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Semin Musculoskelet Radiol 2020; 24(05): 535-548
DOI: 10.1055/s-0040-1710357
Review Article

World Health Organization Classification of Odontogenic Tumors and Imaging Approach of Jaw Lesions

Vasiliki Siozopoulou 
1   Department of Pathology, Antwerp University Hospital and Antwerp University, Edegem, Belgium
2   Center for Oncological Research (CORE), University of Antwerp, Wilrijk, Belgium
,
Filip M. Vanhoenacker 
3   Department of Radiology, Antwerp University Hospital and Antwerp University, Edegem, Belgium
4   Department of Radiology, AZ Sint-Maarten, Mechelen, Belgium
5   Department of Radiology and Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Abstract

Tumors of the jaws represent a heterogeneous group of lesions that are classified histologically in the World Health Organization Classification of Odontogenic Tumors (2017). This article provides an update of the current nomenclature. The main role of imaging is to describe the precise location and extent of these lesions. Although characterization of imaging is often difficult due to overlapping characteristics, imaging is helpful to define which lesions should be referred for histologic examination and subsequent treatment planning. Location and density are the cardinal criteria for potential characterization on imaging. Radiologically, lesions may be radiolucent, radiopaque, or of mixed density. Additional criteria include lesion demarcation, morphology, cortical breakthrough, periosteal reaction, and adjacent soft tissue changes. Final lesion characterization is only definitive after interdisciplinary discussion and radiopathologic correlation. Correct diagnosis is obtained by a combination of the patient's age, lesion location, and clinical and radiologic presentation. It is important that all physicians use a uniform nomenclature.

Keywords

jaws - histopathology - radiography - cone-beam computed tomography


Publication History

Article published online:
09 October 2020

© 2020. Thieme. All rights reserved.

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  • References

  • 1 Rajendra Santosh AB, Ogle OE. Odontogenic tumors. Dent Clin North Am 2020; 64 (01) 121-138
    CrossrefPubMedSearch in Google Scholar
  • 2 Pindborg JKI. Histological typing of odontogenic tumours, jaw cysts and allied lesions. In: WHO International Histological Classification of Tumours. Geneva, Switzerland: WHO; 1971
    Search in Google Scholar
  • 3 Speight PM, Takata T. New tumour entities in the 4th edition of the World Health Organization classification of head and neck tumours: odontogenic and maxillofacial bone tumours. Virchows Arch 2018; 472 (03) 331-339
    CrossrefPubMedSearch in Google Scholar
  • 4 El-Naggar AKCJ, Grandis JR, Takata T, Slootweg PJ. Odontogenic tumours. In: WHO Classification of Head and Neck Tumours. Vol 9. Geneva, Switzerland: WHO; 2017
    Search in Google Scholar
  • 5 Wright JM, Soluk Tekkesin M. Odontogenic tumors: where are we in 2017?. J Istanb Univ Fac Dent 2017; 51 (03) (Suppl. 01) S10-S30
    PubMedSearch in Google Scholar
  • 6 Wright JM, Vered M. Update from the 4th Edition of the World Health Organization Classification of Head and Neck Tumours: Odontogenic and Maxillofacial Bone Tumors. Head Neck Pathol 2017; 11 (01) 68-77
    CrossrefPubMedSearch in Google Scholar
  • 7 Buchner A, Merrell PW, Carpenter WM. Relative frequency of central odontogenic tumors: a study of 1,088 cases from Northern California and comparison to studies from other parts of the world. J Oral Maxillofac Surg 2006; 64 (09) 1343-1352
    CrossrefPubMedSearch in Google Scholar
  • 8 Hertog D, van der Waal I. Ameloblastoma of the jaws: a critical reappraisal based on a 40-years single institution experience. Oral Oncol 2010; 46 (01) 61-64
    CrossrefPubMedSearch in Google Scholar
  • 9 Heikinheimo K, Kurppa KJ, Laiho A. et al. Early dental epithelial transcription factors distinguish ameloblastoma from keratocystic odontogenic tumor. J Dent Res 2015; 94 (01) 101-111
    CrossrefPubMedSearch in Google Scholar
  • 10 Brunet M, Khalifa E, Italiano A. Enabling precision medicine for rare head and neck tumors: the example of BRAF/MEK targeting in patients with metastatic ameloblastoma. Front Oncol 2019; 9: 1204
    CrossrefPubMedSearch in Google Scholar
  • 11 Vasudevan K, Kumar S, , Vijayasamundeeswari, Vigneswari S. Adenomatoid odontogenic tumor, an uncommon tumor. Contemp Clin Dent 2012; 3 (02) 245-247
    CrossrefPubMedSearch in Google Scholar
  • 12 Harnet JC, Pedeutour F, Raybaud H, Ambrosetti D, Fabas T, Lombardi T. Immunohistological features in adenomatoid odontogenic tumor: review of the literature and first expression and mutational analysis of β-catenin in this unusual lesion of the jaws. J Oral Maxillofac Surg 2013; 71 (04) 706-713
    CrossrefPubMedSearch in Google Scholar
  • 13 Buchner A, Vered M. Ameloblastic fibroma: a stage in the development of a hamartomatous odontoma or a true neoplasm? Critical analysis of 162 previously reported cases plus 10 new cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116 (05) 598-606
    Search in Google Scholar
  • 14 Brown NA, Rolland D, McHugh JB. et al. Activating FGFR2-RAS-BRAF mutations in ameloblastoma. Clin Cancer Res 2014; 20 (21) 5517-5526
    CrossrefPubMedSearch in Google Scholar
  • 15 Galvão CF, Gomes CC, Diniz MG. et al. Loss of heterozygosity (LOH) in tumour suppressor genes in benign and malignant mixed odontogenic tumours. J Oral Pathol Med 2012; 41 (05) 389-393
    CrossrefPubMedSearch in Google Scholar
  • 16 Bomfim BB, Prado R, Sampaio RK. et al. Primordial odontogenic tumor: report of a new case and literature review. Head Neck Pathol 2019; 13 (02) 125-130
    CrossrefPubMedSearch in Google Scholar
  • 17 Sun Q, Lee JS, Kim O, Kim Y. Primordial odontogenic tumor: a case report and literature review. Diagn Pathol 2019; 14 (01) 92
    CrossrefPubMedSearch in Google Scholar
  • 18 Amer H, Hafed L, Ibrahim S. Case report: a primordial odontogenic tumor. F1000 Res 2018; 7: 562
    CrossrefPubMedSearch in Google Scholar
  • 19 Poomsawat S, Ngamsom S, Nonpassopon N. Primordial odontogenic tumor with prominent calcifications: a rare case report. J Clin Exp Dent 2019; 11 (10) e952-e956
    PubMedSearch in Google Scholar
  • 20 Basaran G, Erkan M. One of the rarest syndromes in dentistry: Gardner syndrome. Eur J Dent 2008; 2 (03) 208-212
    Thieme ConnectPubMedSearch in Google Scholar
  • 21 Bloch-Zupan A, Goodman JR. Otodental syndrome. Orphanet J Rare Dis 2006; 1: 5
    CrossrefPubMedSearch in Google Scholar
  • 22 Buchner A, Akrish SJ, Vered M. Central dentinogenic ghost cell tumor: an update on a rare aggressive odontogenic tumor. J Oral Maxillofac Surg 2016; 74 (02) 307-314
    CrossrefPubMedSearch in Google Scholar
  • 23 Oginni FO, Stoelinga PJ, Ajike SA. et al. A prospective epidemiological study on odontogenic tumours in a black African population, with emphasis on the relative frequency of ameloblastoma. Int J Oral Maxillofac Surg 2015; 44 (09) 1099-1105
    CrossrefPubMedSearch in Google Scholar
  • 24 Taghavi N, Rajabi M, Mehrdad L, Sajjadi S. A 10-year retrospective study on odontogenic tumors in Iran. Indian J Dent Res 2013; 24 (02) 220-224
    CrossrefPubMedSearch in Google Scholar
  • 25 Harrison MG, O'Neill ID, Chadwick BL. Odontogenic myxoma in an adolescent with tuberous sclerosis. J Oral Pathol Med 1997; 26 (07) 339-341
    CrossrefPubMedSearch in Google Scholar
  • 26 Shao Z, Liu B, Zhang W, Chen X. Synchronous occurrence of odontogenic myxoma with multiple keratocystic odontogenic tumors in nevoid basal cell carcinoma syndrome. J Craniofac Surg 2013; 24 (05) 1840-1842
    CrossrefPubMedSearch in Google Scholar
  • 27 El-Mofty SK. Fibro-osseous lesions of the craniofacial skeleton: an update. Head Neck Pathol 2014; 8 (04) 432-444
    CrossrefPubMedSearch in Google Scholar
  • 28 Johnson NR, Gannon OM, Savage NW, Batstone MD. Frequency of odontogenic cysts and tumors: a systematic review. J Investig Clin Dent 2014; 5 (01) 9-14
    CrossrefPubMedSearch in Google Scholar
  • 29 Morrison A. Odontogenic cysts: dentigerous. Available at: https://www.pathologyoutlines.com/topic/mandiblemaxilladentigerous.html . Accessed February 19, 2020
  • 30 Gomes CC, Diniz MG, Gomez RS. Review of the molecular pathogenesis of the odontogenic keratocyst. Oral Oncol 2009; 45 (12) 1011-1014
    CrossrefPubMedSearch in Google Scholar
  • 31 Viveiros SK, Pinho RFC, Custódio M, de Sousa SCOM, Santos Pinto Jr DD. A rare odontogenic cyst: gingival cyst of the adult. A series of 20 new cases from a single center. J Craniomaxillofac Surg 2019; 47 (04) 647-650
    CrossrefPubMedSearch in Google Scholar
  • 32 Gardner DG, Kessler HP, Morency R, Schaffner DL. The glandular odontogenic cyst: an apparent entity. J Oral Pathol 1988; 17 (08) 359-366
    CrossrefPubMedSearch in Google Scholar
  • 33 Fowler CB, Brannon RB, Kessler HP, Castle JT, Kahn MA. Glandular odontogenic cyst: analysis of 46 cases with special emphasis on microscopic criteria for diagnosis. Head Neck Pathol 2011; 5 (04) 364-375
    CrossrefPubMedSearch in Google Scholar
  • 34 Bishop JA, Yonescu R, Batista D, Warnock GR, Westra WH. Glandular odontogenic cysts (GOCs) lack MAML2 rearrangements: a finding to discredit the putative nature of GOC as a precursor to central mucoepidermoid carcinoma. Head Neck Pathol 2014; 8 (03) 287-290
    CrossrefPubMedSearch in Google Scholar
  • 35 Kaplan I, Gal G, Anavi Y, Manor R, Calderon S. Glandular odontogenic cyst: treatment and recurrence. J Oral Maxillofac Surg 2005; 63 (04) 435-441
    CrossrefPubMedSearch in Google Scholar
  • 36 Jones AV, Craig GT, Franklin CD. Range and demographics of odontogenic cysts diagnosed in a UK population over a 30-year period. J Oral Pathol Med 2006; 35 (08) 500-507
    CrossrefPubMedSearch in Google Scholar
  • 37 Resende RG, Brito JA, Souza LN, Gomez RS, Mesquita RA. Peripheral calcifying odontogenic cyst: a case report and review of the literature. Head Neck Pathol 2011; 5 (01) 76-80
    CrossrefPubMedSearch in Google Scholar
  • 38 Nagao T, Nakajima T, Fukushima M, Ishiki T. Calcifying odontogenic cyst with complex odontoma. J Oral Maxillofac Surg 1982; 40 (12) 810-813
    CrossrefPubMedSearch in Google Scholar
  • 39 Ledesma-Montes C, Gorlin RJ, Shear M. et al. International collaborative study on ghost cell odontogenic tumours: calcifying cystic odontogenic tumour, dentinogenic ghost cell tumour and ghost cell odontogenic carcinoma. J Oral Pathol Med 2008; 37 (05) 302-308
    CrossrefPubMedSearch in Google Scholar
  • 40 Soluk-Tekkeşin M, Wright JM. The World Health Organization Classification of Odontogenic Lesions: a summary of the changes of the 2017 (4th) edition. Turk Patoloji Derg 2018;34(01):
  • 41 Maruyama S, Yamazaki M, Abé T, Babkair H, Cheng J, Saku T. Paradental cyst is an inclusion cyst of the junctional/sulcular epithelium of the gingiva: histopathologic and immunohistochemical confirmation for its pathogenesis. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120 (02) 227-237
    CrossrefPubMedSearch in Google Scholar
  • 42 Rizzitelli A, Smoll NR, Chae MP, Rozen WM, Hunter-Smith DJ. Incidence and overall survival of malignant ameloblastoma. PLOS One 2015; 10 (02) e0117789
    CrossrefPubMedSearch in Google Scholar
  • 43 Kruse AL, Zwahlen RA, Grätz KW. New classification of maxillary ameloblastic carcinoma based on an evidence-based literature review over the last 60 years. Head Neck Oncol 2009; 1: 31
    CrossrefPubMedSearch in Google Scholar
  • 44 Zwetyenga N, Pinsolle J, Rivel J, Majoufre-Lefebvre C, Faucher A, Pinsolle V. Primary intraosseous carcinoma of the jaws. Arch Otolaryngol Head Neck Surg 2001; 127 (07) 794-797
    PubMedSearch in Google Scholar
  • 45 Bilodeau EA, Weinreb I, Antonescu CR. et al. Clear cell odontogenic carcinomas show EWSR1 rearrangements: a novel finding and a biological link to salivary clear cell carcinomas. Am J Surg Pathol 2013; 37 (07) 1001-1005
    CrossrefPubMedSearch in Google Scholar
  • 46 Yancoskie AE, Sreekantaiah C, Jacob J. et al. EWSR1 and ATF1 rearrangements in clear cell odontogenic carcinoma: presentation of a case. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118 (04) e115-e118
    CrossrefPubMedSearch in Google Scholar
  • 47 Del Corso G, Tardio ML, Gissi DB, Marchetti C, Montebugnoli L, Tarsitano A. Ki-67 and p53 expression in ghost cell odontogenic carcinoma: a case report and literature review. Oral Maxillofac Surg 2015; 19 (01) 85-89
    CrossrefPubMedSearch in Google Scholar
  • 48 Ahmed SK, Watanabe M, deMello DE, Daniels TB. Pediatric metastatic odontogenic ghost cell carcinoma: a multimodal treatment approach. Rare Tumors 2015; 7 (02) 5855
    CrossrefPubMedSearch in Google Scholar
  • 49 Chikosi R, Segall N, Augusto P, Freedman P. Odontogenic carcinosarcoma: case report and literature review. J Oral Maxillofac Surg 2011; 69 (05) 1501-1507
    CrossrefPubMedSearch in Google Scholar
  • 50 DeLair D, Bejarano PA, Peleg M, El-Mofty SK. Ameloblastic carcinosarcoma of the mandible arising in ameloblastic fibroma: a case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103 (04) 516-520
    CrossrefPubMedSearch in Google Scholar
  • 51 Bernaerts A, Vanhoenacker FM, Hintjens J, Chapelle K, De Schepper AM. Imaging approach for differential diagnosis of jaw lesions: a quick reference guide. JBR-BTR 2006; 89 (01) 43-46
    PubMedSearch in Google Scholar
  • 52 DelBalso AM. An approach to the diagnostic imaging of jaw lesions, dental implants, and the temporomandibular joint. Radiol Clin North Am 1998; 36 (05) 855-890 , vi vi
    CrossrefPubMedSearch in Google Scholar
  • 53 Neyaz Z, Gadodia A, Gamanagatti S, Mukhopadhyay S. Radiographical approach to jaw lesions. Singapore Med J 2008; 49 (02) 165-176 ; quiz 177
    PubMedSearch in Google Scholar
  • 54 Vanhoenacker C, Vanhoenacker F, Vannitsen L. et al. Dental cone beam CT: a primer for clinical radiologists. Poster presented at: European Society of Head and Neck Radiology meeting; September 27, 2014; Marseille, France
  • 55 Yoshiura K, Weber AL, Runnels S, Scrivani SJ. Cystic lesions of the mandible and maxilla. Neuroimaging Clin N Am 2003; 13 (03) 485-494
    CrossrefPubMedSearch in Google Scholar
  • 56 Gohel A, Villa A, Sakai O. Benign jaw lesions. Dent Clin North Am 2016; 60 (01) 125-141
    CrossrefPubMedSearch in Google Scholar
  • 57 Bharatha A, Pharoah MJ, Lee L, Tay KY, Keller A, Yu E. Pictorial essay: cysts and cyst-like lesions of the jaws. Can Assoc Radiol J 2010; 61 (03) 133-143
    CrossrefPubMedSearch in Google Scholar
  • 58 Avril L, Lombardi T, Ailianou A. et al. Radiolucent lesions of the mandible: a pattern-based approach to diagnosis. Insights Imaging 2014; 5 (01) 85-101
    CrossrefPubMedSearch in Google Scholar