Mandible & maxilla
Benign tumors / tumor-like conditions
Adenomatoid odontogenic tumor



Topic Completed: 1 October 2013

Minor changes: 10 May 2020

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PubMed Search: Adenomatoid odontogenic tumor [title]


Nat Pernick, M.D.
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Cite this page: Pernick N. Benign tumors / tumor-like conditions: adenomatoid odontogenic tumor. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/mandiblemaxillaadenomatoid.html. Accessed May 30th, 2020.
Definition / general
  • Also called adenoameloblastoma
  • Relatively uncommon
  • 70% in teens, remainder from 5 to 50 years, more common in females
  • Associated with unerupted canine tooth
  • Slow growing, few / no symptoms
Sites
  • Incisor-cuspid area of maxilla
Radiology description
  • Well defined unilocular lesion surrounding crown of unerupted or impacted tooth
  • May be cystic or expansive but not invasive
Case reports
Treatment
  • Enucleation; does not recur
Clinical images

Images hosted on other servers:
Missing Image

Fig 1: solitary cyst-like lesion

Gross description
  • Rounded, well defined fibrous capsule, cystic with focal solid areas
  • Crown of tooth usually projects into cystic cavity
Microscopic (histologic) description
  • Well circumscribed, central proliferation of ductlike epithelium surrounding small foci of calcification
  • Epithelium may have rosettes, trabecular or cribriform patterns
  • Columnar type cells with basal nuclei and clear cytoplasm may resemble pre-ameloblasts
  • Eosinophilic fibrillar material is present between tumor cells and within ductlike structures
  • Rarely melanin deposition
Microscopic (histologic) images

Case of the Month #490:


Images hosted on other servers:
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Fig. 2-4: ductlike spaces and solid nodules

Electron microscopy description
  • Glandular differentiation
Differential diagnosis
Board review style question #1
Which of the following scenarios represents the most common set of clinical features associated with the follicular variant of adenomatoid odontogenic tumor (AOT)?

  1. Anterior mandible, unerupted central incisor tooth, elderly male
  2. Anterior maxilla, unerupted canine tooth, teenage female
  3. Posterior mandible, unerupted first molar tooth, middle age female
  4. Posterior maxilla, unerupted premolar tooth, teenage male
Board review answer #1
B. Anterior maxilla, unerupted canine tooth, teenage female

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Reference: Adenomatoid odontogenic tumor
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