Malignant odontogenic tumors: a 22-year experience

Area of Science:

• Oral Pathology
• Oncology
• Head and Neck Surgery

Background:

• Malignant odontogenic tumors (MOTs) are rare neoplasms originating from odontogenic epithelial residues or cysts.
• These tumors are locally aggressive, often requiring radical surgery, and information is limited due to their rarity.
• Existing data primarily comes from case reports, necessitating larger series for better understanding.

Purpose of the Study:

• To analyze a single institution's experience with malignant odontogenic tumors over 22 years.
• To review the clinicopathological features, treatment, and outcomes of diagnosed MOTs.
• To contribute to the limited body of knowledge on these rare malignancies.

Main Methods:

• Retrospective review of 20 reported cases diagnosed between 1981 and 2002.
• Re-evaluation of all pathological slides to confirm malignancy based on specific histological criteria.
• Chart review for patient demographics, tumor location, treatment, and outcomes.

Main Results:

• Nine of the 20 cases were confirmed as malignant odontogenic tumors upon re-evaluation.
• The confirmed cases included malignant ameloblastomas, ameloblastic carcinoma, malignant Pindborg tumor, odontogenic ghost cell carcinoma, and squamous cell carcinoma arising in an odontogenic keratocyst.
• Tumors were predominantly located in the mandible (6/9), with varied patient demographics and outcomes including disease-related death, disease-free survival, and loss to follow-up.

Conclusions:

• Malignant odontogenic tumors are rare and necessitate a multidisciplinary approach for optimal management.
• Radical surgical excision is the primary treatment modality.
• Long-term surveillance, including physical examinations and serial radiographic imaging, is crucial for patient monitoring.