Calcifying epithelial odontogenic tumor: An updated analysis of 339 cases reported in the literature

Abstract

Purpose: The aim of this study was to integrate the available data published on calcifying epithelial odontogenic tumors (CEOT) into a comprehensive analysis of its clinical and radiologic features.

Materials and methods: An electronic search was undertaken in May 2016. Eligibility criteria were publications having enough clinical, radiological and/or histological information to confirm definite diagnosis.

Results: A total of 362 lesions were found, 339 with enough information were analyzed. Variants clear cells (n = 33) and Langerhans cells (n = 10) were rarely described in the literature, as well as lesions with malignant transformation (n = 8). Central lesions (n = 264) were more prevalent than their peripheral counterparts (n = 24). A higher prevalence characterized the mandible, posterior region, and third and fourth decades. About 40% of the peripheral lesions showed signs of underlying bone erosion, and about half of the central ones showed signs of cortical bone perforation. Recurrence was found in all lesions (12.6%), peripheral lesions (18.8%), central lesions (11.6%), clear cell (10.7%), Langerhans cell (0%), and those with malignant transformation (42.9%). Excision or curettage was associated with the highest recurrence rate. None of the variables showed a statistically significant influence on the recurrence rate.

Conclusions: The possible locally aggressive behavior of the lesions recommends a less conservative management than simple curettage. The clear cell variant shows similar demographic data and biological behavior compared to the non-variant lesions, suggesting that the presence of clear cells does not have an important clinical significance.

Keywords: Calcifying epithelial odontogenic tumor; Clinical features; Extraosseous; Intraosseous; Pindborg tumor; Recurrence rate.