Medical Hypotheses 104 (2017) 35
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Medical Hypotheses
journal homepage: www.elsevier.com/locate/mehy
Adenomatoid odontogenic tumor revisited
This article focuses on the true nature (hamartoma versus neo-
plasm) of adenomatoid odontogenic tumor (AOT) hypothesized by
Thakur et al. [1].
There have been 10 reports of recurring AOT [29], five of
which were evaluated by Rick [24]. He concluded that recurrence
of a genuine AOT was nonexistent, even with incomplete removal
of the tumor. We have also been unable to find any evidence that
the remaining two recurrent lesions were AOTs [5,9]. For one AOT
with radiological features of recurrence [6], no pathological exam-
ination was done. Another patient with typical AOT developed a
recurrent lesion one year after enucleation [7]; however, given
the minimal/slow growth potential of nearly all AOTs [2], this
may represent a residual tumor due to inappropriate treatment.
With regard to the 1971 paper of Fukaya et al. [3] describing a
recurrent AOT, Rick [2] could not trace this case to the primary
lesion due to the unavailability of an original Japanese report for
review [10], but also because of linguistic limitations. The field
remained dormant for almost 40 years thereafter until Zhou et al.
[8] contributed a second paper on this topic. From the 1900s to the
present time, only two unequivocal examples of AOT recurrence
have been documented among more than 1300 cases worldwide.
Very important from a clinical standpoint is that in these classic
AOTs, it took about 10 years to recur. Unlike recurrent ameloblas-
tomas, they were never destructive.
In an old Japanese case showing intracranial extension, which
has been repeatedly referred to as a recurring aggressive AOT [4],
we credit Rick [2] in concluding that this was an ameloblastoma,
based on our review of relevant abstracts. Similarly, aggressive
lesions for which the diagnostic accuracy has been lacking have
been reported multiple times in the recent literature under the
title of AOT [9,1113]. We hypothesize from the above results
(uniformly benign biological behavior with no risk of malignant
transformation) that AOT is a hamartoma.
Conflict of interest
We have no conflict of interests associated with this
publication.
http://dx.doi.org/10.1016/j.mehy.2017.05.016
0306-9877/ 2017 Elsevier Ltd. All rights reserved.
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Fumio Ide
Kentaro Kikuchi
Kaoru Kusama
Division of Pathology, Department of Diagnostic and Therapeutic
Sciences, Meikai University School of Dentistry, Saitama, Japan
Corresponding author.
E-mail address: idef@dent.meikai.ac.jp (F. Ide)