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.

THANK YOU !