somatostatin in tumor cells. These findings suggested that the tumor was originated from heterotopic or misplaced salivary gland in the mandible.

Topics: Actins; Adenocarcinoma, Mucinous; Aged; Aged, 80 and over; alpha-Amylases; Calcitonin; Glial Fibrillary Acidic Protein; Humans; Keratin-7; Keratins; Male; Mandibular Neoplasms; Neurosecretory Systems; Osteolysis; Phosphopyruvate Hydratase; Somatostatin; Vimentin

A case of odontogenic ghost cell tumour (OGCT) with clear cell components was encountered in the mandible of a 63-year-old man. The tumour revealed ameloblastomatous-type epithelial components accompanied by clusters of ghost cells and dentinoid juxtaposed to the odontogenic epithelium. In addition, some areas of the tumour tissue showed sheets and islands of clear, glycogen containing epithelial cells, which were separated by a thin fibrous connective tissue stroma. Both ameloblastic and clear cells exhibited positive immunoreactivities for cytokeratin 19 and AE1/3. It is not known whether this tumour represents a clear cell change of a pre-existing OGCT or a separate and distinct neoplasm derived de novo from the odontogenic epithelium. This tumour was given the term 'clear cell OGCT' because it captures the clear cell components, which is one of the most prominent distinguishing features of the tumour.

Topics: Diagnosis, Differential; Humans; Keratins; Male; Mandibular Neoplasms; Middle Aged; Mouth Floor; Odontogenic Tumors

Malignant mesothelioma is a rare tumor arising from the pleura or peritoneum. Distant hematogenous metastasis is seen in more than half of cases, preferentially to the brain, lung, bone and soft tissues [Br. J. Dis. Chest 70 (1976) 246]. There has been only one previous report of this tumor metastasizing to the jaw bone [Pathologica 92 (2000) 273].

Topics: Diagnosis, Differential; Humans; Keratins; Male; Mandibular Neoplasms; Mesothelioma; Middle Aged; Pleural Neoplasms; Radicular Cyst; Vimentin

The purpose of this study was to investigate a case of calcifying odontogenic cyst (COC) in which numerous calcifications were observed not only in the lining epithelium, but also in the cyst wall, using cytokeratins 13 (CK13), 19 (CK19), and core binding factor a-1 (cbfa-1) as primary antibodies. Cells of Malassez's epithelial rest were stained as controls. Cells of the epithelial nests in the cyst wall were reactive for CK13, but their CK19 staining was similar to that observed in the lining epithelial cells. Calcifying nodules were reactive only for CK13. Cells of Malassez's epithelial rest were reactive for CK19 but not for CK13. Cbfa-1 positive reactivity was observed only in nuclei of spindle cells in the periodontal ligament. CK13 was positive superficial to the prickle cells. CK19 was positive in the basal cells of the oral mucosa. In the lining epithelium of the cyst, the expressions of CK13 and CK19 were similar to their immunoreactions in the oral mucosa. These results suggest that the odontogenic epithelium differentiated into squamous epithelial cells, which began as ghost cells in the COC, and that this process depended on the dystrophic calcification of differentiated odontogenic epithelial cells, not of osteogenic cells.

Topics: Adult; Core Binding Factors; Female; Humans; Immunoenzyme Techniques; Keratins; Mandibular Neoplasms; Neoplasm Proteins; Odontogenic Cyst, Calcifying; Transcription Factors

Odontogenic ghost cell tumour (OGCT), also referred to as dentinogenic ghost cell tumour, is an extremely rare tumour classified as a neoplastic variant of calcifying ondontogenic cyst (COC). To date, only 13 cases of OGCT arising in the maxilla or mandible have been reported. We describe an OGCT that recurred after segmental resection of the mandible in a 59-year-old man. Histopathological examination revealed tumour invasion of the surrounding cortical bone, areas containing numerous calcifying flaky cell nests, and dentinoid matrix near epithelial cell nests. No atypical mitosis was found. There has been no evidence of recurrence or metastasis in the 4 years after operation.

Topics: Dentin; Epithelial Cells; Follow-Up Studies; Humans; Keratins; Male; Mandible; Mandibular Neoplasms; Middle Aged; Neoplasm Recurrence, Local; Odontogenic Tumors

Topics: Child, Preschool; Dentigerous Cyst; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Keratins; Mandibular Diseases; Mandibular Neoplasms; Mesoderm; Odontogenic Tumors; Vimentin

Topics: Aged; Aged, 80 and over; Ameloblastoma; Cell Nucleus; Cytoplasm; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Keratins; Mandibular Neoplasms; Mucin-1; Neoplasm Recurrence, Local; Odontogenic Tumors

This case report describes an ameloblastic fibro-odontoma arising from a calcifying odontogenic cyst (COC) in the mandible of a twenty-three-year old male. The patient was referred to the Department of Oral Surgery, Tokyo Dental College, on March 30th, 2000, complaining of a painful swelling, which had appeared three weeks earlier on his left mandibular molar region. In a pathological view, the lesion was a round cyst the size of a chicken-egg, dark red in color, and surrounded by a thick membrane. The cyst had an epithelium of varying thickness which included many ghost cells and an enamel-like structure on the inside, and a thick wall of connective tissue with an ameloblastic fibro-odontoma on the outside. Enamel organ-like epithelial islands were structured radially in the form of strands with immature dentin. Cytokeratin 19 was strongly immunoreactive in the epithelium of the lesion; osteopontin and osteocalcin reacted in the mesenchymal cells and weakly in the epithelial element of this tumor.

Topics: Adult; Connective Tissue; Dental Enamel; Dentin; Enamel Organ; Epithelium; Humans; Keratins; Male; Mandibular Neoplasms; Mesoderm; Neoplasms, Multiple Primary; Odontogenic Cyst, Calcifying; Odontoma; Osteocalcin; Osteopontin; Phosphoproteins; Sialoglycoproteins

Glandular odontogenic cyst (GOC) is an extremely rare lesion occurring in the jawbones. Sialo-odontogenic cyst was first described as a multicystic lesion resembling a botryoid odontogenic cyst (BOC) or a central mucoepidermoid carcinoma by Padayachee in 1987. In 1988, Gardner used the term "glandular odontogenic cyst" and considered it as a histologic variant of BOC. Most authors agreed that GOC was odontogenic because of the concurrent ball-like epithelial structure, ameloblastoma, squamous odontogenic tumor-like proliferation in its wall, or hyaline bodies in the epithelium lining. Recently, immunohistochemical studies of the cytokeratin profiles have also supported this concept. Its aggressive behavior and the recurrent tendency make it important. A new case of GOC in a 59-year-old male presented as a multilocular radiolucency in the anterior region of the mandible, invading the marrow space by epithelial islands is described with other clinicopathologic features and the literature is briefly discussed.

Topics: Humans; Immunohistochemistry; Keratins; Male; Mandibular Neoplasms; Middle Aged; Odontogenic Cysts

The botryoid odontogenic cyst (BOC) is considered a rare multilocular variant of the lateral periodontal cyst. The origin of the BOC can be seen in aberrant odontogenic tissue. The BOC is found especially in the premolar region of the mandible, as well as in the frontal region of the maxilla of patients aged between 60 and 70 years. Most of the 11 published articles of BOC have shown high rates of recurrence. Histopathologically the BOC is marked by multilocular cysts lined by a thin, nonkeratinized epithelium. Clusters of glycogen-rich epithelial cells may be noted in nodular thickenings of the cyst lining. For the clinician, the differentiation of the BOC from the keratocyst and ameloblastoma is relevant. One case of a large BOC (65-year-old male, BOC regio 33-45, diameter 5 cm, radiographically and histologically multilocular) is presented with a review of the literature, including the therapeutic management, and the possible diagnostic criteria are discussed. The immunohistochemically determined expression of cytokeratin (CK) 13 implicates the histogenetic origin of the BOC from the squamous epithelium of the oral cavity and excludes the origin from the small salivary glands. The expression of CK 19 and the lack of expression of p53, as well as the higher proliferation rate of the basal epithelial cell layer by the BOC, may be useful for distinction between the keratocyst.

Topics: Ameloblastoma; Biomarkers, Tumor; Diagnosis, Differential; Humans; Keratins; Male; Mandibular Diseases; Mandibular Neoplasms; Middle Aged; Nonodontogenic Cysts; Odontogenic Cysts

Topics: Adult; Antigens, CD; Carcinoma, Signet Ring Cell; Diagnosis, Differential; Female; Humans; Immunoglobulins; Keratins; Liposarcoma; Lymphoma, B-Cell; Mandibular Neoplasms; Melanoma; Organelles; S100 Proteins; Vimentin

Two cases of ameloblastic carcinoma of the jaws are reported. Histopathologically, the lesions showed cytologic features of malignancy in addition to classical ameloblastoma patterns and were therefore documented as examples of ameloblastic carcinoma. The negative cytokeratin expression by the malignant cells on histochemical analysis is notably different from that normally observed in classical ameloblastomas.

Topics: Adult; Aged; Humans; Keratins; Male; Mandibular Neoplasms; Odontogenic Tumors

In this report, the cytological features and differential diagnosis of the metastasis from and subsequent local recurrence of an unusual case of malignant (metastatic) ameloblastoma are described, with histological confirmation. Characteristic cytological findings included fibrovascular central cores surrounded by palisading crowded basaloid or columnar cells or both and rosette-like structures of tumor cells with central fibrillary material. Keratin debris in the background and cystic cavities were prominent components of the metastatic ameloblastoma. The basaloid cells showed scant-to-absent cytoplasm, round-to-oval to tear-shaped nuclei, rare longitudinal nuclear grooves, single or multiple nucleoli, and smooth-to-clefted nuclear contours. No features to predict malignant behavior were identified (abundant mitotic activity, necrosis, nuclear pleomorphism). The cytological features of ameloblastoma appear to be characteristic enough to allow definitive diagnosis. However, since the cytology of this tumor is underreported in the literature, the unwary observer could easily misdiagnose it, especially at metastatic sites.

Topics: Ameloblastoma; Biopsy, Needle; Diagnosis, Differential; Female; Humans; Keratins; Lung Neoplasms; Mandibular Neoplasms; Middle Aged; Neoplasm Recurrence, Local

Tubulopapillary hidradenoma is a benign sweat gland tumor that appears as a well-defined, superficially located dermal nodule. It combines ductal as well as apocrine and eccrine glandular differentiation. Microscopically, the tumor is composed of tubular structures that characteristically show intraluminal non-villous papillary projections and a peripheral myoepithelial cell layer. A tumor that is histologically and immunohistochemically identical to tubulopapillary hidradenoma occurred in the mandible of a 73-year-old man and resulted in considerable diagnostic difficulty. The neoplasm developed in a mandibular cyst and recurred 5 years after initial enucleation. This is the first report of a central (intraosseous) sweat gland adenoma of the mandible. The differential diagnosis and possible histogenesis are discussed.

Topics: Actins; Adenoma, Sweat Gland; Aged; Apocrine Glands; Bone Cysts; Cell Nucleolus; Cell Nucleus; Cell Transformation, Neoplastic; Cytoplasm; Diagnosis, Differential; Eccrine Glands; Epithelial Cells; Follow-Up Studies; Humans; Keratins; Male; Mandibular Neoplasms; Muscle, Smooth; Neoplasm Recurrence, Local; Vimentin

A case of clear cell odontogenic tumour, which occurred centrally in the mandible of a 56-year-old Japanese woman, is reported with its histochemical, immunohistochemical and ultrastructural findings. Histologically, the tumour nests were composed of large glycogen-rich clear cells and small non-clear polygonal cells and were separated by thin mature fibrous connective tissue septae. Immunohistochemically, both types of tumour cells showed positive expression of various cytokeratins, in particular cytokeratin 19, and of epithelial membrane antigen. Eosinophilic hyaline deposits and possible dentin-like structures were occasionally formed in contact with the epithelial nests and are regarded as indicative of the epithelial-mesenchymal inductive capacity of this tumour. The aggressive nature of the present tumour was assumed through its invasive growth pattern and occasional mitotic figures. Although it was diagnosed as clear cell odontogenic tumour according to the present WHO classification, the patient must be followed carefully because of its probable malignant nature.

Topics: Connective Tissue; Dentin; Epithelial Cells; Female; Glycogen; Humans; Hyalin; Immunohistochemistry; Keratins; Mandibular Neoplasms; Mesoderm; Middle Aged; Mitosis; Mucin-1; Neoplasm Invasiveness; Odontogenic Tumors

To characterize further the nature of calcifying odontogenic cyst (COC), we studied histologically and immunohistochemically an extraosseous and two intraosseous lesions. The extraosseous COC was in continuity with the stratified squamous epithelium of the alveolar mucosa. Immunostaining with monoclonal antibodies showed reactivity of both low- and high-molecular-weight cytokeratins, the degree of coexpression decreasing with the increasing morphological diversity of the cyst/tumour epithelium. Staining for the matrix glycoprotein tenascin-C was seen not only in the connective tissue, where its distribution patterns corresponded to the stage of hard tissue formation, but also in epithelial elements. The staining patterns were analogous to those described during normal tooth formation. Both the morphological characteristics and expression patterns of the various cytokeratin types and tenascin-C implied that COC represents a pathological counterpart of normal odontogenesis. In the case of the extraosseous COC, the correspondence could be traced back to early stages of tooth development.

Topics: Adolescent; Adult; Aged; Antibodies, Monoclonal; Cell Lineage; Child; Coloring Agents; Connective Tissue; Epithelium; Female; Gene Expression Regulation, Neoplastic; Gingiva; Glycoproteins; Humans; Immunohistochemistry; Keratins; Male; Mandibular Neoplasms; Mouth Mucosa; Mouth Neoplasms; Odontogenesis; Odontogenic Cyst, Calcifying; Radicular Cyst; Tenascin

Histopathologic and immunohistochemical features of 3 cases of clear cell odontogenic carcinoma were studied. The tumors were composed of sheets or islands of clear cells separated by mature collageneous tissue. Basaloid cells were also seen in the tumors. Tumor cells showed positive reactions for epithelial membrane antigen and cytokeratin. More PCNA positive cells were seen in basaloid cells than in clear cells. Metastasis to regional lymph nodes was found in all 3 cases.

Topics: Adenocarcinoma, Clear Cell; Adult; Female; Humans; Immunohistochemistry; Keratins; Lymphatic Metastasis; Male; Mandibular Neoplasms; Middle Aged; Mucin-1; Odontogenic Tumors; Proliferating Cell Nuclear Antigen

An ameloblastic fibro-odontoma which occurred in the mandible of a 3-year-old Japanese boy is reported together with immunohistochemical findings. Histologically, the tumor consisted of an ameloblastic fibroma-like area and some typical complex odontoma-like areas. The epithelial islands in the ameloblastic fibroma-like area showed different developmental stages of the epithelial-connective tissue interface. Immunohistochemical examination revealed that all epithelial components in the ameloblastic fibroma-like area showed expression of CK 8, CKs 13, 16, CK 14, CK 18 and CK 19, and coexpression of these cytokeratins and vimentin. These findings suggest that even the epithelial component without obvious epithelial-mesenchymal induction showed the final cell differentiation of the enamel organ with the potential for epithelial-mesenchymal induction.

Topics: Cell Differentiation; Child, Preschool; Connective Tissue; Enamel Organ; Epithelium; Humans; Immunohistochemistry; Keratins; Male; Mandibular Neoplasms; Mesoderm; Odontogenic Tumors; Odontoma; Vimentin

Histological, immunohistochemical and electron microscopical studies revealed one feline and four canine calcifying epithelial odontogenic tumours in 115 oral tumours over a 10-year period. The tumours consisted of islands and sheets of odontogenic epithelium of varying size within a stroma of fibrous connective tissues. The tumour cells were pleomorphic with variable amounts of eosinophilic cytoplasm and large hyperchromatic, polymorphic nuclei with prominent nucleoli. Clusters of keratinized tumour cells ("shadow cells") were frequently seen within the islands and sheets. The multiple spherules of homogeneous eosinophilic material stained positively with Congo red and Dylon stains and produced an apple green birefringence under polarization microscopy, indicative of amyloid. Mineralized foci were scattered throughout the tumour masses and in the homogeneous spherules. Immunohistochemically, the tumour cells reacted with anti-human keratin antibody, but not with anti-human vimentin or anti-chicken desmin antibodies. The homogeneous spherules did not react with anti-human keratin, anti-human vimentin, anti-chicken desmin, anti-amyloid A, anti-laminin or anti-human collagen (type I, III, IV) antibodies. Ultrastructurally, the cytoplasm of tumour cells was abundant and contained a large number of electron-dense bundles of tonofilaments. The homogeneous spherules consisted of fine filaments measuring about 10-12 nm in diameter.

Topics: Amyloid; Animals; Calcinosis; Cat Diseases; Cats; Dog Diseases; Dogs; Female; Keratins; Male; Mandibular Neoplasms; Maxillary Neoplasms; Neoplasm Proteins; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Odontogenic Tumors; Osteolysis; Retrospective Studies

An 82-year-old Caucasian man developed an ulcerated mass on the anterior mandibular gingiva. Five years previously he had been treated for a Merkel cell carcinoma (MCC) on his right cheek. Histopathologic examination showed small tumor cells with scanty cytoplasm, suggestive of malignancy. Immunohistochemical studies were performed with the use of nine antibodies. S-100 protein and leukocyte common antigen were helpful in ruling out melanoma and lymphoma. Pronounced reaction was shown for cytokeratin 20, a new histodiagnostic marker whose expression is almost entirely confined to Merkel cells, the gastric epithelium, and urothelium. The tentative diagnosis of metastasis of MCC was confirmed. Immunohistochemical studies are useful diagnostic aids in the establishment of the diagnosis of Merkel cell carcinoma.

Topics: Aged; Aged, 80 and over; Carcinoma, Merkel Cell; Cheek; Cytoplasm; Diagnosis, Differential; Facial Neoplasms; Gingival Neoplasms; Humans; Keratins; Lymphoma; Male; Mandibular Neoplasms; Melanoma; Skin Neoplasms

A rare case of ameloblastoma with prominent stromal ossification in an 8-year-old female dog was studied. A bony mass recurred rapidly in the right mandible at the first molar region. Histopathologic examination revealed the lesion to be an atypical variant of ameloblastoma. Epithelial cells showed marked cell atypia, and mitotic figures were rather common. The collagenous stroma was abundant, with prominent formation of bone trabecular rimmed by active osteoblasts. The tumor was highly proliferative and aggressive, and thought to be malignant in nature.

Topics: Ameloblastoma; Animals; Cell Division; Dog Diseases; Dogs; Epithelium; Female; Immunohistochemistry; Keratins; Mandible; Mandibular Neoplasms; Ossification, Heterotopic; Osteoblasts

Five out of 4,172 operated maxillary cysts (3 developed within the maxillary and 2 in the mandible) presented a malignant change of epithelium. In all these 5 cases histology demonstrated a transition from normal to cancerous epithelium. The overall percentage of malignant change was of 0.12%, with 0.077% for non-keratinized epithelium lining odontogenic cysts (3 cases) and 0.65%, that is 8 times higher, for keratinized ones (2 cases). Keratinization of cystic epithelium and chronic inflammatory lesions were the main risk factors.

Topics: Adult; Aged; Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; Epidermal Cyst; Epithelium; Female; Humans; Keratins; Male; Mandibular Diseases; Mandibular Neoplasms; Maxillary Diseases; Maxillary Neoplasms; Middle Aged; Odontogenic Cysts; Radicular Cyst

An unusual case of ameloblastoma which depicts cystic follicles containing orthokeratin, parakeratin, desquamated epithelium and necrotic material with dystrophic calcification is presented. The presence of ameloblast-like cells confirms the diagnosis of an ameloblastoma. However, certain features resembled those of the keratoameloblastoma and others, less convincively, the papilliferous keratoameloblastoma. The extensive keratinisation in this tumour and in the aforementioned neoplasms raises the question whether they represent variants of the acanthomatous ameloblastoma.

Topics: Adult; Ameloblastoma; Ameloblasts; Calcinosis; Cysts; Epithelium; Female; Humans; Keratins; Mandibular Neoplasms; Necrosis

Four cases of either combined occurrence of ameloblastoma and odontogenic keratocyst or a rare keratinising variant of ameloblastoma are presented. The cardinal histomorphologic characteristics are simultaneous occurrence of ameloblastomatous epithelial islands with central keratinisation and multiple keratinising cysts. Immunohistochemically the tumour elements were keratin positive and occasionally S-100 protein and desmin positive. Major differential diagnosis of these neoplasms are discussed.

Topics: Adult; Ameloblastoma; Connective Tissue; Desmin; Epithelium; Female; Humans; Keratins; Keratosis; Male; Mandibular Diseases; Mandibular Neoplasms; Maxillary Diseases; Maxillary Neoplasms; Odontogenic Cysts; S100 Proteins

Granular cell ameloblastoma (GCA) is a well recognized variant of follicular ameloblastoma with extensive granular cell change. In contrast, plexiform granular cell odontogenic tumor (PGCOT) is a rare and recently described lesion characterized histologically by a monophasic plexiform pattern of granular cells. In this paper, two cases of an unusual granular cell odontogenic tumor exhibiting combined features of these two entities are described along with their immunohistochemical characteristics. The granular cells of both the GCA and PGCOT areas showed similar patterns of expression for keratin and S-100, which differed from those of typical ameloblastoma. No reactivity for desmin or vimentin was noted. The histomorphologic and immunohistochemical features of these hybrid tumors suggest that the granular cells present have a common origin, most probably the odontogenic epithelium.

Topics: Adult; Ameloblastoma; Desmin; Female; Granular Cell Tumor; Humans; Immunoenzyme Techniques; Immunohistochemistry; Keratins; Mandibular Neoplasms; Middle Aged; Neoplasm Proteins; Odontogenic Tumors; S100 Proteins; Vimentin

Topics: Carcinoma; Diagnosis, Differential; Female; Glycogen; Humans; Immunohistochemistry; Keratins; Mandibular Neoplasms; Middle Aged; Salivary Gland Neoplasms; Salivary Glands, Minor

Primary intraosseous carcinoma (P1OC) of the jaws is rare. They either arise de novo or as a consequence of malignant transformation of a benign cyst or tumor. A 56-year-old patient with a P1OC of the mandible arising from an odontogenic keratocyst is described.

Topics: Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; Humans; Jaw Cysts; Keratins; Male; Mandibular Diseases; Mandibular Neoplasms; Middle Aged; Odontogenic Tumors

A case of papilliferous keratoameloblastoma is reported which is only the second ever documented. The patient was a 76-yr-old black woman with a large expansile multilocular radiolucency of the body, angle and ramus of the mandible. Histologically the lesion consisted of sheets of cystic follicles filled with necrotic debris and sometimes parakeratin. The vast majority of the follicles were lined by a papilliferous epithelium consisting of large rounded cells with centrally placed nuclei. True papillary projections with cores of connective tissue were also present. The remainder of the follicles were lined by a thin parakeratinising stratified squamous epithelium. Histological features characteristic of ameloblastoma were absent. Final classification of these lesions will have to await the reporting of further cases.

Topics: Aged; Ameloblastoma; Connective Tissue; Epithelium; Female; Humans; Keratins; Mandibular Neoplasms; Necrosis

One case of aggressive intramandibular epithelial tumor is presented. This tumor demonstrated an unusual pattern with areas of follicular ameloblastoma together with undifferentiated trabeculae or lobules composed of basophilic cells and of clear glycogenic-rich cells. The odontogenic nature of this tumour and its analogies with common ameloblastoma were demonstrated by electron microscopy, immunohistoenzymology and immunohistochemistry. The signification of such a neoplasm is discussed.

Topics: Adenocarcinoma; Aged; Humans; Immunohistochemistry; Keratins; Male; Mandibular Neoplasms; Odontogenic Tumors; Phosphoric Monoester Hydrolases

A 51-year-old man with microcystic adnexal carcinoma of the face is reported. In addition to extensive soft tissue invasion by the cancer, there was direct bone invasion into the marrow of the mandible as well as perineural spread along the mental and inferior alveolar nerves. This represents the first case of microcystic adnexal carcinoma with documented bone invasion. Recognition of the aggressive nature of this cancer with potential for invasion into the skull is important for proper evaluation and treatment.

Topics: Bone Marrow; Carcinoma; Cysts; Cytoplasm; Facial Neoplasms; Humans; Keratins; Lip Neoplasms; Male; Mandibular Neoplasms; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local

A rare case of granular cell ameloblastoma in the anterior mandible of a 59-year-old man has been studied by light and electron microscopy. In some areas, the tumor was very similar to an oncocytoma (oxyphilic adenoma). Almost all tumor cells were full of eosinophilic granules, whereas in the common type of granular cell ameloblastoma, only the cells located in the central portion of the tumor are granular.

Topics: Adenoma; Ameloblastoma; Cell Nucleus; Cytoplasm; Cytoplasmic Granules; Diagnosis, Differential; Epithelium; Humans; Keratins; Male; Mandibular Neoplasms; Middle Aged

Immunohistochemical observations of intermediate sized proteins in five cases of adenomatoid odontogenic tumour (AOT) are described. The immunohistochemical detections of keratins were made with polyclonal antiserum (TK, 41-65 kDa) and three monoclonal keratin antibodies (KL1: 55-57 kDa; PKK1: 40, 45, and 52.5 kDa and nos. 19, 18, 8; K8.12: nos. 16, 13) and vimentin and desmin monoclonal antibodies. Histologically, the tumour epithelia could be divided into two types: type A cells were a spindle or columnar shape and formed solid, ductal, tubular or whorled structures. Type B cells were small and compact cells at the periphery of the A cell-containing focus. Immunohistochemically, the type A cells showed very slight reaction with all antibodies to keratins, whereas the type B cells indicated slight-to-moderate expression of keratin and vimentin, and showed coexpression. Both types of cell showed a negative reaction for desmin. Only one case was associated with cystic lesions, and the cyst-lining was composed of thin squamous epithelium. Keratin expression in this epithelium was strong. In the histogenesis of AOT it was postulated that the tumour cells may have originated from undifferentiated odontogenic epithelium or stratum intermedium cells.

Topics: Adolescent; Child; Female; Humans; Immunohistochemistry; Keratins; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Odontogenic Tumors; Vimentin

164 odontogenic keratocysts from 60 patients with the basal cell naevus syndrome were compared with a similar number of single keratocysts matched for age and site. Significant differences between the two groups were found in the numbers of satellite cysts, solid islands of epithelial proliferation and odontogenic rests within the capsule, and in the numbers of mitotic figures in the epithelium lining the main cavity. An index of activity derived from these parameters suggests a greater growth potential in syndrome cysts; in addition, the patterns of association of the features support the theory that the odontogenic rests give rise to satellite cysts.

Topics: Adolescent; Adult; Aged; Basal Cell Nevus Syndrome; Carcinoma, Basal Cell; Cell Division; Child; Female; Humans; Keratins; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Odontogenic Cysts

An immunohistochemical technique was used on paraffin-embedded tissues of four cases of calcifying epithelial odontogenic tumors (CEOT). These studies were performed to gain an additional understanding of the nature of amyloid-like deposits in these tumors. For these studies antibodies to Type IV collagen, laminin, and the five classes of intermediate filament proteins were employed. In all of the tumors examined basement membrane components and intermediate filament proteins (cytokeratin) were demonstrated both in the epithelial tumor islands and within the extracellular amyloid-like deposits. Antibodies to vimentin intermediate filaments were localized only in the stromal fibroblasts. Limited proteolysis or the use of a chaotropic agent was required to express the antigenic determinants present. These studies substantiate the presence of basement membrane components in the amyloid-like deposits of CEOT. In addition, these extracellular deposits are shown to be heterogenous in composition by the immunohistochemical demonstration of cytokeratin intermediate filament proteins.

Topics: Adult; Amyloid; Basement Membrane; Cytoskeleton; Female; Fluorescent Antibody Technique; Humans; Intermediate Filament Proteins; Keratins; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Odontogenic Tumors

The nature and location of intermediate filament proteins (IFP) may provide new insights into the origin and differentiation of neoplastic cells. An immunofluorescent study of these IFP in a case of a granular cell ameloblastoma revealed that all tumor cells contained the IFP keratin. Some granular cells, however, also contained the IFP vimentin, which is considered specific for mesenchymal tissues only. The implications of these observations are discussed. Study with monoclonal antibodies indicated the origin of the ameloblastoma from non-keratinized squamous epithelium. A comparison of the anti-keratin immunofluorescence pattern of the ameloblast-like cells in the present tumor with ameloblasts in the tooth germ revealed no similarities, indicating that despite some resemblance of the peripheral columnar cells to ameloblasts, these cells differ in other aspects.

Topics: Aged; Ameloblastoma; Animals; Antibodies, Monoclonal; Female; Fluorescent Antibody Technique; Histocytochemistry; Humans; Intermediate Filament Proteins; Keratins; Mandibular Neoplasms; Rabbits; Vimentin

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.

Topics: Adult; Aged; Female; Humans; Keratins; Male; Mandibular Diseases; Mandibular Neoplasms; Maxillary Diseases; Maxillary Neoplasms; Middle Aged; Odontogenic Cysts; Odontogenic Tumors

Topics: Adult; Alveolar Process; Calcinosis; Connective Tissue; Epithelium; Female; Humans; Hyalin; Jaw Neoplasms; Keratins; Mandibular Neoplasms; Maxillary Neoplasms; Odontogenic Tumors

Topics: Adolescent; Ameloblastoma; Dentigerous Cyst; Female; Humans; Keratins; Mandibular Neoplasms

The unusual feature of an intramandibular chondroma in association with an odontogenic keratocyst in a 59-year-old man is described. The keratocyst recurred and required two reoperations. The coexistence of an odontogenic keratocyst and a chondroma of the jaw was probably a coincidence of two simultaneous but otherwise unrelated lesions. The possibility that the keratocyst and the chondroma were due to a single developmental disturbance of the region cannot be excluded. No signs of a recurrence were seen at the last follow-up examination four years after the operation.

Topics: Chondroma; Humans; Keratins; Male; Mandibular Neoplasms; Middle Aged; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Odontogenic Cysts

A large keratocyst was conservatively treated for four years. The use of the Partsch operation, with subsequent cyst enucleation after several years, prevented paresthesia, allowed bone healing, and facilitated surgical access. Because of the high incidence of recurrence, we will continue to follow up on the patient's condition.

Topics: Adult; Humans; Keratins; Male; Mandibular Neoplasms; Odontogenic Cysts

Topics: Calcinosis; Female; Humans; Keratins; Mandibular Neoplasms; Middle Aged; Odontogenic Cysts

Although odontogenic keratocysts are benign they are often locally destructive and tend to recur after conservative surgical treatment. They must therefore be distinguished from other cysts of the jaw. Keratocysts possess outpouchings and microscopic daughter cysts from which recurrences may arise. Histologic examination is essential for diagnosis since the appearances on roentgenograms and at operation usually do not reveal the true nature of the lesion. Since many nondental surgeons and pathologists are unaware of odontogenic keratocysts a case is presented in which surgical treatment was originally conservative and finally relatively radical.

Topics: Adult; Diagnosis, Differential; Humans; Keratins; Male; Mandible; Mandibular Neoplasms; Odontogenic Cysts; Recurrence

Topics: Adult; Humans; Keratins; Male; Mandibular Neoplasms; Odontogenic Cysts

An analysis was made of the clinical features of 312 acceptable cases of odontogenic keratocysts from the files of the Department of Oral Pathology, Indiana University School of Dentistry. A total of 5.1 per cent of the keratocysts were from patients with the basal-cell nevus syndrome and 5.8 per cent were from patients with multiple keratocysts but with no other features of the syndrome. There was a wide age range, with a peak incidence in the second and third decades of life. The mandible: maxilla ratio was 2:1, with the mandibular third molar area and ramus being the most common sites. Dentigerous cyst was the most frequent clinical as well as histologic diagnosis for the majority of the keratocysts in this study. The primordial cyst comprised the greatest percentage of keratocysts (44.4 per cent). A total of 50.3 per cent of the patients were symptomatic before seeking treatment, the most common finding being intraoral drainage and swelling. Their radiographic appearance was quite variable, although they frequently resembled ameloblastoma. These cysts may be very aggressive clinically. They have a relatively high recurrence rate, as previously reported in the literature, in comparison with other types of odontogenic cyst. The findings in this study support the theory that the histologic appearance of an odontogenic keratocyst may be assumed by any of the odontogenic or nonodontogenic cysts.

Topics: Adolescent; Adult; Aged; Child; Female; Humans; Jaw Neoplasms; Keratins; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Neoplasm Recurrence, Local; Odontogenic Cysts; Radiography; Sex Factors

Locally aggressive benign lesions of the jaws, such as odontogenic keratocysts and ameloblastomas, require complete excision in view of the high incidence of recurrence after incomplete surgical removal. Because of the limitations of conventional radiology as the sole technique for determining the extent of these lesions, the use of 99m-technetium-labeled bone-imaging agents is suggested. This method of defining the location of surgical margins is based on the agent's sensitivity as an indicator of subtle changes in bone metabolism. A case of an unusually large recurrent odontogenic keratocyst is presented in which the planning of the surgical procedure was predicated on the results of a bone scan of the jaws in addition to conventional radiology. This diagnostic procedure, especially when used in conjunction with conventional radiology, appears to be of considerable value in defining the extent of a variety of oral-maxillofacial bony lesions.

Topics: Female; Humans; Keratins; Mandibular Neoplasms; Middle Aged; Odontogenic Cysts; Patient Care Planning; Radionuclide Imaging

The potential of odontogenic epithelium to keratinize in the form of ghost cells is demonstrated in the histologic variants of a number of odontongic tumors. Although the cells lack keratohyaline granules, they do contain abundant tonofilaments and probably represent an altered form of keratin. The presence of this material in odontogenic tumors does not appear to alter clinical occurence or clinical behavior.

Topics: Adolescent; Adult; Aged; Ameloblastoma; Cell Membrane; Child; Epithelial Cells; Epithelium; Female; Gingival Neoplasms; Humans; Keratins; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Odontogenic Tumors; Odontoma; Organoids

Topics: Adolescent; Carcinoma, Basal Cell; Humans; Keratins; Male; Mandibular Neoplasms; Nevus; Odontogenic Cysts

Topics: Adolescent; Adult; Female; Humans; Keratins; Male; Mandibular Neoplasms; Mouth Neoplasms; Odontogenic Cysts; Radiography

Topics: Adolescent; Adult; Age Factors; Aged; Child; Female; Humans; Jaw Neoplasms; Keratins; Male; Mandibular Neoplasms; Maxillary Neoplasms; Microscopy, Electron; Middle Aged; Odontogenic Cysts; Radiography; Sex Factors; Tooth Resorption

Topics: Adolescent; Adult; Age Factors; Aged; Child; Female; Follow-Up Studies; Humans; Jaw Neoplasms; Keratins; Male; Mandibular Neoplasms; Middle Aged; Neoplasm Recurrence, Local; Odontogenic Cysts; Radiography; Sex Factors; Time Factors

Topics: Biopsy, Needle; Carcinoma; Female; Humans; Jaw Neoplasms; Keratins; Keratosis; Male; Mandibular Neoplasms; Maxillary Neoplasms; Mitosis; Neoplasm Recurrence, Local; Odontogenic Cysts; Radiography

Topics: Adult; Age Factors; Bicuspid; Biopsy; Cuspid; Dentigerous Cyst; Female; Humans; Incisor; Keratins; Male; Mandibular Neoplasms; Maxillary Neoplasms; Molar; Odontogenic Cysts; Prospective Studies; Retrospective Studies; Sex Factors

Topics: Adolescent; Adult; Aged; Child; Epithelial Cells; Epithelium; Female; Humans; Keratins; Male; Mandible; Mandibular Neoplasms; Maxilla; Maxillary Neoplasms; Middle Aged; Neoplasm Recurrence, Local; Odontogenic Cysts

Topics: Amyloid; Calcinosis; Histocytochemistry; Humans; Keratins; Male; Mandibular Neoplasms; Microscopy, Electron; Middle Aged; Neoplasm Proteins; Odontogenic Tumors; Staining and Labeling

Topics: Ameloblastoma; Diagnosis, Differential; Humans; Keratins; Mandibular Neoplasms; Neoplasm Recurrence, Local; Odontogenic Cysts; Radiography; Root Resorption

Topics: Adolescent; Adult; Age Factors; Aged; Female; Humans; Keratins; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Neoplasm Recurrence, Local; Odontogenic Cysts; Radiography; Tooth

Topics: Calcification, Physiologic; Child; Epithelium; Geriatrics; Histological Techniques; Humans; Keratins; Mandibular Neoplasms; Odontogenic Cyst, Calcifying; Odontogenic Tumors; Pathology; Radiography, Dental; Surgery, Oral