Mandibular hybrid odontogenic tumor

Area of Science:

• Oral and Maxillofacial Surgery
• Pathology
• Oncology

Background:

• Hybrid Odontogenic Tumors (HOT) are characterized by the coexistence of two or more distinct odontogenic tumor types within the same maxillofacial region.
• These complex lesions present diagnostic and therapeutic challenges due to their rarity and varied histological components.

Purpose of the Study:

• To report the first case of a mandibular hybrid odontogenic tumor (HOT) involving Ameloblastoma, Calcifying Epithelial Odontogenic Tumor, and Ameloblastic Fibroma.
• To highlight the diagnostic considerations and surgical management of such rare complex odontogenic pathologies.

Main Methods:

• A comprehensive clinical presentation of a 37-year-old male with a mandibular swelling is described.
• Diagnostic imaging included computed tomography (CT) to delineate the osteolytic, multilocular, and expansile lesion.
• Surgical resection via an intraoral approach with a 1 cm safety margin, followed by microvascularized fibula flap reconstruction.

Main Results:

• The patient presented with a large, expansile mandibular lesion involving multiple odontogenic tumor types.
• Successful surgical resection and reconstruction were achieved.
• A ten-year follow-up confirmed no recurrence of the hybrid odontogenic tumor.

Conclusions:

• Hybrid odontogenic tumors, though rare, must be considered in the differential diagnosis of extensive odontogenic pathologies.
• Thorough histopathological examination with multiple biopsies is essential for accurate diagnosis due to microscopic variability.
• Understanding the pathogenesis and pathophysiology is key to improving treatment strategies and surgical outcomes for HOTs.