Odontogenic cysts with sebaceous glands: 4 unusual cases.

Jaw cysts with sebaceous elements are unusual. Four cases of developmental odontogenic cyst associated with sebaceous glands are reported. Two of the cases were parakeratinized odontogenic keratocysts (Keratocystic odontogenic tumor) and two were orthokeratotic odontogenic keratocysts (Orthokeratinized odontogenic cyst). Two patients were female and two were male. One of these cases was in the second decade, two were in the third decade and one was in the sixth decade. All cysts were in the mandible. Three of the lesions were located in the posterior region including mandibular ramus; one was located between the right first molar and the left canine teeth, including embedded right canine. Some authors claim that cysts with sebaceous elements are intraosseous counterpart of dermoid cysts and refuse theories of their odontogenic origin. Whereas all of our lesions were odontogenic developmental cysts, we observed sebaceous glands within, subjacent or distant to epithelial lining in some areas

Ameloblastic Fibro-Odontoma: At the Crossroad Between "Developing Odontoma" and True Odontogenic Tumour

Ameloblastic fibro-odontoma (AFO) is a controversial, rare benign mixed odontogenic tumour that was re-defined as "developing odontoma" in the 2017 WHO classification arguing that once dental hard tissues form, it is programmed to transform into odontoma. However, AFO still remains unclear in terms of its nature. We aimed to analyze a large series of AFOs and compare it to a large series of odontomas (ODs) in an attempt to set cut-off diagnostic parameters between these entities and discuss latest updates on AFO histopathologic, clinical and molecular features. A total of 23 well-documented AFOs were analyzed versus 310 ODs focusing on the age of the patients and size of the lesions. For AFO, mean age was 9.4 +/- 3.9 years (range 3-16 years) and mean size (greatest diameter) was 2.9 +/- 1.5 cm (range 0.8-5.5 cm). For OD-mean age was 26.5 +/- 15.6 years (range 3-81 years), mean size 1.9 +/- 0.9 cm (range 1-5 cm). Receiver operating curve (ROC) showed that a cut-off age of 13.5 years and below [area under the curve (AUC) 0.902, 95%CI 0.859-0.945; p < 001; sensitivity 80%, specificity 87%] and a cut-off size of 2.1 cm and above are likely to be associated with AFO (AUC 0.7, 95%CI 0.574-0.827; p = 0.001; sensitivity 57%, specificity 77%). Thus, the combination of age and lesion size may be used to distinguish between lesions of a true neoplastic nature (i.e., AFO) and hamartomatous formation (i.e., OD). Further molecular and genetic specifications are needed to provide a better understanding on the pathogenesis of AFO in support of our suggestion and aid in an accurate classification of AFO

The World Health Organization Classification of dontogenic Lesions: A Summary of the Changes of the 2017 (4th) Edition

The 4th edition of the World Health Organization (WHO) Classification of Head and Neck Tumors was published in January 2017. The edition serves to provide an updated classification scheme, and extended genetic and molecular data that are useful as diagnostic tools for the lesions of the head and neck region. This review focuses on the most current update of odontogenic cysts and tumors based on the 2017 WHO edition. The updated classification has some important differences from the 3rd edition (2005), including a new classification of odontogenic cysts, ‘reclassified’ odontogenic tumors, and some new entities