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CALCIFYING EPITHELIALODONTOGENIC TUMOR

PINDBORG TUMOR)

UNDER THE GUIDENCE OF: SUBMITTED BY

DR NAVEEN CHABRA ASIMA JAAN

DR SHRUTI CHABRA ROLL NO:960

DR SHIKHA BDS 3rdYR

DR NITIN 1

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CLASSIFICATION:(BY WHO)

BENIGN ODONTOGENC EPITHELIUM WITHOUT ODONTOGENIC

ECTOMESENCHYME:

Ameloblastoma

Squamous odontogenic tumor

calcifying epithilal odontogenic tumor (Pindborgs tumor)Adenomatoid odontogenic tumor

ODONTOGENIC EPITHELIUM WITH ODONTOGENICECTOMESENCHYME WITH OR WITHOUT DENTAL HARDTISSUE:

Ameloblastic fibroma

Ameloblastic fibrodentinomaAmeloblastic fibro-odontoma

Odontoameloblastoma

Adenomatoid odontgenic tumor

Compound and complex odontoma

Calcifying odontogenic cyst2

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CALCIFYING EPITHELIAL

ODONTOGENIC TUMOR

INTRODUCTION:

It is a rare type of slow growing, usually

benign, odontogenic tumor.

first described in 1956 by the late DR JENSJORGEN PINDBORG. So also known aspindborgstumor.

Alternative abbreviation commonly used is

CEOT(calcifying epithelial odontogenic tumor). It accounts less than 1% of all odontogenic

tumors.

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DEFINITION:

It is an uncommon , benign ,

odon togenic neop lasm that is

exclusively epithel ial in o rigin .

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ETIOLOGY

Definite etiology of this neoplasm isenigmatic..Two theories have beensuggested

Some say that the epithelial cells ofthis tumor are reminiscent of the cellsin the stratum intermedium layer of theenamel organ in the tooth

development. some say that this tumor arises from

the remnants of the primitive dental

lamina found in the initial stage ofodonto enesis. 6

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CLINICAL FEATURES:

Clinically it is of two types

INTRAOSSEOUS EXTRAOSSEOUSINTRAOSSEOUS LESIONS: Mostly this type of lesions are seen.(113

reported cases)

Occurs mostly in middle age(40 yr) No significant diff. in male female ratio.

Slightly more in females. More commonly seen in mandible over

maxilla by ratio 2:1 Mostly seen in molar region than bicuspids.And even distribution in other regions ofjaw

asymptomatic lesion, only painless 7

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Extraosseous lesionS: This type of lesions are quite rare.(8

reported cases)

Occur at the age of 35 yr

Equal sex distribution

Mostly lesions occur on gingiva.. Mostlymandibular. And may be seen in anterior

segment, and rarely on the upper lip.

These lesions are histologically similar to

intraosseous lesions.

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HISTOLOGICAL FEATURES: It is composed of polyhedral epithelial cells

seen in large sheets closely packedtogether or scattered small islands of cell

in fibrous connective tissue stroma.

Tumor cells are arranged in rows or cordswith well outlined cell border and granular

eosinophilic cytoplasm.

intercellular bridges are often prominent. Nuclei are pleomorphic, with giant cell

nuclei and multinucleation.

Mitotic figures are rare. 12

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Clear cell varian tis a well recognizedform of this neoplasm. The tumor cells

exhibit a clear vacuolated cytoplasm ,nucleus may be round or oval in thecenter of the cell or flattened againstthe cell membrane.

There is presence of homogenous ,eosinophilic substance interpreted asamyloid. Which may be present inlarge or limited quantities.

Large amount of calcifications arepresent in form of LiesegangRings.

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Differential diagnosis:Dentigerous cyst

Ameloblastoma

Mucoepidermoid carcinoma

Adenomatoid odontogenic tumorCalcifying epithelial odontogenic cyst

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Treatment: Small intrabony lesions with well

defined borders can be treated withEnucleation or Curettage. Judicial

removal of a thin layer of bone

adjacent to the tumor. Recurrent or persistent tumors which

have become large and more

extensive (>4cm) require segmentalresections such as partial or hemi

mandibulectomy or hemi

maxillectomy. 16

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References:Text book of oral pathology:

SHAFERS

Text book of oral $maxillofacial pathology:

NEVILLE

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