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Ameloblastic Fibrodentinoma: Case Report and the Controversies in Etiopathogenesis
ORAL AND MAXILLOFACIAL PATHOLOGY e64 Abstracts PCC-201 - AMELOBLASTIC FIBRODENTINOMA: CASE REPORT AND THE CONTROVERSIES IN ETIOPATHOGENESIS. MARTHA ALAYDE ALCANTARA SALIM, THUANY SERVARE DE LIMA, TERESA CRISTINA RANGEL PEREIRA, DANIELA NASCIMENTO SILVA, ROSSIENE BERTOLLO MOTTA, LILIANA APARECIDA PIMENTA DE BARROS, TÂNIA REGINA GRÃO VELLOSO. UNIVERSIDADE FEDERAL DO ESPÍRITO SANTO. Ameloblastic fibrodentinoma (AFD) is a rare benign odontogenic tumor usually diagnosed in the first decades of life. It is characterized by neoplastic odontogenic epithelium and ectomesenchyme with dentin. Clinically, it presents as an asymptomatic slow-growing lesion that can become extremely large. Radiographically, it appears as a well-defined radiolucent image with varying degrees of radiopacity. Because of its rarity, its acceptance as a disease entity is not fully supported. In fact, on the basis of its histopathological features, AFD has been considered by some authors as an intermediate stage between ameloblastic fibroma and ameloblastic fibro-odontoma. A 17-year-old male presented with a lesion in the left mandibular premolar and molar regions, accompanied by mobility in the first molar. Radiographic examination revealed a mixed radiolucent and radiopaque image with corticalization of the edges. We discuss the clinical and microscopic diagnosis of AFD, as well as its controversial pathogenesis.
PCC-202 - AMELOBLASTOMA WITH LUNG METASTASIS TREATED WITH RADIOTHERAPY: A CASE REPORT. KALYNE KELLY NEGROMONTE GONÇALVES, BELMIRO CAVALCANTI DO EGITO VASCONCELOS, SUZANA CÉLIA DE AGUIAR SOARES CARNEIRO, EMANUEL SÁVIO DE SOUZA ANDRADE, JEFFERSON LUIZ FIGUEIREDO LEAL, JÉSSICA CAROLINE AFONSO PEREIRA, IVSON SOUZA CATUNDA. FACULDADE DE ODONTOLOGIA DE PERNAMBUCO e UPE. Ameloblastoma is the most common of the odontogenic tumors and it rarely exhibits malignant behavior with metastasis development. Here, we report the case of a 48-year-old patient. In 2001, the patient had been diagnosed with ameloblastoma, as confirmed by computed tomography and histopathology, and had undergone segmental hemimandibulectomy and reconstruction with rib graft. In 2007, the same patient again sought treatment, presenting with an extensive tumor involving the entire floor of the mouth. The patient was referred to a department of head and neck radiotherapy. The response to treatment was excellent, with remission of the lesion. One year later, a tumor was discovered in the left lung and was attributed to the ameloblastoma. The same radiotherapy strategy was adopted. The patient is under rigorous outpatient monitoring and is free of disease. The final considerations are justified by the effectiveness of radiation therapy for a benign tumor, eliminating mandibular recurrence and metastatic lung tumor.
PCC-203 - CALCIFYING CYSTIC ODONTOGENIC TUMOR IN THE RIGHT MAXILLARY SINUS: A CASE REPORT. JULIANA MARIA SOUZA DE OLIVEIRA, RENATA GUALBERTO, ARIANY CRISTINA FREITAS RIBEIRO, ROBERTO LUIZ DE MENEZES MARTINHO, LUCILEIDE CASTRO DE OLIVEIRA, TATIANA NAYARA LIBÓRIO KIMURA, JECONIAS CÂMARA. UNIVERSIDADE FEDERAL DE AMAZONAS.
OOOO August 2015 Calcifying cystic odontogenic tumor (CCOT) is a rare odontogenic benign cystic neoplasm. A 27-year-old female was referred to a school of dentistry for evaluation of right facial asymmetry with erythema and pain for approximately 6 months. Intraoral examination showed extensive swelling in the maxilla. Radiographic examination showed a large, well-circumscribed radiolucent lesion, in the right maxillary sinus, containing radiopaque structures associated with an unerupted canine. Incisional biopsy was performed with the hypothesis of a cyst, and the microscopic examination resulted in a preliminary diagnosis of CCOT. Subsequent microscopic examination of an excisional biopsy sample revealed proliferation of columnar and polyhedral cells resembling ameloblasts within a fibrous stroma sometimes lining a cystic cavity. There were also large eosinophilic cells, with aberrant keratinization, known as “ghost cells”, and areas with calcified focal bodies. These findings confirmed the diagnosis of CCOT. After 8 months of clinical and radiographic follow-up, no recurrence was observed.
PCC-204 - DESMOPLASTIC AMELOBLASTOMA: A CASE REPORT. ISABELA FÁTIMA ARAÚJO SOUZA, MATHEUS ALVES PACHECO, JEAN NUNES DOS SANTOS, MICHELLE MIRANDA LOPES FALCÃO, MARLA SMILLE PEDROSA CRUZ RIBEIRO, JAMILLE RIOS MOURA, VALÉRIA SOUZA FREITAS. UNIVERSIDADE ESTADUAL DE FEIRA DE SANTANA. Desmoplastic ameloblastoma (DA) is a variant of ameloblastoma, with specific clinical, radiological, and histological features. A 36-year-old female sought treatment, complaining of an approximately 2-month history of “swelling” in the mandible. Intraoral clinical examination revealed an asymptomatic, 4-cm volume increase, with a hard consistency, in the region of the right mandibular parasymphysis, causing expansion of the buccal cortical plate and erosion of the lingual cortical plate. Panoramic radiography revealed an extensive, well-defined unilocular radiolucent lesion, causing tooth displacement. We performed an exploratory puncture biopsy (which was positive for citrine liquid) and an incisional biopsy. Histopathological analysis showed proliferating islands and cords of odontogenic epithelium, irregularly embedded in an intense desmoplastic connective tissue stroma. The histopathological diagnosis was DA, and the patient was referred for surgical resection of the lesion.
PCC-205 - DIAGNOSIS OF COMPOUND ODONTOMA AT A DENTAL URGENT CARE SERVICE: A CASE REPORT. CARINA DOMANESCHI, SEA RA HONG, VANESSA JULIANA GOMES CARVALHO, INÊS APARECIDA BUSCARIOLO, ISABEL PEIXOTO TORTAMANO, SIBELE SARTI PENHA, MARIA APARECIDA BORSATTI. FACULDADE DE ODONTOLOGIA DA UNIVERSIDADE DE SÃO PAULO. At dental urgent care clinics, the main patient complaint is usually pain and rarely oral lesions. Compound odontoma is a common benign odontogenic tumor. It is usually asymptomatic and often affects bone tissue in the anterior maxilla. Therefore, it is often identified during oral clinical examination. It has a higher incidence in the first 2 decades of life, with no predilection for gender. A 21-year-old black male sought a dental urgent care service, complaining of “swollen and painful gingiva around the tooth”. Intraoral examination revealed inflammation, surrounding whitish hard tissue, of the palatal gingiva between teeth #12 and #13. Radiography showed radiopaque areas of different sizes with
PCC-202 - AMELOBLASTOMA WITH LUNG METASTASIS TREATED WITH RADIOTHERAPY: A CASE REPORT. KALYNE KELLY NEGROMONTE GONÇALVES, BELMIRO CAVALCANTI DO EGITO VASCONCELOS, SUZANA CÉLIA DE AGUIAR SOARES CARNEIRO, EMANUEL SÁVIO DE SOUZA ANDRADE, JEFFERSON LUIZ FIGUEIREDO LEAL, JÉSSICA CAROLINE AFONSO PEREIRA, IVSON SOUZA CATUNDA. FACULDADE DE ODONTOLOGIA DE PERNAMBUCO e UPE. Ameloblastoma is the most common of the odontogenic tumors and it rarely exhibits malignant behavior with metastasis development. Here, we report the case of a 48-year-old patient. In 2001, the patient had been diagnosed with ameloblastoma, as confirmed by computed tomography and histopathology, and had undergone segmental hemimandibulectomy and reconstruction with rib graft. In 2007, the same patient again sought treatment, presenting with an extensive tumor involving the entire floor of the mouth. The patient was referred to a department of head and neck radiotherapy. The response to treatment was excellent, with remission of the lesion. One year later, a tumor was discovered in the left lung and was attributed to the ameloblastoma. The same radiotherapy strategy was adopted. The patient is under rigorous outpatient monitoring and is free of disease. The final considerations are justified by the effectiveness of radiation therapy for a benign tumor, eliminating mandibular recurrence and metastatic lung tumor.
PCC-203 - CALCIFYING CYSTIC ODONTOGENIC TUMOR IN THE RIGHT MAXILLARY SINUS: A CASE REPORT. JULIANA MARIA SOUZA DE OLIVEIRA, RENATA GUALBERTO, ARIANY CRISTINA FREITAS RIBEIRO, ROBERTO LUIZ DE MENEZES MARTINHO, LUCILEIDE CASTRO DE OLIVEIRA, TATIANA NAYARA LIBÓRIO KIMURA, JECONIAS CÂMARA. UNIVERSIDADE FEDERAL DE AMAZONAS.
OOOO August 2015 Calcifying cystic odontogenic tumor (CCOT) is a rare odontogenic benign cystic neoplasm. A 27-year-old female was referred to a school of dentistry for evaluation of right facial asymmetry with erythema and pain for approximately 6 months. Intraoral examination showed extensive swelling in the maxilla. Radiographic examination showed a large, well-circumscribed radiolucent lesion, in the right maxillary sinus, containing radiopaque structures associated with an unerupted canine. Incisional biopsy was performed with the hypothesis of a cyst, and the microscopic examination resulted in a preliminary diagnosis of CCOT. Subsequent microscopic examination of an excisional biopsy sample revealed proliferation of columnar and polyhedral cells resembling ameloblasts within a fibrous stroma sometimes lining a cystic cavity. There were also large eosinophilic cells, with aberrant keratinization, known as “ghost cells”, and areas with calcified focal bodies. These findings confirmed the diagnosis of CCOT. After 8 months of clinical and radiographic follow-up, no recurrence was observed.
PCC-204 - DESMOPLASTIC AMELOBLASTOMA: A CASE REPORT. ISABELA FÁTIMA ARAÚJO SOUZA, MATHEUS ALVES PACHECO, JEAN NUNES DOS SANTOS, MICHELLE MIRANDA LOPES FALCÃO, MARLA SMILLE PEDROSA CRUZ RIBEIRO, JAMILLE RIOS MOURA, VALÉRIA SOUZA FREITAS. UNIVERSIDADE ESTADUAL DE FEIRA DE SANTANA. Desmoplastic ameloblastoma (DA) is a variant of ameloblastoma, with specific clinical, radiological, and histological features. A 36-year-old female sought treatment, complaining of an approximately 2-month history of “swelling” in the mandible. Intraoral clinical examination revealed an asymptomatic, 4-cm volume increase, with a hard consistency, in the region of the right mandibular parasymphysis, causing expansion of the buccal cortical plate and erosion of the lingual cortical plate. Panoramic radiography revealed an extensive, well-defined unilocular radiolucent lesion, causing tooth displacement. We performed an exploratory puncture biopsy (which was positive for citrine liquid) and an incisional biopsy. Histopathological analysis showed proliferating islands and cords of odontogenic epithelium, irregularly embedded in an intense desmoplastic connective tissue stroma. The histopathological diagnosis was DA, and the patient was referred for surgical resection of the lesion.
PCC-205 - DIAGNOSIS OF COMPOUND ODONTOMA AT A DENTAL URGENT CARE SERVICE: A CASE REPORT. CARINA DOMANESCHI, SEA RA HONG, VANESSA JULIANA GOMES CARVALHO, INÊS APARECIDA BUSCARIOLO, ISABEL PEIXOTO TORTAMANO, SIBELE SARTI PENHA, MARIA APARECIDA BORSATTI. FACULDADE DE ODONTOLOGIA DA UNIVERSIDADE DE SÃO PAULO. At dental urgent care clinics, the main patient complaint is usually pain and rarely oral lesions. Compound odontoma is a common benign odontogenic tumor. It is usually asymptomatic and often affects bone tissue in the anterior maxilla. Therefore, it is often identified during oral clinical examination. It has a higher incidence in the first 2 decades of life, with no predilection for gender. A 21-year-old black male sought a dental urgent care service, complaining of “swollen and painful gingiva around the tooth”. Intraoral examination revealed inflammation, surrounding whitish hard tissue, of the palatal gingiva between teeth #12 and #13. Radiography showed radiopaque areas of different sizes with