Odontogenic Tumors

Lecture given 8/14/2026

odontogenic keratocyst

ameloblastoma

odontogenic myxoma

tumors of odontogenic epithelium

ameloblastoma, adenomatoid odontogenic tumor, calcifying epithelial odontogenic tumor, squamous odontogenic tumor, clear cell odontogenic carcinoma

ameloblastoma

most common odontogenic tumor

can arise from rests of dental lamina, developing enamel organ, epithelial lining of the odontogenic cyst, or from basal cells of the oral mucosa

benign, slow growing, locally invasive tumors

age 20-60 yr

mandible > maxilla, posterior > anterior

asymptomatic or painless expansion

often associated with impacted 3rd molars

resorption of adjacent tooth roots common

multilocular/unilocular radiolucent lesion (soap bubble/honeycombed)

tx: margina resection, progressive infiltration to involve vital structures is occasionally seen

ameloblastoma

ameloblastoma

ameloblastoma

ameloblastoma

ameloblastoma

what are the common histopathologic features of an ameloblastoma?

connective tissue (pink) is normal, epithelial tissue is ‘tumor’ aka arranged in islands

epithelial cells are elongated, hyperchromatic, and reverse polarized

center of islands are loosely arranged

when comparing malignant ameloblastoma and ameloblastic carcinoma, what are the common features of malignant ameloblastoma ?

affects any age

metastases to the lung, cervical lymph node, bone

no cytologic atypia

poor prognosis

when comparing malignant ameloblastoma and ameloblastic carcinoma, what are the common features of ameloblastic carcinoma?

affects any age but more common in older age groups

metastases do not necessarily occur

cytological features of malignancy

poor prognosis

adenomatoid odontogenic tumor

3-7% of all odontogenic tumor

arises from epithelial remnants of dental lamina or from the enamel organ epithelium

young pts between 10-19 yrs

anterior maxilla

females > males

asymptomatic/sometimes causes painless expansion

often involves the crown of an unerupted canine

unilocular radiolucency, may show snowflake like calcifications

tx: enucleation, does not recur

adenomatoid odontogenic tumor

adenomatoid odontogenic tumor

adenomatoid odontogenic tumor

adenomatoid odontogenic tumor

adenomatoid odontogenic tumor

adenomatoid odontogenic tumor

adenomatoid odontogenic tumor

adenomatoid odontogenic tumor, left image

ameloblastoma, left image

what are the common histopathologic features of an adenomatoid odontogenic tumor?

connective tissue is within normal limits

has duct like structures

forms swirls