Primordial odontogenic tumor: report of a rare case with a review of literature

Abstract

The primordial odontogenic tumor (POT) was first described in 2014. The term was used due to the histologic similarity of the tumor with the elements of the early stages of tooth development. It is a benign odontogenic tumor with epithelial and mesenchymal components. It occurs in the first and second decades of life. It is prevalent in the tooth-bearing areas of the mandible. Almost 18 cases have been published in peer-reviewed journals so far. It commonly presents as a well-defined pericoronal unilocular radiolucency. It is composed of fibromyxoid tissue with areas resembling the dental papilla and lined by epithelium that resembles the inner enamel epithelium of the enamel organ. Focal stellate reticulum-like cells can be seen external to the lining epithelium. A few cases in the literature have shown small focal calcifications. Treatment with conservative surgical excision appears to be curative, with no recurrence potential. Here we report a case of a primordial odontogenic tumor.

Case

An 8-year-old male patient presented to the Loma Linda University Ear, Nose, and Throat Surgery Department with a soft tissue mass in the right maxillary sinus along with a free-floating devitalized tooth. A clinical diagnosis of a maxillary cyst was made. A Caldwell-Luc (transantral) approach was utilized for enucleation of the lesion in the right maxillary sinus. A right maxillary antrostomy was also performed. The histopathology showed a biphasic tumor with an epithelial lining that was composed of columnar cells with focal stellate reticulum. A diagnosis of primordial odontogenic tumor was made based on the microscopic features. Upon a 2-year follow-up, the patient appears to have responded well to treatment with no evidence of recurrence.