Table Of ContentPeterA. Heichart/Hans P.Philipsen
Odontogenic Tumors and Allied Lesions
Odontogenic Tumors
and Allied besions
Prof Dr Peter A. Reichart
Humboldt-University of Berlin
Berlin, Germany
Prof Dr odont Hans P. Philipsen
Guadalmina Alta, Spain
Quintessence Publishing Co Ltd
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British Library Cataloguing in Publication Data
Reichart, P. (Peter)
Odontogenic tumors and allied lesions
1.Odontogenictumors 2.Odontogeniccysts 3.Jaws- Cancer
I.Title II.Philipsen,H.P.(HansP.)
616 .9'923 14
ISBN 1850970599
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Contents
SectionThree: Benign Neoplasms and Tumor-like Lesions Showing
Odontogenic Epithelium With Odontogenic Ectomesenchyme, With
orWithout Dental Hard Tissue Formation 117
Introduction to Mixed Odontogenic Tumors 117
Chapter 12 Ameloblastic Fibroma 121
Chapter 13 Ameloblastic Fibrodentinoma 129
Chapter 14 Ameloblastic Fibro-odontoma 133
Chapter 15 Complex Odontoma 141
Chapter 16 Compound Odontoma 149
Chapter 17 Calcifying Ghost CellOdontogenic Cysts/Tumors
(Odontogenic Ghost Cell Lesions) 155
Chapter 18 Odontoameloblastoma 171
Section Four: Benign Neoplasmsand Tumor-like Lesions Showing
Mesenchyme and/or Ectornesenchyrne 177
ss-;
Introduction 177
Chapter 19 Odontogenic Fibroma 179
Chapter 20 Odontogenic Myxoma or Myxofibroma 189
Chapter 21 Benign Cementoblastoma 199
Section Five: Malignant Epithelial Odontoqenic Neoplasms 205
Introduction to Odontogenic Carcinomas 205
Chapter22 Metastasizing,MalignantAmeloblastoma 207
Chapter23 Ameloblastic Carcinoma(Primary,Secondary[Dedifferentiated]
Intraosseous; Secondary [Dedifferentiated] Extraosseous) 215
Chapter 24 Primary Intraosseous Squamous Cell Carcinoma (Solid) 221
Chapter 25 Primary Intraosseous Squamous Cell Carcinoma Derived
from Odontogenic Cysts 227
Chapter 26 Primary Intraosseous Squamous Cell Carcinoma Derived
from Keratinizing Cystic Odontogenic Tumor 233
Chapter 27 Clear Cell Odontogenic Carcinoma 239
Chapter 28 Ghost Cell Odontogenic Carcinoma 249
Contents
Section Six: Malignant Ectomesenchymal Odontogenic Neoplasms
(Odontogenic Sarcomas) 253
Introductionto OdontogenicSarcomas 253
Chapter 29 Ameloblastic Fibrosarcoma 255
Chapter 30 Ameioblastic Fibrodentinosarcoma and Fibro-odontosarcoma 263
Chapter 31 Odontogenic Carcinosarcoma 269
Section Seven: Neoplasms and Other Lesions Occurring inthe
Maxillofacial Skeleton 271
Introduction to Neoplastic and Non-neoplastic Osseous Lesions 271
Chapter 32 Ossifying Fibroma 273
Chapter 33 Fibrous Dysplasia 281
Chapter 34 Focal Cemento-osseous Dysplasia 293
Chapter 35 Florid Cemento-osseous Dysplasia 301
Chapter 36 Cherubism 309
Chapter 37 Central Giant Cell Lesion (Granuloma) 319
Section Eight: Pseudocysts of the Jaws 333
Introduction 333
Chapter 38 Aneurysmal Bone Cavity (Aneurysmal Bone Cyst) 335
Chapter 39 Simple Bone Cavity (Simple Bone Cyst) 343
Chapter 40 Lingual Mandibular Bone Depression (Stafne's Cavity) 351
Chapter 41 Focal Marrow-containing Jaw Cavity (Focal Osteoporotic
Bone Marrow Defect) 359
Secti,onNine: Nonodontogenic Jaw Tumor of Neurocrest Origin 365
Introduction 365
Chapter 42 Melanotic Neuroectodermal Tumor of Infancy 367
Index 375
Foreword
Intheyears since the Second World War, and ified by an international panel of oral and
particularly in the past three decades, there anatomical patho logists appointed by the
have been considerable advances in under World Health Organization and chaired by
standing of the natural history, structure and Jens Pindborg. Their recommendations
behaviour of the odontogenic tumors. Prior were published in 1971 in the work Histo
lothis,therewasofcourse interestinthesub logicalTyping ofOdontogenic Tumours,Jaw
jectandattemptswere madetoclassifythem Cysts, and Allied Lesions. These proposals
inalogicalmanner. Asearlyas 1887,Bland were refined further in 1992 in the Second
Sutton had proposed subd ividing the 'odon EditionofthisWHO seriesunderthesimpler
tomes' into those arising from aberrations of heading Histological Typing ofOdontogenic
the enamel organ, aberrations of the follicle, Tumours. This 1992 classification classified
ofthe papilla,and aberrations of the whole both benign and malignant odontogenic tu
tooth germ. He also included a fifth group of mors into those of odontogenic epithelium
anomalous odontomes. The report of the without odontogenic ectomesenchyme,
BritishDentalAssociation,published in1914 those of odontogenic epithelium with odon
and authored by Gabell, James and Payne, togenic ectomesenchyme, and those of
included both radicu lar and den tigerous odontogenic ectomesenchyme.
cysts as odontomes, and also grouped the Contemporaneously, large numbers of
lesions into three categories, those of ep clinicopathological and laboratorystudies of
ithelial, composite and connective tissue ori t he range of odontogenic tumors have
gin. been published in peer-reviewed journals,
The 1946 classification published by contributing greatlyto our understanding of
Thoma and Goldman separated the odon these lesions. Peter Reichart and Hans Pe
togenic tumors into those of ectodermal, ter Philipsen, the authors of this book, have
mesodermal and mixed origin. This was themselves made valuable contributions to
widelyaccepted intextbooks and formed the scholarship inthisfield inaseriesofmeticu
basisofthe 1950 classification approved by louslydocumentedreviewsand descriptions
theAmerican Academy ofOral Patholocy. of topics such as the amelob lastoma, uni
In1958,Pindborgand Clausen(FinnPree cystic ameloblastoma, desmoplastic amelo
torius) proposed a classification that sepa blastoma,adenomatoid odontogenictumor,
rated the epithelial odontogenic tumors into and most recently a suggestion for revisions
twogroups accordingtowhetherornotthere of the 1992 WHO classification. It is worth
wereinductivechanges intheconnectivetis recording herethatitwasPhilipsenwho,with
sue.This concept was developed and mod Birn, introduced the term adenomatoid
9
Preface
Wehavemadean effortto presentthechap as witnessed by a rather steep increase in
tersof this book in a uniform and easy-to-use publications on lesions covered bythe clas
format. In some instances, however, we have sification. The purpose of the WHO classifi
had to deviate from the "beaten track" and cations was clearly expressed by Kramer et
introduce an extra paragraph or section al5 whenthey wrote thefollowing: "The pub
when appropriate. The terminology of the lications in the series International Histologi
chapter titles may not immediately be tarnll cal Classification of Tumours are not intend
iartoyou.We havea priorichosen theterms ed to serve as textbooks, but rather to
agreed on today by a majority of investiga facilitate the adoption of a uniforrn terminol
tors,andthosewe,basedonthemost recent ogy that will facilitate and irnprove commu
suggestions, find the most appropriate. The nication arnong cancer workers. For this rea
subtitle (in brackets) may, however, be met son literature references have been omitted
with a nod of recognition. and readers should refer to standard works
The reader willappreciatethatthetumors for bibliographies."
andlesionscovered inthe text arerarein re There is no doubt that the publication of
lation to the frequency of benign and malig the WHO classifications intensified the zeal
nant tumors in all locations; Baden1 gave a fordoing researchinthefield ofodontogenic
conservative estimate of about 0.002% to tumors and publishing the results, because
0.003%ofallsurgicalsreceived inlargecen terminology and a diagnostic frarnework
ters. If only neoplasms were considered, the were now available. We have, however, gen
frequency wouid increaseto about 0.006%. erally been disappointed in trying to trace
Bhaskar? found that odontogenic tumors "standard works for bibliographies." A true
comprise 2.4% of all lesions biopsied in a standard workonodontogenictumorsdoes
dentaloffice.A more recent comparablefig not exist, apart from Baden's, which is now
urefrom Mexico City"was2.5%. 30 years old but was comprehensive at the
Odontogenic tumors, neoplasms, and time.
other lesions related to the jawbones have Weundertook to writethisbook because
foryearsbeenrecognized aspresenting clin we felt a need to fill this gap by co mpiling the
ical, radiologic, and histopathologic chal increasing amount of data within this field.
lenges.The firstappearanceof World Health Whatinitiated thoughtsofembarkingonthis
Organization (WHO) Histologic Typing of projectwere boththeinnumerabletimeswe
Odontogenic Tumors in 19714 made a had to look up passages in the blue WHO
marked impact onthegeneralinterestinthe booksovertheyearsandthefactthat wedid
study of this particular field of oral pathology, not always agree with the authors. Having
11
Description:Humboldt-University of Berlin, Germany. Describes the epidemiologic, radiologic, and histopathologic features of odontogenic tumors. Discusses recurrence rates and presents information about the most recent treatments available, as well as accurate diagnosis methods. Abundant halftone and two-tone i
