Derived from odontogenic epithelium continued..

1. CEOT
Dr. Ali Tahir. M.Phil Oral Pathology

2. CEOT
 Also called ‘Pindborg’ tumour
 Rare, < 1% of all tumours
 Locally aggressive like ameloblastoma
 Arises from rests of dental lamina or reduced enamel
epithelium
 Central & peripheral types
Dr. Ali Tahir. M.Phil Oral Pathology

3. Clinical features
 20-60yrs of age
 More common in
mandible
 Molar premolar area
 Slow growing painless
mass
 Maxillary lesions can
cause nasal, sinus & eye
sypmtoms
 Peripheral appears as a
small, sessile mass, often
without calcification Oral Pathology
Dr. Ali Tahir. M.Phil

4. Radiographical Features
 Radiolucent with flecks of radio-opacities
 Less commonly appears as a mixture of radio-opaque
& radiolucent areas
 Unilocular/Multilocular
 May appear as mixed areas
 Mostly associated with an impacted tooth
 Indistinct line of demarcation
Dr. Ali Tahir. M.Phil Oral Pathology

5. Radiograph
Calcifications are
prominent around the
crown of impacted tooth
Dr. Ali Tahir. M.Phil Oral Pathology

6. CEOT
 D.D:
 Dentigerous cyst
 AOT
 Ameloblastic fibro-odontoma
Dr. Ali Tahir. M.Phil Oral Pathology

7. Histological Features
 Sheets of polyhedral cells
 Prominent intercellular bridges
 Nuclie vary in size, pleomorphism may be seen but it
doesn’t indicate malignancy
 Unlike ameloblastoma, it has calcifications which may
be spherical or diffuse
 Pools of amorphous, eosinophilic, hyalinized material
 A clear cell variant also exists
 Nature of Eosinophilic material is controversial
Dr. Ali Tahir. M.Phil Oral Pathology

8. Histopathology
Sheets of Polyhedral cells
Prominent intercellular
bridges
Pools of Eosinophilic material
Dr. Ali Tahir. M.Phil Oral Pathology

9. Histopathology
Spherical calcifications can
be seen
Dr. Ali Tahir. M.Phil Oral Pathology

10. Clear cell variant
Dr. Ali Tahir. M.Phil Oral Pathology

11. Congo red stain in polarized light
Dr. Ali Tahir. M.Phil Oral Pathology

12. AOT
Dr. Ali Tahir. M.Phil Oral Pathology

13. Adenomatoid Odontogenic tumour
An odontogenic tumour arising from odontogenic
epithelium, around the crowns of un-erupted anterior
teeth in young patients
Biologically non-aggressive
Dr. Ali Tahir. M.Phil Oral Pathology

14. Clinical Features
 3-7% of all odontogenic
tumours
 Common in anterior jaws
 More common in maxilla
 Frequently associated with an
impacted tooth
 Common in younger patients
(14-15yrs)
 Female predilection
 Presents as swelling around
un-erupted tooth
 Usually asymptomatic
 Peripheral appears as small,
sessile mass on Dr. Ali Tahir. M.Phil Oral Pathology
gingiva

15. Clinical Features
 Presents as swelling
around un-erupted tooth
 Usually asymptomatic
 Large lesions cause
painless expansion of
bone, although seldom
exceeds 3cm
 Peripheral appears as
small, sessile mass on
gingiva
Dr. Ali Tahir. M.Phil Oral Pathology

16. Radiographic features
 Well corticated,
unilocular radiolucency
around an impacted
tooth
 Flecks of radio-opacity
(snow-flake
calcifications)
 Extends apically beyond
CE junction
Dr. Ali Tahir. M.Phil Oral Pathology

17. Extra-follicular type
Dr. Ali Tahir. M.Phil Oral Pathology

18. Histological Features
 Outer capsule of thick
fibrous CT
 Surrounds a
nodular,/ductal/whorled
pattern of epithelium
(spindled or columnar)
surrounding pools of
PAS positive material
(type of basement
membrane)
 Spherical calcifications
Dr. Ali Tahir. M.Phil Oral Pathology

19. Histological Features
• Columnar epithelium
arranged in duct-like
tubular structures
• These are not true ducts or
glands
• Foci of calcifications may
be seen
Dr. Ali Tahir. M.Phil Oral Pathology

20. Gorlin cyst
Odontogenic Ghost Cell Tumour
Dr. Ali Tahir. M.Phil Oral Pathology

21. COC
 A rare, well circumscribed solid or cystic lesion with a
wide spectrum of histological features & contains
ghost cells & spherical calcifications
 Associated with odontomas
 Mostly occurs as solid, non-cystic lesion called
odontogenic ghost cell tumour
Dr. Ali Tahir. M.Phil Oral Pathology

22. Clinical Features
 Common in areas
anterior to molars
 2nd decade
 Intraosseous/extraosseo
us
 Intraosseous causes
expansion of cortical
plates
 Usually painless
Dr. Ali Tahir. M.Phil Oral Pathology

23. Radiographical Features
 Well defined unilocular
radiolucency
 Flecks of radio-opacities
which may be irregular
calcifications or tooth-
like structures
 1/3rd cases associated
with unerupted canine
 Root resorption &
divergence
Dr. Ali Tahir. M.Phil Oral Pathology

24. R/F
Dr. Ali Tahir. M.Phil Oral Pathology

25. Histology
 Variable
 Cystic/Solid
 Epithelium resembles
that of ameloblastoma
 Outer layer of palisaded
columnar cells
 Inner layer ressembels
stellate reticulum
Dr. Ali Tahir. M.Phil Oral Pathology

26.  Eosinophilic epithelial
cells without nuclie
Histopathology referred to as ‘ghost cells’
 Spherical calcifications
 Hyalinized material
Dr. Ali Tahir. M.Phil Oral Pathology

27. Squamous Odontogenic Tumour
 Rare benign odontogenic neoplasm that may be
clinically aggressive
Clinical Features:
 Anterior to molars
 Peak incidence in 3rd decade
 Presents as painless swelling with loosening of teeth
 Slow growing
Dr. Ali Tahir. M.Phil Oral Pathology

28. Radiographical features
 Small lesions have
Unilocular radiolucency
 Large are multilocular
 Indistinct borders
 Displaces teeth
Dr. Ali Tahir. M.Phil Oral Pathology

29. Histology
 Islands of normal appearing stratified squamous
epithelium
 Islands may have microcyst formation in the centre
 Spherical or irregular shaped calcifications
Dr. Ali Tahir. M.Phil Oral Pathology

30. Histopathology
Dr. Ali Tahir. M.Phil Oral Pathology