AOT mimicking a dentigerous cyst - unravelling a rare radiologic puzzle with review of literature

Abstract

Adenomatoid odontogenic tumor or AOT is a slow-growing benign odontogenic neoplasm common in the maxilla and often misdiagnosed as Dentigerous cyst. But there are certain intricate radiographic features which are exclusively diagnostic to AOT. The more common variant is the follicular type of AOT, which involves an unerupted tooth, often mistaken as a dentigerous cyst. Here, we report a case of a 14- year-old girl, with an AOT, located in the anterolateral region of the maxilla associated with an impacted canine and premolar tooth. It was initially diagnosed as dentigerous cyst, due to clinical similarities. The reports of fine needle aspiration cytology and incisional biopsy were also suggestive of DC (Dentigerous Cyst). But the Cone beam computed tomography scan (CBCT) findings were in favour of AOT. Finally, the histopathological report after total excision was that of Adenomatoid Odontogenic Tumour, hence emphasizing the accuracy of CBCT in diagnosing large bony lesions. The case report highlights the importance of early diagnosis of odontogenic neoplasms, it’s treatment and gives a review on the clinical characteristics of similar cases. Therefore, AOT should be considered as a differential diagnosis of unilocular lesions surrounding the impacted tooth in the anterior maxillary region.