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doi:10.4317/medoral.17630
http://dx.doi.org/doi:10.4317/medoral.17630
MD. PhD Pathology Graduate Program, Fluminense Federal University (UFF), Brazil
DC Anatomic Pathology Service, Army Central Hospital (HCE-RJ), Brazil
3
MD Pathology Division, National Cancer Institute (INCA), Brazil
4
MD Department of Statistics, Fluminense Federal University (UFF), Brazil
5
DDS, MSc Department of Health Care, Universidad Autnoma Metropolitana Xochimilco, Mxico
1
2
Correspondence:
Av. das Accias, 150, bl.01, ap. 104
Barra da Tijuca, RJ, Brazil 22776000
silourenco@br.inter.net
Received: 28/03/2011
Accepted: 16/09/2011
Costa DOP, Maurcio AS, Faria PAS, Silva LE, Mosqueda-Taylor A, Loureno SQC. Odontogenic tumors: A retrospective study of four Brazilian
diagnostic pathology centers. Med Oral Patol Oral Cir Bucal. 2012 May
1;17 (3):e389-94.
http://www.medicinaoral.com/medoralfree01/v17i3/medoralv17i3p389.pdf
Abstract
Objective: This article presents the results of a retrospective study of the frequency and classification of odontogenic tumors recorded at four centers of diagnostic pathology in Rio de Janeiro, Brazil.
Study Design: All medical records and microscopic slides of odontogenic tumor specimens for the years 1997 to
2007 were retrieved from the files of four services of diagnostic pathology in Rio de Janeiro City. Diagnoses were
re-evaluated and the tumors classified according to the latest (2005) World Health Organization Classification of
Tumors.
Results: A total of 201 odontogenic tumors were found among 15,758 oral biopsies (1.3%). The frequencies of
these tumors at the four centers ranged from 0.5% at the National Cancer Institute to 3.3% in a private laboratory.
Chi-square analysis revealed statistically significant differences (p<0.05) between the proportions of odontogenic
tumors in the studied centers. Of these, 94.5% were benign and 5.5% were malignant. Keratocystic odontogenic
tumor (32.3%) was the most frequent lesion, followed by ameloblastoma (29.8%) and odontoma (18.4%).
Conclusions: Odontogenic tumors are uncommon in Brazil. Different pathology laboratories reported divergent
frequencies of odontogenic tumors, which may reflect institutional specializations and the patient populations
served.
Key words: Odontogenic tumors, jaw neoplasms, epidemiology, WHO classification.
e389
Med Oral Patol Oral Cir Bucal. 2012 May 1;17 (3):e389-94.
Introduction
age, gender, and the tumor site, were obtained from the
medical records.
The research protocol was approved by the Research
Ethics Committee of Federal Fluminense University
(Niteri-RJ), the National Cancer Institute (RJ), and
the Army Central Hospital (RJ) for its implementation.
The Director of the private laboratory also authorized
the research.
Hematoxylin and eosin-stained slides of all the cases
were retrieved from the laboratories for review and the
diagnoses were re-evaluated and the tumors reclassified according to WHO (2005) criteria. The independent opinions of two examiners were compared to reach
the final diagnosis and in cases of doubt we consulted
another expert oral pathologist to obtain a diagnosis by
consensus.
For the statistical analysis, commercially available software (SPSS 10.0; SPSS Inc, Chicago, IL) was used. Descriptive statistics were used in a preliminary analysis
of the relationship between baseline variables. Continuous variables were categorized to facilitate data analysis
and presentation. Gender and tumor site analyses were
done using the binomial test. The chi-square test was
used to investigate differences between proportions of
independent groups. Tests were considered statistically
significant when the p-value was <0.05.
Results
Med Oral Patol Oral Cir Bucal. 2012 May 1;17 (3):e389-94.
Table 1. Distribution of oral lesions and odontogenic tumors in the diagnostic pathology
centers.
Centers
Odontogenic
Tumor (%)
4.429
105 (2.4%)
815
17 (2.1%)
9.411
43 (0.5%)
1.093
36 (3.3%)
Total
15.748
201 (1.27%)
Table 2. Distribution of 201 benign and malignant odontogenic tumors from four diagnostic pathology centers.
Type of Odontogenic Tumor
Antonio Pedro
University Hospital
Army Central
Hospital
National Cancer
Institute
Private pathology
Laboratory
25
1
7
16
Total
N
60
4
2
65
29.8
2.0
1.0
32.3
4
2
37
4
1
2.0
1.0
18.4
2.0
0.5
3
1
9
2
4.5
1.0
3.5
0.5
0.5
BENIGN TUMORS
Odontogenic epithelium with mature, fibrous stroma without odontogenic ectomesenchyme
Ameloblastoma
22
5
Calcifying epithelial odontogenic tumor
4
Adenomatoid odontogenic tumor
1
Keratocystic odontogenic tumor
38
4
Odontogenic epithelium with odontogenic ectomesenchyme, with or without hard tissue formation
Ameloblastic fibroma/Fibrodentinoma
1
Ameloblastic fibro-odontoma
1
Odontoma
26
8
Calcifying cystic odontogenic tumor
4
Dentinogenic ghost cell tumor
1
Mesenchyme and/or odontogenic ectomesenchyme with or without odontogenic epithelium
Odontogenic myxoma / myxofibroma
5
Cementoblastoma
1
MALIGNANT TUMORS
Odontogenic carcinomas
Ameloblastic carcinoma
Primary intraosseous squamous cell carcinoma
derived from
keratocystic odontogenic tumor
Clear cell odontogenic carcinoma
1
2
1
1
Odontogenic sarcomas
Ameloblastic fibrosarcoma
Total
105
17
e391
1.0
43
36
201
100
Med Oral Patol Oral Cir Bucal. 2012 May 1;17 (3):e389-94.
Table 3. Gender, age and site distribution of 201 odontogenic tumors of patients at four diagnostic pathology centers.
Age (years)
Type of Tumor
Male
Female
Total
Ameloblastoma
Calcifying epithelial odontogenic tumor
Adenomatoid odontogenic tumor
Keratocystic odontogenic tumor
Ameloblastic fibroma Fibrodentinoma
Ameloblastic fibro-odontoma
Odontoma
Calcifying cystic odontogenic tumor
Dentinogenic ghost cell tumor
Odontogenic myxoma / myxofibroma
Cementoblastoma
Ameloblastic carcinoma
Primary intraosseous squamous cell
carcinoma derived from
keratocystic odontogenic tumor
Clear cell odontogenic carcinoma
Ameloblastic fibrosarcoma
Total
35
1
25
3
2
27
1
1
11
2
60
4
2
65
4
2
37
4
1
9
2
7
38
3
1
26
2
1
2
1
4
7
1
3
115
1-19
20-39
40-59
60-89
NS*
Total
25
2
13
2
15
18
21
13
2
3
1
1
60
4
2
65
4
2
37
4
1
9
2
7
2
11
1
1
18
3
1
3
1
1
1
2
86
1
2
201
Site
1
11
1
1
4
1
1
1
48
1
64
44
32
13
Max Mand
**
***
7
52
4
1
1
12
49
1
3
1
1
19
15
2
2
1
5
4
1
1
3
3
NS*
Total
60
4
2
65
4
2
37
4
1
9
2
7
1
2
201
1
2
140
1
2
201
52
Discussion
Med Oral Patol Oral Cir Bucal. 2012 May 1;17 (3):e389-94.
References
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Med Oral Patol Oral Cir Bucal. 2012 May 1;17 (3):e389-94.
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