An Unusual Presentation of Adenomatoid Odontogenic Tumor: A Case Report

Abstract

Background
Adenomatoid odontogenic tumor (AOT) is uncommon, nonaggressive neoplasms of odontogenic epithelium. It is also known as two-third (2/3rd) tumor as 2/3rd occur in maxilla, 2/3rd occur in females, 2/3rd cases are associated with unerupted/impacted tooth and 2/3rd teeth affected are canines.

Case description
A 17-years female reported to department with complaint of swelling in lower front region of jaw since 9 months which was sudden in onset, gradually progressive. On examination single, localized, well-defined, oval, firm, non-tender swelling present with no discharge on palpation. Size was approximately 8cm×4cm extending mesial of 35 to mesial of 44 and from crest of marginal gingiva to the depth of buccal vestibule. 33 was missing and grade 3 mobility w.r.t. 31, 32, 41, 42, 43. Expansion of buccal and lingual cortical plate with displacement of teeth present.
Panoramic radiograph revealed single, localized, well-defined, oval, corticated, unilocular radiolucency with flecks of radioopacity interspersed within radiolucency. Tooth displacement and external root resorption present w.r.t. 32-43 with transmigrated 33. Discontinuity of inferior border of mandible seen w.r.t. 31-34 region. Provisional diagnosis of Dentigerous cyst (DC) w.r.t. 33 was made with differential diagnosis of Adenomatoid odontogenic tumor (AOT) and Calcifying odontogenic cyst (COC). Biopsy followed by histopathological examination confirmed the diagnosis of AOT.

Conclusion
Based on our clinical findings, provisional diagnosis of DC was given but histopathological examination diagnosed as AOT. So, whenever we encounter a lesion in young patients with unerupted tooth in anterior mandible region AOT should be kept as a part of differential diagnosis.