Atlas of Tumors of the Facial Skeleton: Odontogenic and by PD Dr. med. et med. dent. Joachim Prein, Prof. Dr. med.

By PD Dr. med. et med. dent. Joachim Prein, Prof. Dr. med. Wolfgang Remagen, Prof. Dr. med. et med. dent. Bernd Spiessl, Prof. Dr. Erwin Uehlinger (auth.)

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Radiographic Features. Radiographs show a well defined area of osteolysis, often with a more radio dense peripheral zone. Multiple radiopaque masses may be seen within the lesion, depending on the amount of hard tissue that has been formed (Fig. 1). Frequently the lesion is seen just above the crown of an impacted or semi-impacted molar. Morphology. Histologically, the dentinoma consists largely of a more or less cellular connective tissue, dentine, and odontogenic epithelium. The latter may be absent, however.

However, we have seen a case in which a myxofibroma involved the entire horizontal ramus of the mandible without affecting the mandibular nerve (Fig. 4). When localized in the maxilla, the tumor may completely fill the maxillary sinus, possibly causing elevation of the eyeball and sensory disturbances in the region of the infraorbital nerve (Zimmermann and Dahlin 1958). As a rule, myxofibromas grow slowly, but rapid growth is occasionally observed, presumably in association with increased mucus production (Pindborg and Kramer 1971).

Isolated cases of "ameloblastic odontosarcoma" have been described (Villa 1955; Pindborg and Kramer 1971; personal unpublished observation). Like ameloblastic fibrosarcoma, this tumor exhibits the polymorphous cellularity of a sarcoma in its mesenchymal component. However, this lesion appears to be extremely rare; hence we do not devote a sepa- rate chapter to its description (cf. 25). The same is true for odonto-ameloblastoma, which is still presented as a separate entity in the WHO classification.

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