Byline: Mark. Nwoga
Adenomatoid odontogenic tumors (AOTs) are very rare. We present a case series of eight AOTs seen and managed at University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu State, Nigeria over a 10-year period, from 2012 to 2021. Their epidemiological data and clinic-pathological information were obtained from the biopsy forms, histopathology reports, and case files archived in the Records Department of the hospital. The AOTs were diagnosed in 8 patients out of the 225 odontogenic tumors seen during the period giving a prevalence of 3.6%. Five patients (62.5%) were males, whereas three (37.5%) were females giving a male-to-female ratio of 1.7:1. The mean (SD) age at onset of lesion was 12.4 (5.4) years with a range of 5-21 years. The location of the tumors was anterior in 62.5% of the jaw cases. A maxillary location was observed in 62.5% of the cases. Pain complaint was reported in 25% of the subjects. Tumor fluid was aspirated in 75.0% (n = 6) of the lesions: straw aspirate (83.3%),and dark-brown aspirate (16.7%). A tooth was associated with the tumor in 87.5% (n = 7) of the cases, with the canine impacted in 85.7% (n = 6) of these. Only one case (12.5%) was extrafollicular. The AOTs are uncommon and differed from other Nigerian studies by exhibiting a male gender prevalence, lower mean age, and frequent straw aspirates.
Introduction
Adenomatoid odontogenic tumor (AOT) is a benign, slow-growing epithelial tumor of the jaws.[1] It is a rare tumor which arises from remnants of dental lamina.[2] It is reported to constitute 2.2-13% of all odontogenic tumors.[3],[4],[5] However, in Nigeria, it is reported to make up to 4.5% of all odontogenic tumors.[6] AOT occurs most frequently in the second decade of life.[1],[6]
'Two-third tumor' is a term that highlights its characteristic features of constituting two-thirds of cases in four aspects: the maxilla, in young females, in association with an un-erupted tooth, and of canine involvement.[7],[8],[9] A female preponderance has been reported,[1] but a large Nigerian study reported a near equal gender distribution with a male: female ratio of 1:1.3.[6]
AOT presents clinically as intraosseous and extraosseous (or peripheral) types. The intraosseous type is subclassified as follicular and extrafollicular variants depending on the presence or absence of tooth involvement, respectively.[2],[6],[10],[11] The maxilla continues to be the most common site of occurrence.[12] AOT responds well to treatment by enucleation, and the likelihood of a recurrence is very low.[6]
To the best knowledge of the author, no study has reported the prevalence and histopathologic features of AOT among the population of the Southeast Nigeria consisting of native Igbos, one of the three major tribes of Nigeria. The large study of AOTs among Nigerians by Adisa et al. [6] had no data representation from the population of the Southeast Nigerians. This study would also add to the baseline data of AOT cases in Enugu State, Southeast Nigeria.
This is a case series study of the prevalence and clinicopathologic features of AOTs in a tertiary hospital in Enugu, southeast Nigeria....