Sep09
Posted by Dr. Reji Abraham on Tuesday, 9th September 2014
Geetha Kamath1, Reji Abraham21Departments of Oral Medicine and Radiology, and 2Orthodontics, Sri Hasanamba Dental College and Hospital, Hassan, Karnataka, India
Dental Research Journal / Mar 2012 / Vol 9 / Issue 2 233
Dental Research Journal
Case Report
Recurrent CEOT of the maxilla
Geetha Kamath1, Reji Abraham2
1Departments of Oral Medicine and Radiology, and 2Orthodontics, Sri Hasanamba Dental College and Hospital, Hassan, Karnataka, India
ABSTRACT
Calcifying epithelial odontogenic tumor (CEOT) is a rare benign, but locally infiltrating odontogenic
neoplasm. It accounts for less than 1% of all odontogenic tumors. This is a case report of recurrent
CEOT in the maxilla. A 35-year-old patient reported after three years of surgical excision of the
lesion, with a recurrence. It is of particular concern because of its anatomic location in the maxilla.
Maxillary tumors tend to be more aggressive and rapidly spreading and may involve the surrounding
vital structures. Adequate resection of the lesion with disease-free surgical margins and long-term
follow-up is recommended.
Key Words: Calcifying epithelial odontogenic tumor, maxillary tumors, odontogenic tumor
INTRODUCTION
The calcifying epithelial odontogenic tumor
(Pindborgs tumor) is a benign neoplasm of
odontogenic origin.[1] It is a rare tumor accounting
for less than 1% of all odontogenic tumors.[2] It is
a benign, though occasionally locally invasive, slowgrowing
neoplasm. They are localized generally in
posterior part of mandible and rarely occur in the
maxilla.[1,2] This article reports a case of recurrent
CEOT of the maxilla in a 35 year old male patient.
CASE REPORT
A male patient aged 35 years reported with a painless
swelling of eight months duration in the left upper jaw
in 2005. On examination, it was hard in consistency
with expansion of the cortical plates [Figures 1
and 2]. The first premolar tooth was missing with
no history of previous dental extractions. The
panoramic radiograph showed a diffuse honeycomb
type of radiolucency extending from premolar to
third molar region withfew radiopacities [Figures 3
and 4]. The lesion was associated with an impacted
tooth, which resembled a premolar and was displaced
posterosuperiorly. There was no evidence of root
resorption of the adjacent teeth .The lesion was
surgically excised and histopathologically diagnosed
as calcifying epithelial odontogenic tumor (CEOT).
Microscopic examination of the tissue revealed
sheets and strands of polyhedral epithelial cells
with hyperchromatic nuclei, mild to moderate
pleomorphism and prominent intercellular bridges.
Eosinophilic hyaline deposits with calcifications were
found within and between sheets of epithelial cells.
The patient was not regular for the follow up and
reported again in 2008, three years after excision.
The patient had noticed a growth in the same region
five months back and experienced no discomfort.
A computed tomography (CT) scan showed a large,
expansile, radiolucent lesion with multiple areas of
calcification which completely obliterated the left
maxillary antrum [Figures 4 and 5]. The scan showed
the tumor extending and involving the lateral nasal
wall, orbital floor and the medial pterygoid plate
[Figures 6 and 7]. An incisional biopsy confirmed
the lesion to be a recurrence of CEOT. No atypias
or mitoses were found. The lesion was excised
with wide surgical margins and the patient is under
observation for the past three years without any signs
of recurrence.
Received: September 2011
Accepted: December 2011
Address for correspondence:
Dr. Reji Abraham,
Department of
Orthodontics, Sri
Hasanamba Dental College
and Hospital, Vidyanagar,
Hassan 573201, Karnataka,
India.
E-mail: rejiabm@gmail.com
Access this article online
Website: www.drj.ir
ABSTRACT
Calcifying epithelial odontogenic tumor (CEOT) is a rare benign, but locally infiltrating odontogenic
neoplasm. It accounts for less than 1% of all odontogenic tumors. This is a case report of recurrent
CEOT in the maxilla. A 35-year-old patient reported after three years of surgical excision of the
lesion, with a recurrence. It is of particular concern because of its anatomic location in the maxilla.
Maxillary tumors tend to be more aggressive and rapidly spreading and may involve the surrounding
vital structures. Adequate resection of the lesion with disease-free surgical margins and long-term
follow-up is recommended.
Key Words: Calcifying epithelial odontogenic tumor, maxillary tumors, odontogenic tumor