Three-dimensional radiographic features of calcifying odontogenic cyst and calcifying epithelial odontogenic tumor

  • Xiaotong LING ,
  • Liuyang QU ,
  • Danni ZHENG ,
  • Jing YANG ,
  • Xuebing YAN ,
  • Denggao LIU ,
  • Yan GAO
Expand
  • 1. Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
    2. Special Dental Department, The First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
    3. Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China

Received date: 2023-06-27

  Online published: 2024-02-06

Abstract

Objective: To analyze the three-dimensional radiographic characteristics of calcifying odontogenic cyst and calcifying epithelial odontogenic tumor using spiral computed tomography (CT) and cone-beam computed tomography (CBCT). Methods: Clinical records, histopathological reports, and CBCT or non-enhanced spiral CT images of 19 consecutive patients with calcifying odontogenic cyst (COC) and 16 consecutive patients with calcifying epithelial odontogenic tumor (CEOT) were retrospectively acquired, and radiographic features, including location, size, expansion, internal structure and calcification, were analyzed. Results: Among the 19 COC cases (12 males and 7 females, with an average age of 27 years), 89.5% (17/19) of the lesions originated from the anterior and premolar areas, 100.0% of them exhibited cortex expansion, and 78.9% had discontinued cortex. Among the 16 CEOT cases (3 males and 13 females, with an average age of 36 years), 81.3% (13/16) of the lesions were in the premolar and molar areas, 56.3% of them exhibited cortex expansion, and 96.8% had discontinued cortex. According to the distribution of internal calcifications, these lesions were divided into: Ⅰ (non-calcification type): absence of calcification; Ⅱ (eccentric marginal type): multiple calcifications scattered along one side of the lesion; Ⅲ (diffused type): numerous calcifications diffusely distributed into the lesion; Ⅳ (plaque type): with a ≥ 5 mm calcified patch; Ⅴ (peri-coronal type): multiple calcifications clustered around impacted teeth. Calcifications were present in 73.7% of COC lesions, including 9 type Ⅱ, 3 type Ⅲ and 2 type Ⅳ lesions, and 42.8% of CEOT lesions had calcification images, including 2 type Ⅲ and 5 type Ⅴ lesions. Six COC lesions had odontoma-like images. Moreover, 8 of 9 type Ⅰ CEOTs were histologically Langerhans cell-rich subtype, which had a smaller size (with an average mesiodistal diameter of 17.8 mm) and were not associated with impacted teeth. Conclusion: COC lesions tended to originate from the anterior part of the jaw and exhibit cortex expansion, and were sometimes associated with odontoma. CEOT commonly occurred in the posterior jaw and had discontinued cortex. Two lesions had significantly different calcification map. Over 70% of COC lesions had calcification images, which were mostly scattered along one side of the cysts, far from the impacted teeth. Approximately 60% of CEOT lesions exhibited smaller size and non-calcification, and the remaining CEOT cases often had calcification images clustered around the impacted teeth.

Cite this article

Xiaotong LING , Liuyang QU , Danni ZHENG , Jing YANG , Xuebing YAN , Denggao LIU , Yan GAO . Three-dimensional radiographic features of calcifying odontogenic cyst and calcifying epithelial odontogenic tumor[J]. Journal of Peking University(Health Sciences), 2024 , 56(1) : 131 -137 . DOI: 10.19723/j.issn.1671-167X.2024.01.020

References

1 Lee SK , Kim YS . Current concepts and occurrence of epithelial odontogenic tumors: Ⅱ. Calcifying epithelial odontogenic tumor versus ghost cell odontogenic tumors derived from calcifying odontogenic cyst[J]. Korean J Pathol,, 2014, 48 (3): 175- 187.
2 马绪臣. 口腔颌面医学影像学[M]. 北京: 北京大学医学出版社, 2006.
3 Philipsen HP , Reichart PA . Adenomatoid odontogenic tumour: Facts and figures[J]. Oral Oncol, 1999, 35 (2): 125- 131.
4 Bansal SP , Shaikh S , Arvandekar AS , et al. Analysis of 55 cases of adenomatoid odontogenic tumor in an Indian population and review of literature[J]. Med Oral Patol Oral Cir Bucal, 2022, 27 (1): e85- e93.
5 陈菲, 张庆庆, 陆东辉, 等. 牙源性钙化囊性瘤临床病理研究[J]. 临床与实验病理学杂志, 2012, 28 (8): 891- 894.
6 付文荣, 程正江. 牙源性钙化上皮瘤3例临床病理观察[J]. 诊断病理学杂志, 2014, 21 (4): 231- 233.
7 Sonone A , Sabane VS , Desai R . Calcifying ghost cell odontogenic cyst: Report of a case and review of literature[J]. Case Rep Dent, 2011, 2011, 328743.
8 刘梅, 孙国文, 唐恩溢, 等. 牙源性钙化囊肿的临床病理分析[J]. 实用口腔医学杂志, 2020, 36 (1): 96- 99.
9 陶谦, 梁培盛. 2017版WHO牙源性肿瘤新分类之述评[J]. 口腔疾病防治, 2017, 25 (12): 749- 754.
10 Soluk-Tekkesin M , Wright JM . The World Health Organization classification of odontogenic lesions: A summary of the changes of the 2022 (5th) edition[J]. Turk Patoloji Derg, 2022, 38 (2): 168- 184.
11 Buchner A . The central (intraosseous) calcifying odontogenic cyst: An analysis of 215 cases[J]. J Oral Maxillofac Surg, 1991, 49 (4): 330- 339.
12 Ahmad SA , Popli DB , Sircar K , et al. Calcifying odontogenic cyst: Report of an uncommon entity with a brief literature review[J]. J Oral Maxillofac Pathol, 2022, 26 (1): 131.
13 Chandran A , Nachiappan S , Selvakumar R , et al. Calcifying epithelial odontogenic cyst of maxilla: Report of a case and review and discussion on the terminology and classification[J]. J Microsc Ultrastruct, 2020, 9 (2): 98- 102.
14 de Arruda JAA , Schuch LF , Abreu LG , et al. A multicenter study of 268 cases of calcifying odontogenic cysts and a literature review[J]. Oral Dis, 2018, 24 (7): 1282- 1293.
15 Rojo R , Prados-Frutos JC , Gutierrez Lázaro I , et al. Calcifying odontogenic cysts[J]. J Stomatol Oral Maxillofac Surg, 2017, 118 (2): 122- 124.
16 Chindasombatjaroen J , Poomsawat S , Boonsiriseth K . Two unique cases of calcifying cystic odontogenic tumor in the maxillary posterior region[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2014, 118 (4): 497- 504.
17 Santos HBP , de Morais EF , Moreira DGL , et al. Calcifying odontogenic cyst with extensive areas of dentinoid: uncommon case report and update of main findings[J]. Case Rep Pathol, 2018, 2018, 8323215.
18 Gamoh S , Akiyama H , Furukawa C , et al. Calcifying cystic odontogenic tumor accompanied by a dentigerous cyst: A case report[J]. Oncol Lett, 2017, 14 (5): 5785- 5790.
19 Hirshberg A , Kaplan I , Buchner A . Calcifying odontogenic cyst associated with odontoma: A possible separate entity (odontocalcifying odontogenic cyst)[J]. J Oral Maxillofac Surg, 1994, 52 (6): 555- 558.
20 Vizuete-Bola?os MX , Salgado-Chavarria F , Ramírez-Martínez CM , et al. Compound odontoma associated with a calcifying odontogenic cyst. Case report and systematic review[J]. J Stomatol Oral Maxillofac Surg, 2022, 123 (3): e97- e105.
21 张艳宁, 侯亚丽, 于美清, 等. 牙源性钙化上皮瘤1例临床病理分析及文献复习[J]. 实用口腔医学杂志, 2021, 37 (3): 431- 433.
22 Mujib BR , Kulkarni PG , Lingappa A , et al. An atypical presentation of Pindborg tumor in anterior maxilla[J]. Dent Res J (Isfahan), 2012, 9 (4): 495- 498.
23 Ibituruna ACH , Costa ARGF , Paulo LFB , et al. Multiple calcifying epithelial odontogenic tumor: Case report and review of the literature[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2019, 128 (3): 268- 272.
24 Zhang A , Chaw SY , Talacko AA , et al. Central calcifying epithelial odontogenic tumour in the posterior maxilla: A case report[J]. Aust Dent J, 2016, 61 (3): 381- 385.
25 王凯利, 郑广宁, 刘莉, 等. 牙源性钙化上皮瘤2例[J]. 华西口腔医学杂志, 2016, 34 (1): 104- 107.
26 Vered M , Wright JM . Update from the 5th edition of the World Health Organization classification of head and neck tumors: Odontogenic and maxillofacial bone tumours[J]. Head Neck Pathol, 2022, 16 (1): 63- 75.
27 王丽, 汪说之, 陈新明, 等. 牙源性钙化上皮瘤中朗格汉斯细胞的研究[J]. 口腔医学研究, 2005, 21 (6): 645- 648.
28 Hong SP , Ellis GL , Hartman KS . Calcifying odontogenic cyst. A review of ninety-two cases with reevaluation of their nature as cysts or neoplasms, the nature of ghost cells, and subclassification[J]. Oral Surg Oral Med Oral Pathol, 1991, 72 (1): 56- 64.
29 刘轶芳. 245例颌骨良恶性肿瘤的CT影像学特征的对比研究[D]. 上海: 上海交通大学, 2020.
30 叶婷婷, 陈蔚华, 裴婧, 等. 青少年牙本质生成性影细胞瘤1例[J]. 口腔医学研究, 2022, 38 (10): 995- 996.
31 王予江, 李琳琳. 外周型牙源性钙化囊性瘤病例报道[C]//中华口腔医学会口腔颌面外科专业委员会. 第十四次中国口腔颌面外科学术会议论文汇编. 重庆: [出版者不详], 2018: 1.
Outlines

/