Etiology • A benign odontogenic tumor of uncertain histogenesis • Stratum intermedium component of enamel organ is favored
cell of origin
Clinical Presentation • Chiefly in posterior mandible • Painless, slow growing • Mean age of occurrence is approximately 40 years • Occasional soft tissue origin (peripheral) noted as a sessile
gingival mass • Jaw expansion a common clinical presentation
Radiographic Findings • Usually noted in association with an impacted tooth • Multilocular; most often with mixed radiolucent and
radiopaque features • Impacted tooth often obscured by tumor-
associated calcification • Margins may be well defined or sclerotic and vague.cell of origin
Clinical Presentation • Chiefly in posterior mandible • Painless, slow growing • Mean age of occurrence is approximately 40 years • Occasional soft tissue origin (peripheral) noted as a sessile
gingival mass • Jaw expansion a common clinical presentation
Radiographic Findings • Usually noted in association with an impacted tooth • Multilocular; most often with mixed radiolucent and
radiopaque features • Impacted tooth often obscured by tumor-
Diagnosis • Radiographic features • Biopsy findings of polyhedral epithelial cells, nuclear pleomor-
phism, amyloid material, and concentric calcifications with epithelial islands
Differential Diagnosis • When radiolucency predominates: dentigerous cyst, odonto-
genic keratocyst, ameloblastoma, odontogenic myxoma • With mixed radiolucent and radiopaque features: calcifying
odontogenic cyst, adenomatoid odontogenic tumor, ameloblastic fibro-odontoma, fibro-osseous lesion, osteoblastoma
Treatment • Local, conservative excision including a thin rim of normal
bone (so-called ostectomy) versus conservative en bloc removal • Peripheral lesions with a narrow periphery of normal-appearing
mucosa
Prognosis • Very good • Recurrence rate is low, from 10 to 15% • Long-term follow-up recommended