Mandible & maxilla
Benign odontogenic tumors
Adenomatoid odontogenic tumor
Author: Nat Pernick, M.D.
Last author update: 1 October 2013
Last staff update: 7 October 2022
Copyright: 2004-2023, PathologyOutlines.com, Inc.
PubMed Search: Adenomatoid odontogenic tumor [title]
Table of Contents
Definition / general | Sites | Radiology description | Case reports | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Electron microscopy description | Differential diagnosis | Board review style question #1 | Board review style answer #1Cite this page: Pernick N. Adenomatoid odontogenic tumor. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/mandiblemaxillaadenomatoid.html. Accessed March 27th, 2023.
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
- 17 year old girl with a 2 cm maxillary lesion surrounding an impacted canine tooth (Case of the Month #490)
- 28 year old man with impacted tooth (Arch Pathol Lab Med 2003;127:e173)
Treatment
- Enucleation; does not recur
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
Contributed by Kelly Magliocca, D.D.S., M.P.H.
Adenomatoid odontogenic tumor
Case of the Month #490:
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)?
- Anterior mandible, unerupted central incisor tooth, elderly male
- Anterior maxilla, unerupted canine tooth, teenage female
- Posterior mandible, unerupted first molar tooth, middle age female
- Posterior maxilla, unerupted premolar tooth, teenage male
Board review style answer #1
B. Anterior maxilla, unerupted canine tooth, teenage female
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Reference: Adenomatoid odontogenic tumor
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