Mandible / maxilla
Benign tumors / tumorlike conditions
Odontoameloblastoma

Author: Anthony Martinez, M.D. (see Authors page)
Editor: Kelly R. Magliocca, M.D.

Revised: 14 December 2017, last major update December 2017

Copyright: (c) 2004-2017, PathologyOutlines.com, Inc.

PubMed Search: Odontoameloblastoma
Cite this page: Martinez, A. Odontoameloblastoma. PathologyOutlines.com website. http://pathologyoutlines.com/topic/mandiblemaxillaodontoameloblastoma.html. Accessed January 18th, 2018.
Definition / general
  • Odontoameloblastoma (OA) is / was viewed as an extremely rare mixed odontogenic tumor with both epithelial and mesenchymal components
    • Epithelial component represented by ameloblastoma
    • Mesenchymal component - a compound or complex odontoma
  • Not considered an entity in the current 4th edition WHO (El-Naggar: WHO Classification of Head and Neck Tumours, 4th Edition, 2017)
Essential features
Terminology
  • Odontoblastoma
  • Adamant-odontoma
  • Calcified mixed odontogenic tumor
  • Soft and calcified odontoma
  • Ameloblastic odontoma
Epidemiology
Sites
  • Molar / premolar region of maxilla or mandible
Clinical features
  • Swelling, dull pain, delayed eruption of teeth, bone expansion
Diagnosis
  • Diagnosis dependent on clinical, radiologic and pathologic correlation
Radiology description
  • Radiolucent lesion that can be destructive
    • Contains calcified structures resembling mature dental tissue
Radiology images

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Cystic lesion

Diffuse foci of radiopacities

Prognostic factors
  • Known to recur after curettage
  • No long term prognostic data, given so few cases
Case reports
Treatment
Gross images

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Surgical specimens

Microscopic (histologic) description
  • Proliferating odontogenic epithelium portion identical to that of an ameloblastoma with peripheral palisading, reverse polarization and stellate reticulum
    • Generally presenting as plexiform or follicular pattern
  • This epithelial portion appears intermingled with dental tissues of variable degrees of maturity
    • Can show resemblance to the developing rudimentary teeth, as in a compound odontoma
    • Can also show conglomerate masses of enamel, dentin and cementum, as seen in complex odontoma
Microscopic (histologic) images

Images hosted on PathOut server:

Case of the Week #367



Images hosted on other servers:

Various images

Odontogenic epithelial cells

Irregular masses of dysplastic dentin

Differential diagnosis
  • Ameloblastic fibroma
    • Composed of odontogenic epithelial component strands, cords and islands that may exhibit peripheral palisading, reverse polarization and stellate reticulum
    • Primitive appearing stroma that is delicate and lobular in appearance
    • Should not have the mesenchymal (odontoma) component
  • Ameloblastic fibro-odontoma
    • Has soft tissue component that is similar to ameloblastic fibroma
    • Also contains a calcifying component composed of enamel and dentin structures
  • Ameloblastoma
    • Same histologic epithelial features with peripheral palisading, reverse polarization and stellate reticulum
    • Should not have mixed mesenchymal component (odontoma)
  • Calcifying cystic odontogenic tumor (CCOT)
    • Benign cystic tumor of odontogenic origin, also known as Gorlin cyst or calcifying odontogenic cyst
    • Can have ameloblastic features: columnar or cuboidal basal cells with lumen lined by tissue resembling stellate reticulum
    • Will have ghost cells or anucleate epithelial cells
    • Can also have dentinoid materal resembling odontoma in around 20% of cases
  • Odontoma
    • Compound odontoma: cluster of denticles of varying sizes
    • Complex odontoma: conglomerate of dentin admixed with enamel matrix