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Primordial odontogenic tumor occurred in the maxilla with unique calcifications and its crucial points for differential diagnosis
Author(s) -
Kayamori Kou,
Tsuchiya Maiko,
Michi Yasuyuki,
Kuribayashi Ami,
Mikami Toshinari,
Sakamoto Kei,
Yoda Tetsuya,
Ikeda Tohru
Publication year - 2021
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/pin.13036
Subject(s) - pathology , enamel organ , differential diagnosis , odontogenic tumor , maxilla , lesion , anatomy , dental papilla , epithelium , adamantinoma , connective tissue , ameloblastoma , biology , medicine , enamel paint , dentin , ameloblast , dentistry , odontoblast
Primordial odontogenic tumor (POT) is a newly classified, mixed epithelial and mesenchymal odontogenic tumor, with only 17 reported cases to date. Herein, we report a case of POT that occurred in the right maxilla of a 10‐year‐old boy and reveal unique features in comparison with those previously reported. Radiologically, the lesion presented as a well‐defined, unilocular radiolucency with notable radiopaque foci on the periphery. Microscopically, the tumor was mainly composed of dental papilla‐like myxoid fibrous connective tissue, largely surrounded by non‐keratinized squamous epithelium with numerous calcified particles, and partly enclosed by inner enamel epithelium‐like columnar cells and enamel organ‐like structures accompanied with cuboidal and/or stellate reticulum‐like cells. Immunohistochemically, the epithelium tested positive for cytokeratin 14 and 19. Moreover, amelogenin and ameloblastin, matrix proteins relating to enamel formation, were positive in the covering epithelium. The tumor was enucleated as a whole, and no recurrence was recorded thereafter. Although the presence of numerous calcified particles was unique, we diagnosed this lesion as POT based on the above‐described features. Furthermore, we emphasize the importance of the differential diagnosis of POT and other odontogenic tumors that resemble corresponding tooth germ components.