Adenomatoid Odontogenic Tumor

The adenomatoid odontogenic tumor accounts for approximately 5% of odontogenic tumors and is one of the most innocuous. The name derives from the histopathol-ogy, which reveals the formation of duct-like structures that impart a glandular appearance. It is a tumor of youth; most occur before age 30. Approximately 75% are found to be associated with an unerupted tooth. They occur more often in the anterior segments of the jaws and two-thirds of all cases occur in the maxilla. There is some variation in the radiographic appearance. Most are purely radi-olucent but small calcifications may be seen in a minority of cases. Those that are associated with an unerupted tooth radiographically resemble a typical dentigerous cyst. The tumor is enveloped by a thick capsule of fibrous connective tissue. Within the capsule is tumor tissue that consists of oval to spindle epithelium that forms round "rosettes." In the typical case, the rosettes develop a central cavity lined by cuboidal to columnar epithelial cells that form duct-like structures. The tumor stroma is scant and acellular and may contain small areas of dystrophic calcification. Anastomosing thin strands of tumor cells often form a network at the tumor-capsule interface. The presence of a thick capsule eases curettage, and recurrences are virtually unknown.

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