Epithelial Odontogenic Tumor

Question 1

Benign but locally infiltrative Odontogenic neoplasm

Answer 1

Ameloblastoma

Question 2

Location of ameloblastoma

Answer 2

Mandibular molar-ramus and maxillary molar

Question 3

Age where ameloblastoma occurs in life

Answer 3

4th or 5th decade of life

Question 4

It is asymptpmatic unless there is nerve impingement or the lesion is very big

Range from simple swelling in gingiva or cystic lesion

Answer 4

Ameloblastoma

Question 5

What radiographic lesion is this

Molar ramus area
Monolocular or multilocular
Associated with an IMPACTED TOOTH
Expansion of jaw and resorption of roots of room
Separation of roots or teeth

Answer 5

Ameloblastoma

Question 6

Treatment of ameloblastoma

Answer 6

Resection

Question 7

Most commonly seen histological subtype of ameloblastoma

Answer 7

Follicular ameloblastoma

Question 8

A subtype of ameloblastoma in which the islands and sheets are interconnected together in cords or strands of odontogenic epithelium

Answer 8

Plexiform ameloblastoma

Question 9

A subtype of ameloblastoma in which it is related to the skin

Epithelial keratin pearls are present

And the eithelium is squamous type

Answer 9

Acanthomatous “squamous metaplasia”

Question 10

A subtype of ameloblastoma that its cells have granules (pink dots_ which can be seen in higher magnification

It also contain high lysosomal production

Exhibits prominent cytoplasmic granularity and swelling

Answer 10

Granular cell ameloblastoma

Question 11

A subtype of amelloblastoma it which the hyperchromatic nuclei is more dense than the follicular type

It also contains stellate-reticular like cells

Answer 11

Basal cell ameloblastoma

Question 12

A subtype of ameloblastoma it which it has a dense collagenous stroma or sometimes spindle shaped.

Cords of odontogenic epithelium are present

There are sharp areas

Answer 12

Desmoplastic ammeloblastoma

Question 13

What are the biologic subtypes of ameloblastoma

Answer 13

1. Conventional
2. Peripheral / extraosseous
3. Unicystic - fluid filled sac
4. Metastasizing

Question 14

Intraosseous / within bone
Single cyst cavity
Associated with unerupted or impacted teeth
Bony expansion / root resorption

Answer 14

Unicystic ameloblastoma

Question 15

Histologic feature

Cuboidal palisading cells
Thin, nonkeratinized epithelium
Spongiosis
Eithelial invaginations
Subepithelial hyalinization
Spongiotic epithelial lining “parachute cells”

Answer 15

Unicystic ameloblastoma

Question 16

Treatment for unicystic ameloblastoma

Answer 16

Excision

Question 17

Soft tissue counterpart of intraosseus

Answer 17

Peripheral / extraosseous

Question 18

Where does peripheral ameloblastoma arises from its overlying epithelium

Answer 18

Rests of serres

Question 19

Columnar paslisading reverse polarity

What biological subtype of ameloblastoma

Answer 19

Peripheral / extraosseous

Question 20

Treatment for peripheral ameloblasotma

Answer 20

Local Excision

Question 21

Primary tumor location of metastasizing ameloblastoma

Answer 21

Mandible

Question 22

An ameloblastoma that can transfer from one location to another

It metastasize despite benign histopathological appearance

Answer 22

Metastasizing ameloblastoma

Question 23

Risk factor of metastasizing ameloblastoma

Answer 23

1. Large size / may enlarge fast
2. Protracted clinical course
3. Multiple recurrences at the primary site
4. Inadequate removal

Question 24

A gene that is associated with ameloblastoma

Answer 24

BRAF gene

Question 25

A drug that is promising for the treatment of metastaszing ameloblastoma

Answer 25

MAPK inhibitory drugs BRAF inhibitors

Question 26

Benign epithelial ofontogenic tumor characterized by amyloid, which my calcify

Answer 26

Calcifying epithelial odontogenic tumor ( pindborg tumor )

Question 27

Other name for calcifying epithelial odontogenic tumor

Answer 27

Pindborg tumor

Question 28

Clinical features AsymptomTic Slow growing localized expansion of the jaw and tooth mobility Occurs in tooth bearing areas of the jaw 60% mandible, 85% arise centrally

Answer 28

Calcifying epithelial odontogenic tumor

Question 29

Histologic features: Sheets, islands, and cords of polyhedral cells with distinct borders Amyloid Prominent intercellular bridges Nuclear and cellular pleomorphism

Answer 29

Calcifying epithelial odontogenic tumor

Question 30

Calcified deposits seen as concentric circles

Answer 30

Liesgang rings - calcifying epithelial odontogenic tumor

Question 31

Treatment for ceot

Answer 31

Enucleation to resection

Question 32

Benign encapsulated epithelial Engolfs crown of the tooth Have rosette or duct like structures Has an indolent behavior

Answer 32

Adenomatoic odontogenic tumor

Question 33

Have rosette or duct like structure

Answer 33

Adenomatoic odontogenic tumor

Question 34

Gene mutation of adenomatoid odontogenic tumor

Answer 34

KRAS gene (70% of cases)

Question 35

More common in female Seen in 2/3 of maxilla

Answer 35

Adenomatoid odontogenic tumor

Question 36

Benign, slow growing, squamoud differentiation Asymptomatic swelling - minority are associated with pain, tenderness, mobility of teeth or bone expansion

Answer 36

Squamous odontogenic tumor

Question 37

Radiographic feature of squamous odontogenic tumor

Answer 37

Triangular or semicircular unilocular radiolucency with well-defined borders along one or more tooth roots

Question 38

Histologic feature Squamous metaplasia -flat cuboidal cells at the periphery Center is flat Collagenous stroma

Answer 38

Squamous odontogenic tumor

Question 39

Treatment of squamous odontogenic tumor

Answer 39

Curretage or excision (Minimal risk of occurence)