Calcifying epithelial odontogenic (Pindborg) tumor. A clinical case

Area of Science:

• Oral Pathology
• Odontogenic Neoplasms
• Surgical Oncology

Background:

• Calcifying epithelial odontogenic tumor (CEOT), or Pindborg tumor, is a rare benign odontogenic neoplasm, accounting for 0.4-3% of all such tumors.
• CEOT primarily affects adults aged 20-60, with a peak incidence between 40-60 years, and approximately 190 cases reported.
• Fifty-two percent of CEOT cases are associated with impacted or displaced teeth, and recurrence rates range from 10-15% after complete excision.

Observation:

• A case of primary intra-osseous CEOT is presented, involving the mandibular right second molar in a 24-year-old male.
• Radiographic findings revealed a well-defined, unilocular osteolytic lesion causing mandibular swelling, bone resorption, and displacement of the inferior alveolar nerve.
• The tumor exhibited a capsule-like structure surrounding the inferior alveolar neuro-vascular bundle.

Findings:

• Conservative surgical treatment involved enucleation of the CEOT with a margin of tumor-free bone and debridement of the affected neuro-vascular bundle.
• Postoperative histological examination confirmed the benign nature of the tumor, showing typical CEOT features.
• The tumor was successfully treated with conservative surgery, preserving the neuro-vascular bundle.

Implications:

• This case highlights the feasibility of conservative surgical management for intra-osseous CEOT, even when involving critical structures.
• Accurate differential diagnosis and consideration of tumor histology and location are crucial for appropriate treatment planning.
• Further research into CEOT management strategies can improve patient outcomes and minimize recurrence risk.