Page 107 - FINAL COMPENDIUM 2020-2021 27.2.2022

ADENOMATOID ODONTOGENIC TUMOUR IN DISGUISE: A CASE REPORT
NMRR-21-166-58547

Ibne Walid AM, Mohd Ariffin S, Che’ Azmi AS

Introduction: Adenomatoid Odontogenic Tumour (AOT) is a benign, slow growing lesion
of odontogenic origin. AOT exhibits predilection for the anterior region of the maxilla.
AOT can be classified into three variants - follicular, extrafollicular and peripheral types.
The most common follicular type is usually associated with an impacted tooth and is
frequently misdiagnosed as a dentigerous cyst. Case report: A healthy 14-year-old boy
was referred to our department for management of his unerupted permanent maxillary
right lateral incisor (#12) and permanent maxillary right canine (#13). No significant
findings upon extraoral assessment. Intraoral examination revealed presence of a bony
bulge on the maxillary labial and palatal gingiva, measuring 2x2cm, extending from
mesial of primary maxillary right canine (#53) until permanent maxillary right first
premolar (#14). Orthopantomogram and intraoral radiographic assessment revealed a
unilocular radiolucency ungloving the impacted tooth #12 while tooth #13 was displaced
laterally, suggestive of a dentigerous cyst. Following a multidisciplinary team discussion,
patient was initially planned for an extraction of #53, enucleation of the cyst and surgical
exposure and bonding of #12 and #13. However, patient subsequently developed an
enlarged right facial swelling, associated with pain and facial asymmetry. Fine needle
aspiration was performed on the lesion and no fluid content was aspirated. Thus, patient
underwent urgent surgery for enucleation of cyst and removal of #12 under general
anaesthesia, followed by placement of bismuth iodoform paraffin paste into the
resultant cavity, which was changed regularly. Histopathological examination report
revealed that the lesion is consistent with AOT. Conclusion: Clinical and radiographic
characteristics of AOT has been reported to have close resemblance to dentigerous cyst.
Both lesions are benign, encapsulated lesions and associated with an impacted tooth.
Therefore, histopathological examination is essential for a definitive diagnosis and
management.

Keywords: Adenomatoid odontogenic tumour, Dentigerous cyst

Virtual presentation at the MAPD Scientific Conference 2021 on 8 March 2021
Dr Anis Marlina binti Ibne Walid
Dr Shina Mohd Ariffin
Department of Paediatric Dentistry
Hospital Sultan Haji Ahmad Shah
Temerloh, Pahang

Dr Aida Shafiza binti Che’ Azmi
Department of Paediatric Dentistry
Hospital Sultanah Bahiyah
Alor Setar, Kedah

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