pindborg tumor by anchal mehra
TRANSCRIPT
GOOD AFTERNOON
Introduction
Definition
Etiology
Clinical Features
Radiologic Features
Histopathological Features
Differential Diagnosis
Treatment
References
It was first described by Dr Jens J Pindborg in1956 .
Pindborg tumor is its synonym.
Abbreviated as CEOT .
It accounts for <1% of all odontogenic tumors.
The calcifying epithelial odontogenic tumor isclassified as an Uncommon , Benign , Odontogenicneoplasm that is exclusively epithelial in origin .
CEOT is defined as a locally invasive epithelialneoplasm characterized by the development ofintraepithelial structures, probably of an amyloidlike nature, which may be liberated as cellsbreakdown.
-WHO(1992)
Originates from the epithelial rests of the dental lamina or from the reduced enamel epithelium that overlies the crown of the tooth.
Some have suggested that the epithelial cells are reminiscent of the cells in the stratum intermedium layer of the enamel organ in the tooth development.
Though stimulus for growth & definite etiology still remains enigmatic.
Mean age of occurence - 40 yrs inboth the genders.
Occurs most frequently in middleage.
No significant occurencebetween the gender , since 49%of the cases were in men & 51% inwomen.
Predilection of occurence inmandible over maxilla by 2:1 ratio.
Prevalence in molar region is 3times than in the bicuspid region.Else where there is evendistribution.
Painless swelling. Jaw expansion or incidental
observation on routineradiographs.
Bone erosion near the tumor
Associated with impacted teeth.
Translucent area with poorly defined margins &increased radiopacities within the tumor as it matures.
EPITHELIAL CELLS.
HOMOGENOUS EOSINOPHILIC AMYLOIDMATERIAL.
CALCIFICATION. Epithelial cells - polygonal
arranged in sheets or islands
clear to eosinophilic cytoplasm
variation in nuclei
Extra cellular, pale eosinophilic material resemblingamyloid is observed interspersed amidst the tumor cells.
Presence of calcification –small, rounded,LIESEGANGRINGS,large aggregates.
AMYLOID LIKE MATERIAL AFTER STAINING WITH CONGO RED STAIN GIVES - APPLE GREEN APPEARENCE .
LIESEGANG RINGS.
At lower magnification
At high magnification
A well recognised form of this tumor is Clear cellvariant.
In this tumor cells exhibit a clear vacuolatedcytoplasm rather than eosinophilic cytoplasm.
It is distinguished by sheets & islands of tumorcells that are devoid of stainable cytoplasm.
WHEN ONLY RADIOLUCENCY IS SEEN
Dentigerous cyst,
Okc
Ameloblastoma
Odontogenic myxoma.
WHEN MIXED RADIOLUCENCY i.e radiopacitypattern is encontered
COC
Complete excision with border of normal bone.
Recurrence follows incomplete excision.
Overall recurrence rate <20% .
Regressive surgery not indicated.
Rare neoplasm of odontogenic epithelium.
Usually presents between 30-40 years.
Many bizarre pleomorphic & hyperchromatic nuclei& formation of amyloid like material.
Solid tumor , mixed radiolucency.
Most commonly forms in posterior mandible.
Locally invasive but doesnot metastasize.
Treatment by excision with a small margin.
Shafer’s textbook of oral pathology 6th Edition.
Neville Damm Allen Bouquot
R.A Cawson, E.W Odell Essentials of oralpathology & oral medicine 6th Edition.
Josheph A Regezi ,James J Sciubba Oralpathology clinical pathology correlations 3rd
Edition.
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