Pigmented odontogenic tumors: Adding color to diagnosis?

Abstract

Melanocytes are neural crest derivatives that exhibit a ubiquitous presence in the epidermis. They determine the complexion of an individual and most importantly, provide a barrier against ultraviolet radiations from the sun. Their presence in the oral cavity is a consistent finding, especially in the gingiva and buccal mucosa of the dark complexioned. Melanocytes occasionally form a part of the histology of a variety of odontogenic cysts and tumors. How these cells make their way into the lesional tissue and the diagnostic relevance of their presence remains elusive. This write up attempts to trace the path melanocytes take to find themselves within odontogenic tumors and also offer possible explanations for the same.

Keywords: Melanocytes; neural crest cells; odontogenic tumors.

Figure 1

The epithelial lining of a cystic odontogenic tumors (CCOT) showed basal palisaded cuboidal cells and suprabasal stellate cells. Small focal calcifi cations within the epithelium can also be observed (H&E stain, ×100). Inset: Small organoid denticles may also be seen. (H&E stain, ×40) (as shown in the inset).

Figure 2

Odontogenic epithelium and ghost cells stained with Masson Fontana for melanin pigmentation. Melanin pigments are detected within the epithelial cells, in the ghost cells and also lie freely within the extracellular connective tissue. (Masson Fontana stain, ×400)

Figure 3

Photomicrograph of odontogenic epithelial cell rests stained using Masson Fontana, exhibiting the presence of intracellular melanin pigmentation (Masson Fontana, ×100)

Figure 4

Bar graph showing the increased tendency for pigmented tumors to occur in the maxilla in females and the mandible in males

Figure 5

Bar diagram showing racial preponderance for occurrence of pigmented odontogenic tumors