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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists


 
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ENIGMATIC MORPHO INSIGHT  
Year : 2017  |  Volume : 21  |  Issue : 2  |  Page : 192-193
 

The so-called “combined epithelial odontogenic tumor”: A specific entity or not?


Department of Oral Pathology and Microbiology, Saraswati Dental College, 233 Tiwari Ganj, Faizabad Road, Lucknow - 227 105, Uttar Pradesh, India

Date of Web Publication18-Aug-2017

Correspondence Address:
Kunal Sah
Department of Oral Pathology and Microbiology, Saraswati Dental College, 233 Tiwari Ganj, Faizabad Road, Lucknow - 227 105, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jomfp.JOMFP_92_16

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How to cite this article:
Sah K. The so-called “combined epithelial odontogenic tumor”: A specific entity or not?. J Oral Maxillofac Pathol 2017;21:192-3

How to cite this URL:
Sah K. The so-called “combined epithelial odontogenic tumor”: A specific entity or not?. J Oral Maxillofac Pathol [serial online] 2017 [cited 2017 Dec 13];21:192-3. Available from: http://www.jomfp.in/text.asp?2017/21/2/192/213213


Adenomatoid odontogenic tumor (AOT) is believe to be a true benign, nonaggressive, noninvasive neoplasm, but few also categorize it as a developmental hamartomatous odontogenic growth.[1] Almost all variants of AOT show identical histology, where tumor may be partly cystic or solid, odontogenic epithelium with various patterns and varying degrees of inductive change in the connective tissue.

Damm et al. (1983) first described the presence of “CEOT-like areas” within two cases of AOT, and named these as “combined epithelial odontogenic tumor.”[2] The presence of “combined epithelial odontogenic tumor (CEOT)-like cells” in AOT has led some authors to consider these areas as true foci of CEOT.[3] Spindle-shaped cells in AOT are morphologically and histochemically similar to stratum intermedium cells of the enamel organ, and according to some authors, it is also the origin of CEOT cells. This could explain the coexistence of these two embryologically related cells, which was also supported by Montes Ledesma et al.[3] and Mosqueda-Taylor et al.[4]

To the best of our knowledge, there are no reported cases in English literature where CEOT predominates over AOT. We suggest that CEOT-like areas in AOT are the normal constituent of AOT and are specific to those areas where inductive changes are taking place. These are “CEOT-like areas” and not true CEOT as it does not show predominance over AOT and also lacks typical pleomorphism seen in CEOT.

A low-power view shows “CEOT-like areas” surrounded by cuboidal, columnar and spindle cells arranged in sheets, ductal and lace-like pattern with variable amount of calcification [Figure 1]a and [Figure 1]c. A high-power view shows polyhedral cells with eosinophilic cytoplasm of squamous appearance with well-defined cell borders, few areas showing intercellular bridges and intracytoplasmic homogeneous substance which are more prominent in CEOT-like areas [Figure 1]b and [Figure 1]d. Handmade illustration of “CEOT-like area” is shown in [Figure 2].
Figure 1: (a and c) Combined epithelial odontogenic tumor-like areas surrounded by cuboidal, columnar and spindle cells arranged in sheets, ductal and lace-like pattern with variable amount of mineralization (H & E stain, ×100). (b and d) Foci of combined epithelial odontogenic tumor-like cells; polyhedral cells with eosinophilic cytoplasm with well-defined cell borders, few areas showing intercellular bridges and intracytoplasmic homogeneous substance (H & E stain, ×400)

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Figure 2: A hand-drawn illustration (H & E stain, ×400)

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   References Top

1.
Sah K, Kale AD, Kotrashetti V, Chandra S. Adenomatoid odontogenic tumor expressing p53 and PCNA: A true benign neoplasm? Eur J Gen Dent 2013;2:328-31.  Back to cited text no. 1
  [Full text]  
2.
Damm DD, White DK, Drummond JF, Poindexter JB, Henry BB. Combined epithelial odontogenic tumor: Adenomatoid odontogenic tumor and calcifying epithelial odontogenic tumor. Oral Surg Oral Med Oral Pathol 1983;55:487-96.  Back to cited text no. 2
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3.
Montes Ledesma C, Mosqueda Taylor A, Romero de León E, de la Piedra Garza M, Goldberg Jaukin P, Portilla Robertson J. Adenomatoid odontogenic tumour with features of calcifying epithelial odontogenic tumour. (The so-called combined epithelial odontogenic tumour.) Clinico-pathological report of 12 cases. Eur J Cancer B Oral Oncol 1993;29B: 221-4.  Back to cited text no. 3
    
4.
Mosqueda-Taylor A, Carlos-Bregni R, Ledesma-Montes C, Fillipi RZ, de Almeida OP, Vargas PA. Calcifying epithelial odontogenic tumor-like areas are common findings in adenomatoid odontogenic tumors and not a specific entity. Oral Oncol 2005;41:214-5.  Back to cited text no. 4
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