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Case Report
Maxillary peripheral calcifying epithelial odontogenic tumour (Pindborg tumor) R. Marino, M. Berrone, M. Nesti, M. Pentenero, S. Gandolfo Department of Oncology, Oral Medicine and Oral Oncology Unit, University of Turin, Italy A 37-year-old female was referred to our clinic for a single, slow-growing, painless, fibrous, upper gingival swelling. Intraoral examination revealed a 20 mm sessile mass involving the left alveolar process and displacing the lateral incisor and the canine which were vital and not mobile. The overlying mucosa showed an ulcer due to chronic dental trauma from the lower teeth. Panoramic radiographs did not indicate any bone involvement. An incisional biopsy was consistent with peripheral calcifying epithelial odontogenic tumor (CEOT). After a CT assessment showing bone resorption with maintenance of the vestibular cortical bone, the mass was excised under general anesthesia with a conservative surgical approach, comprehending the displaced teeth. The underlying bone resorption was corrected by a fresh frozen homologous bone graft provided by the local Tissue Bank. Healing was uneventful with successful bone graft integration and no recurrence was found after a 2-year follow-up. The histopathological assessment showed sheets of polyhedral epithelial cells with well-defined borders, pleomorphic nuclei and prominent intercellular bridges, amyloid-like material within the sheets of epithelial cells and calcification in the form of Liesegang rings, thus confirming the diagnosis of CEOT. Peripheral CEOTs are extremely rare, accounting for 6% of all CEOTs and for approximately 0.024-0.18% of all the odontogenic tumours. After the first description by Pindborg in 1966, about 20 cases of peripheral CEOTs have been reported in the literature. They generally occur as single, painless, non-bleeding, gingival masses mainly located in the anterior and premolar regions, that commonly resemble oral hyperplastic or reactive lesions. The significant bone resorption observed in the present case underlines the importance of reconstructive surgery for a proper management and rehabilitation. References • •
Pindborg JJ. Calcifying epithelial odontogenic tumor. Review of the literature and report of an extraosseous case. Acta Odontol Scand 1966; 24:419-30. Studart-Soares EC, Gurgel-Costa FW, Silveira-Esses DF, Alves-Filho EP, Nunes-Alves. APN Gingival calcifying epithelial odontogenic tumor: Case report and review of the literature comprising a period of 44 years. Journal of Clinical and Experimental Dentistry 2011; 3:e491-e6.
Annali di Stomatologia 2013; Suppl. 2: 1-48
27
Case Report
Maxillary peripheral calcifying epithelial odontogenic tumour (Pindborg tumor) R. Marino, M. Berrone, M. Nesti, M. Pentenero, S. Gandolfo Department of Oncology, Oral Medicine and Oral Oncology Unit, University of Turin, Italy A 37-year-old female was referred to our clinic for a single, slow-growing, painless, fibrous, upper gingival swelling. Intraoral examination revealed a 20 mm sessile mass involving the left alveolar process and displacing the lateral incisor and the canine which were vital and not mobile. The overlying mucosa showed an ulcer due to chronic dental trauma from the lower teeth. Panoramic radiographs did not indicate any bone involvement. An incisional biopsy was consistent with peripheral calcifying epithelial odontogenic tumor (CEOT). After a CT assessment showing bone resorption with maintenance of the vestibular cortical bone, the mass was excised under general anesthesia with a conservative surgical approach, comprehending the displaced teeth. The underlying bone resorption was corrected by a fresh frozen homologous bone graft provided by the local Tissue Bank. Healing was uneventful with successful bone graft integration and no recurrence was found after a 2-year follow-up. The histopathological assessment showed sheets of polyhedral epithelial cells with well-defined borders, pleomorphic nuclei and prominent intercellular bridges, amyloid-like material within the sheets of epithelial cells and calcification in the form of Liesegang rings, thus confirming the diagnosis of CEOT. Peripheral CEOTs are extremely rare, accounting for 6% of all CEOTs and for approximately 0.024-0.18% of all the odontogenic tumours. After the first description by Pindborg in 1966, about 20 cases of peripheral CEOTs have been reported in the literature. They generally occur as single, painless, non-bleeding, gingival masses mainly located in the anterior and premolar regions, that commonly resemble oral hyperplastic or reactive lesions. The significant bone resorption observed in the present case underlines the importance of reconstructive surgery for a proper management and rehabilitation. References • •
Pindborg JJ. Calcifying epithelial odontogenic tumor. Review of the literature and report of an extraosseous case. Acta Odontol Scand 1966; 24:419-30. Studart-Soares EC, Gurgel-Costa FW, Silveira-Esses DF, Alves-Filho EP, Nunes-Alves. APN Gingival calcifying epithelial odontogenic tumor: Case report and review of the literature comprising a period of 44 years. Journal of Clinical and Experimental Dentistry 2011; 3:e491-e6.
Annali di Stomatologia 2013; Suppl. 2: 1-48
27
