CT and MR imaging appearances of an extraosseous calcifying epithelial odontogenic tumor (Pindborg tumor)

Abstract

We herein report a rare case of extraosseous calcifying epithelial odontogenic tumor with local aggressive behavior. CT and MR imaging showed the distinctive appearances of this histologic entity. We briefly discuss the radiologic features of calcifying epithelial odontogenic tumor and the relevant literature.

Fig 1. Images from the case of a 23-year-old man with left facial swelling. A, Lateral radiograph of the sinus shows opacities within the left maxilla and an unerupted tooth in its posterior wall. B, Coronal CT scan reveals a rounded heterogeneous mass almost filling the entire left maxillary antrum. The lesion contains a central tooth with surrounding amorphous calcifications and soft tissue elements in the periphery. C, Coronal T2-weighted MR image shows a large heterogeneous mass occupying the expanded left maxilla. There were intralesional areas of low signal in the T2-weighted sequences, consistent with calcification and the maxillary teeth identified on the CT scan. D, Axial contrast-enhanced T1-weighted image shows a large heterogeneous mass occupying the expanded left maxilla. There were intralesional areas of low signal in the T1-weighted sequences, consistent with calcification and the maxillary teeth identified on the CT scan. Non-homogeneous enhancement can be seen, especially on the periphery of the lesion. Anterolaterally, there is a small cortical breakage and extension to the buccinator muscle and subcutaneous tissues of the left cheek. E, Gross specimen shows an unerupted second molar (arrow) in the calcified substance of the well-encapsulated tumor.