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European Society of Pathology
Cologne, September 2016
WHO classification of head and neck

tumours: What's new?
School of Clinical Dentistry
University of Sheffield
Odontogenic tumours.
Paul M Speight
Oral & Maxillofacial Pathology

University of Sheffield
1971 1992 2005
2017 – What’s new?
WHO classification 1971
“Odontogenic Tumours, Jaw Cysts and Allied lesions”
I. Neoplasms and other tumours related to the II. Neoplasms and other tumours related to
Odontogenic apparatus Bone
A. Benign
• Ameloblastoma A.Osteogenic neoplasms:
• Calcifying epithelial odontogenic tumour • Ossifying fibroma
• Ameloblastic fibroma
• Adenomatoid odontogenic tumour B. Non-neoplastic Bone Lesions
• Calcifying odontogenic cyst • Fibrous dysplasia
• Dentinoma • Cherubism
• Ameloblastic fibro-odontoma • Giant cell granuloma
• Aneurysmal bone cyst
• Odonto-ameloblastoma
• Simple bone cyst
• Complex odontoma
• Compound odontoma
• Fibroma III.Epithelial cysts
• Myxoma
• Cementomas A.Developmental
• Melanotic neuroectoderaml tumour of infancy
1. Odontogenic
B. Malignant • Primordial Cyst (keratocyst)
• Gingival cyst
1. Odontogenic carcinomas: • Eruption cyst
• Dentigerous (follicular) cyst
• Malignant ameloblastoma
• Primary intraosseous carcinoma 2. Non-odontogenic
• Other Carcinomas • Naso-palatine cyst
• Globulomaxillary cyst
• Naso-labial cyst
2. Odontogenic sarcomas:
• Ameloblastic fibrosarcoma
B. Inflammatory
• Ameloblastic odontosarcoma • Radicular cyst
IV. Unclassificed Lesions

“Odontogenic Tumours, Jaw Cysts and Allied lesions”
I. Neoplasms and other tumours related to the II. Neoplasms and other tumours related to
A. Benign
• Ameloblastoma A.Osteogenic neoplasms:
• Calcifying epithelial odontogenic tumour • Ossifying fibroma
• Adenomatoid odontogenic tumour B. Non-neoplastic Bone Lesions
• Calcifying odontogenic cyst • Fibrous dysplasia
• Dentinoma • Cherubism
• Ameloblastic fibro-odontoma • Giant cell granuloma
• Odonto-ameloblastoma
• Simple bone cyst
• Complex odontoma
• Compound odontoma
• Fibroma III.Epithelial cysts
• Myxoma
• Cementomas A.Developmental
• Melanotic neuroectoderaml tumour of infancy
1. Odontogenic
B. Malignant • Primordial Cyst (keratocyst)
• Gingival cyst
1. Odontogenic carcinomas: • Eruption cyst
• Dentigerous (follicular) cyst
• Malignant ameloblastoma
• Primary intraosseous carcinoma 2. Non-odontogenic
• Other Carcinomas • Naso-palatine cyst
• Globulomaxillary cyst
• Naso-labial cyst
2. Odontogenic sarcomas:
• Ameloblastic fibrosarcoma
B. Inflammatory
Included cysts
• Ameloblastic odontosarcoma • Radicular cyst
IV. Unclassificed Lesions

‘Odontogenic tumours’
1 Neoplasms and other tumours related to the 2. Neoplasms and other lesions related to
1.1 Benign
Osteogenic neoplasms:
Odontogenic epithelium only:
• Cemento - ossifying fibroma
• Ameloblastoma
• Squamous odontogenic tumour
Non-neoplastic Bone Lesions
• Calcifying epithelial odontogenic tumour
• Fibrous dysplasia
Odontogenic epithelium and odontogenic mesenchyme:
• Cemento-osseous dysplasia:
• Ameloblastic fibroma Periapical osseous dysplasia
• Ameloblastic fibro-odontome Florid cemento-osseous dysplasia
• Adenomatoid odontogenic tumour Other cemento-osseous dysplasias
• Calcifying odontogenic cyst • Cherubism
• Odontomes - complex and compound • Giant cell granuloma
Odontogenic mesenchyme: • Aneurysmal bone cyst
• Cementoblastoma • Solitary bone cyst
• Fibroma
• Myxoma 3. Epithelial cysts
Developmental
1.2 Malignant Odontogenic
Odontogenic carcinomas: • Gingival cyst of infants
• Malignant ameloblastoma • Odontogenci Keratocyst (Primordial Cyst)
• Primary intraosseous carcinoma • Dentigerous (follicular) cyst
• Malignant variants of other tumours and cysts • Eruption cyst
• Lateral Periodontal cysts
Odontogenic sarcomas: • Gingival cyst of adults
• Ameloblastic fibrosarcoma • Glandular odontogenic cysts
Non-odontogenic
• Ameloblastic fibrodentinosarcoma
• Naso-palatine cyst
• Odontogenic carcinosarcoma • Naso-labial cyst
Osteogenic neoplasms: Inflammatory

• Cemento-ossifying fibroma • Radicular cyst
• Osteoblastoma • Paradental cyst
• Osteosarcoma
‘Odontogenic Tumours’
Malignant tumours Benign Tumours
Odontogenic carcinomas: Odontogenic epithelium only:

• Metastasing (malignant) ameloblastoma • Ameloblastoma, solid/multicystic type
• Ameloblastic carcinoma – primary type • Ameloblastoma, extraosseous/peripheral type
• Ameloblastic carcinoma – secondary type (dedifferentiated) intraosseous • Ameloblastoma, desmoplastic type
• Ameloblastic carcinoma – secondary type (dedifferentiated) peripheral • Ameloblastoma, unicystic type
• Primary intraosseous squamous cell carcinoma – solid type • Squamous odontogenic tumour
• Primary intraosseous squamous cell carcinoma – derived from • Calcifying epithelial odontogenic tumour
keratocystic odontogenic tumour • Adenomatoid odontogenic tumour
• Primary intraosseous squamous cell carcinoma – derived from • Keratocystic odontogenic tumour
Odontogenic cysts
• Clear cell odontogenic carcinoma Odontogenic epithelium and odontogenic mesenchyme:
• Ghost cell Odontogenic carcinoma • Ameloblastic fibroma
• Ameloblastic fibro-odontome
Odontogenic sarcomas: • Ameloblastic fibrodentinoma
• Ameloblastic fibrosarcoma • Odontomes - complex and compound
• Ameloblastic fibrodentinosarcoma • Odontoameloblastoma
• Calcifying cystic odontogenic tumour
Bone-related lesions • Dentinogenic ghost cell tumour
• Ossifying fibroma
Odontogenic mesenchyme:
• Osseous dysplasias
• Central giant cell lesion (granuloma) • Odontogenic Fibroma
• Cherubism • Odontogenic Myxoma
• Aneurysmal bone cyst • Cementoblastoma
• Solitary bone cyst
Other tumours
• Melanotic neuroectodermal tumour of infancy

Odontogenic cysts
No Cysts
• Central giant cell lesion (granuloma) • Odontogenic Fibroma
Other tumours
Odontogenic carcinomas: Epithelial odontogenic tumours

• Ameloblastic carcinoma • Ameloblastoma
• Metastasizing (malignant) ameloblastoma • Ameloblastoma, unicystic type
• Primary intraosseous carcinoma • Ameloblastoma, extraosseous/ peripheral type
• Sclerosing odontogenic carcinoma • Squamous odontogenic tumour
• Clear cell odontogenic carcinoma • Calcifying epithelial odontogenic tumour
• Ghost cell odontogenic carcinoma • Adenomatoid odontogenic tumour
Odontogenic sarcomas: Mixed epithelial and mesenchymal odontogenic tumours

• Odontogenic carcinosarcoma • Ameloblastic fibroma
• Odontogenic sarcomas • Primordial odontogenic tumour
• Odontoma
• Odontoma, compound type
• Odontoma, complex type
• Dentinogenic ghost cell tumour
Odontogenic cysts of inflammatory origin Mesenchymal odontogenic tumours

• Radicular cyst • Odontogenic fibroma
• Odontogenic myxoma/myxofibroma
• Inflammatory collateral cysts
• Cementoblastoma
• Cemento-ossifying fibroma
Odontogenic and non-odontogenic developmental
cysts
• Dentigerous cyst
• Odontogenic keratocyst
• Lateral periodontal and botyroid odontogenic cyst
• Gingival cyst
• Glandular odontogenic cyst
• Calcifying odontogenic cyst
• Orthokeratinised odontogenic cyst
• Nasopalatine duct cyst
Cysts are back
Major changes to the Odontogenic Tumours
1. Odontogenic cysts are included

2. Attempts have been made to simplify the classification as much
as possible, leaving out sub-types or suffixes that have no clinical
importance.
3. Ameloblastic fibro-dentinoma and fibro-odontoma have been
dropped as defined entities, as most cases probably represent
developing odontoma.
4. Odontoameloblastoma was also dropped as there are insufficient
data to justify its recognition as a genuine entity.
5. New entities that have been described since the last WHO
classification are added.
6. Much discussion was devoted to the interface between neoplastic
and non-neoplastic cystic lesions.
Odontogenic carcinomas: 9
• Metastasing (malignant) ameloblastoma
Odontogenic epithelium only:
• Ameloblastoma, solid/multicystic type
Odontogenic cysts
• Clear cell odontogenic carcinoma Odontogenic carcinomas:
• Ameloblastic carcinoma fibro-odontome
• Ameloblastic
Odontogenic sarcomas: • Metastasizing (malignant) ameloblastoma
• Ameloblastic fibrodentinoma
• Ameloblastic fibrosarcoma • Primary intraosseous carcinoma
• • Odontomes
Sclerosing odontogenic -carcinoma
complex and compound
• Ameloblastic fibrodentinosarcoma • odontogenic
Odontoameloblastoma
• Clear cell carcinoma
• odontogenic
• Ghost cell Calcifying cystic odontogenic tumour
carcinoma
Classifications simplified Odontogenic mesenchyme:

• Odontogenic Fibroma
• Odontogenic Myxoma
6
• Cementoblastoma
Number of “entities”
reduced

• Ameloblastic carcinoma – primary type
• Ameloblastic carcinoma – secondary type (dedifferentiated) intraosseous
2005
• Ameloblastoma, extraosseous/peripheral type
• Ameloblastoma, desmoplastic type
keratocystic odontogenic tumour 29 odontogenic tumours
• Primary intraosseous squamous cell carcinoma – derived from
• Adenomatoid odontogenic tumour
• Keratocystic odontogenic tumour
Odontogenic cysts
2017 • Odontogenic Fibroma
• Odontogenic Myxoma
• Cementoblastoma
22 odontogenic tumours
Major changes to the Odontogenic Tumours
1. Odontogenic cysts are included

2. Attempts have been made to simplify the classification as much as
possible, leaving out sub-types or suffixes that have no clinical
importance.
3. Ameloblastic fibro-dentinoma and fibro-odontoma have been
dropped as defined entities, as most cases probably represent
developing odontoma.
4. Odontoameloblastoma was also dropped as there are insufficient
data to justify its recognition as a genuine entity.
5. New entities that have been described since the last WHO
classification are added.
6. Much discussion was devoted to the interface between
neoplastic and non-neoplastic cystic lesions.

Two new entities:
• Clear cell odontogenic carcinoma
• Ghost cell odontogenic carcinoma

• Primordial odontogenic tumour

• Odontoma
• Sclerosing odontogenic carcinoma

• Inflammatory collateral cysts • Odontogenic myxoma/myxofibroma
• Cementoblastoma
Odontogenic and non-odontogenic developmental cysts • Cemento-ossifying fibroma
• Gingival cyst
2014
First report of 6 cases of a new tumour
Slater LJ, Eftimie LF, Herford AS. (2016). Primordial odontogenic

Tumour: Report of a Case. J Oral & Maxillofac Surg. 74:547-551
Primordial Odontogenic Tumour
• 7 cases reported
• 4 males; 3 females
• Age: 3 to 19 years (Mean, 11.5years)
• Well-demarcated radiolucencies
• Dentigerous relationship
• 5 on third molars
• 2 on first molar
Mosquedo-Taylor et al. (2014) Histopathology. 65: 606.
Primordial Odontogenic Tumour
• Well circumscribed, lobulated
pale masses
• Not cystic
• Loose fibrous tissue
• Stellate, fusiform fibroblasts
• May be myxoid
• Surrounded by
columnar/cuboidal epithelium
• Resembles internal enamel
epithelium
Mosquedo-Taylor et al. (2014) Histopathology. 65: 606.

Slater et al. 2016. J Oral & Maxillofac Surg. 74:547-551
Sclerosing Odontogenic Carcinoma
• A new entity
• 3 cases first reported in 2008:
Am J Surg Pathol. 2008; 32: 1613 - 1619

Koutlas IG, Allen CM, Warnock GR, Manivel JC. Sclerosing odontogenic carcinoma: a previously unreported variant of
a locally aggressive odontogenic neoplasm without apparent metastatic potential. Am J Surg Pathol. 2008
Nov;32(11):1613-9.
Iri T, Ogawa I, Takata T, Toyosawa S, Saito N, Akiba M, Isobe T, Hokazono C, Tachikawa T, Suzuki Y. Sclerosing
odontogenic carcinoma with benign fibro-osseous lesion of the mandible: an extremely rare case report. Pathol Int.
2010 Oct;60(10):694-700.
Ide F, Kikuchi K, Kusama K. Sclerosing odontogenic carcinoma. Pathol Int. 2011 Apr;61(4):259-61.
Hussain O, Rendon AT, Orr RL, Speight PM. Sclerosing odontogenic carcinoma in the maxilla: a rare primary
intraosseous carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Oct;116(4):e283-6.
Tan SH, Yeo JF, Kheem Pang BN, Petersson F. An intraosseous sclerosing odontogenic tumor predominantly
composed of epithelial cells: relation to (so-called) sclerosing odontogenic carcinoma and epithelial-rich central
odontogenic fibroma. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Oct;118(4):e119-25.
A. Wood, F. Young, J. Morrison, B.I. Conn. Sclerosing odontogenic carcinoma presenting on the hard palate of a 43
year old female: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016. July (in press)
8 cases now reported

A low grade but locally aggressive tumour
• Mandible or maxilla
• Age: 40 – 80 years
• Have not metastasised
• Radiolucent lesions
associated with the teeth
Sclerosing odontogenic carcinoma:
…a primary intraosseous carcinoma of

the jaws, with bland cytology, markedly
sclerotic stroma, and aggressive
infiltration.
Sclerosing odontogenic carcinoma:
…a primary intraosseous carcinoma of

the jaws, with bland cytology, markedly
sclerotic stroma, and aggressive
infiltration.
Characterised by
perineural infiltration

Changes to terminology:
keratocystic odontogenic tumour
Odontogenic cysts



Bone-related lesions
• Central giant cell lesion (granuloma)
Other tumours

Odontogenic sarcomas:
• Odontogenic carcinosarcoma
Mixed epithelial and mesenchymal odontogenic tumours
• Primordial odontogenic tumour
• Odontogenic sarcomas
• Odontoma

Odontogenic cysts of inflammatory origin
• Radicular cyst
Mesenchymal odontogenic tumours
• Odontogenic fibroma

• Cementoblastoma
• Gingival cyst

Odontogenic sarcomas:
Mixed epithelial and mesenchymal odontogenic tumours
• Odontoma


Odontogenic and non-odontogenic developmental cysts
• Cementoblastoma
• Gingival cyst


Keratocystic odontogenic tumour
Odontogenic cysts
• Ghost cell Odontogenic carcinoma A new entity replaced
Odontogenic keratocyst
•
•
Odontoameloblastoma
Calcifying cystic odontogenic tumour
• Fibrous dysplasia Odontogenic mesenchyme:
Other tumours


Keratocystic odontogenic tumour
Odontogenic cysts
• Ghost cell Odontogenic carcinoma A new entity
But should it replace OKC? •
•
Odontoameloblastoma
Calcifying cystic odontogenic tumour
Bone-related lesions •
• Ossifying fibroma Is it a neoplasm? Dentinogenic ghost cell tumour

• Central giant cell lesion (granuloma) Are OKC and KCOT synonymous?
Other tumours
Evidence that it may be a benign neoplasm:

• High rate of cell proliferation in the wall
• High rate of recurrence
• ‘Aggressive’ and infiltrative growth
• Association with basal cell carcinoma in ‘Gorlin-
Goltz syndrome’
• Molecular changes similar to basal cell
carcinoma
• PTCH (chromosome 9q) mutation or inactivation
in BCC and Gorlin’s syndrome
Evidence that it may be a benign neoplasm:

• High rate of cell proliferation in the wall
• High rate of recurrence
• ‘Aggressive’ and infiltrative growth
• Association with basal cell carcinoma in ‘Gorlin-
Goltz syndrome’
• Molecular changes similar to basal cell
carcinoma
• PTCH (chromosome 9q) mutation or
inactivation in BCC and Gorlin’s syndrome
PTCH gene
inactivation
Loss of PTCH
Activation of
Hedgehog pathway:
Increase cell
proliferation
Li TJ. 2011. J Dent Res. 90: 133-142

Li TJ. 2011. J Dent Res. 90: 133-142
PTCH mutations found in:
• 85% of syndromic cysts
• 30% of sporadic cysts
Li TJ. 2011. J Dent Res. 90: 133-142

Inactivation of PTCH gene
Over 30% of
OKC show no
change in PTCH
gene
Gomes CC, et al., 2009. Oral Oncology 45: 1011-1014

PTCH gene alterations are also seen in
Dentigerous Cysts
Keratocysts Dentigerous Radicular

Cysts Cysts
(n=10) (n=10) (n=10)
LOH 50% * 50% 0
PTCH alterations ND
+ +
Pavelic et al. 2001. J Oral Pathol Med: 30: 569-576
* Barretto et al. 2000. J Dent Res: 79:1418-1422

PTCH gene alterations are also seen in
Dentigerous Cysts
• Changes only demonstrated by LOH &

PCR in PTCH gene region
• No sequencing data
• Work needs to be repeated
Pavelic et al. 2001. J Oral Pathol Med: 30: 569-576

Barretto et al. 2000. J Dent Res: 79:1418-1422
PTCH gene
inactivation
Loss of PTCH
PTCH alterations are neither

Activation of
Hedgehog pathway:
necessary nor specific
Increase cell
proliferation
Li TJ. 2011. J Dent Res. 90: 133-142

• 10 patients with OKC
• Marsupialised through a 1cm window
• Complete resolution in 7-19 months in all cases
• No recurrences
• Histology after treatment showed normal mucosal
epithelium
Pogrel & Jordan. J Oral Maxillofac Surg 62:651-655, 2004

Before
After
(11 months)
Pogrel & Jordan. J Oral Maxillofac Surg 62:651-655, 2004

• 10 patients with OKC
• Marsupialised through a 1cm window
• Complete resolution in 7-19 months in all cases
• No recurrences
• Histology after treatment showed normal mucosal
epithelium
• Not the behaviour of a neoplasm

• Aggressive treatment is not always
indicated
WHO 4th edition, 2017
Odontogenic Keratocyst re-instated
Further research is needed, but at the

present time there appears to be
insufficient evidence to support a
neoplastic origin of OKC. It is felt therefore
that OKC remains the most appropriate
name for this lesion.
‘Odontogenic tumours’ – WHO
classification 2005

Calcifying Odontogenic Cyst disappeared
Odontogenic cysts

Replaced by:
• Ameloblastic fibrodentinosarcoma Calcifying cystic odontogenic tumour
• Odontoameloblastoma
Dentinogenic ghost cell tumour • Calcifying cystic odontogenic tumour
Other tumours
2005
Calcifying cystic odontogenic
tumour (CCOT):
‘A benign cystic neoplasm of

odontogenic origin, characterized
by an ameloblastoma-like
epithelium with ghost cells that
may calcify’
Dentinogenic ghost cell tumour
(DGCT): Neoplasms
‘A locally invasive neoplasm

characterised by ameloblastoma-
like islands of epithelial cells in a
mature connective tissue stroma.
Aberrant keratinisation may be
found in the form of ghost cells in
association with varying amounts
of dysplastic dentin’
88% are ‘simple cystic’ or associated with odontomes
“ cystic lesion” or
“cystic tumour”
? Non-neoplastic
“..neoplastic tumour” or
“solid neoplastic growth”
Neoplastic
“……..two basic entities may be present:
a cystic tumour and a solid neoplasm”
WHO 4th edition 2017
There has been considerable
debate as to whether its origin is as
a neoplasm or as a developmental
cyst.
On the basis of its behaviour and

clinicopathological features, COC is
now thought to be a developmental
cyst that arises from the dental
lamina.
Simple cyst
May show luminal proliferations


• Odontoma

• Cementoblastoma
• Gingival cyst

Some entities restored:
• Ghost cell odontogenic carcinoma

• Odontoma
• Orthokeratised odontogenic cyst

• Cementoblastoma
• Gingival cyst
Odontogenic carcinosarcoma
• True malignant mixed tumour
• Similar to ameloblastic fibroma
• Both epithelial and mesenchymal components are malignant
• Was included in 1992 (but not 1971 or 2005)
• Very rare – only ~6 cases reported
Orthokeratinised Odontogenic Cyst
• “variant” of OKC
• 60% in males
• Usually mandible
• Orthokeratin
• Cuboidal or flat basal cells
• Well demarcated unilocular radiolucency
• Rarely recur
Wright J (1981). Oral Surg Oral Med Oral Pathol 51: 609–618
Orthokeratinised Odontogenic Cyst
Now included as a separate entity

WHO 4th Edition 2017
Classification of cysts.
• Radicular cyst
• Gingival cyst
WHO 4th Edition 2017
Classification of cysts.
• Radicular cyst
• Gingival cyst

• Sclerosing odontogenic carcinoma
• Squamous odontogenic tumour

“Cemento-” returns
• Odontoma

• Radicular cyst
• Odontogenic fibroma
• Odontogenic myxoma/myxofibroma
• Cementoblastoma
• Cemento-osseous dysplasia
• Gingival cyst
2005
Bone-related lesions

• Cherubism
Odontogenic carcinomas
Ameloblastic carcinoma
Metastasizing (malignant) ameloblastoma
Primary intraosseous carcinoma
Sclerosing odontogenic carcinoma
Clear cell odontogenic carcinoma
Ghost cell odontogenic carcinoma
Odontogenic sarcomas
Benign epithelial odonotogenic tumours

Ameloblastoma
Squamous odontogenic tumour
Calcifying epithelial odontogenic tumour
Adenomatoid odontogenic tumour
Benign mixed epithelial and mesenchymal odontogenic tumours

Ameloblastic fibroma
Primordial odontogenic tumour
Odontomas
Benign mesenchymal odontogenic tumours

Odontogenic fibroma
Odontogenic myxoma/myxofibroma
Cementoblastoma
Cemento-ossifying fibroma
Odontogenic carcinomas
Ameloblastic carcinoma
Metastasizing (malignant) ameloblastoma
Primary intraosseous carcinoma
Sclerosing odontogenic carcinoma
Clear cell odontogenic carcinoma
Ghost cell odontogenic carcinoma
Odontogenic sarcomas
Benign epithelial odonotogenic tumours

Ameloblastoma
Squamous odontogenic tumour
Calcifying epithelial odontogenic tumour
Adenomatoid odontogenic tumour
Benign mixed epithelial and mesenchymal odontogenic tumours

Ameloblastic fibroma
Primordial odontogenic tumour
Odontomas
Benign mesenchymal odontogenic tumours

Odontogenic fibroma
Odontogenic myxoma/myxofibroma
Cementoblastoma
* Cemento-ossifying fibroma
Cemento-ossifying fibroma
• Old term re-instated
• Recognises its odontogenic origin
• Arises in periodontal ligament
• Contains cementum?
• Distinguishes it from other types of OF
2017
Ossifying fibromas
• Juvenile trabecular ossifying fibroma
• Juvenile psammomatoid ossifying fibroma

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European Society of Pathology

Cologne, September 2016

WHO classification of head and neck

Oral & Maxillofacial Pathology

IV. Unclassificed Lesions

IV. Unclassificed Lesions

Osteogenic neoplasms: Inflammatory

Odontogenic carcinomas: Odontogenic epithelium only:

Odontogenic carcinomas: Odontogenic epithelium only:

Odontogenic carcinomas: Epithelial odontogenic tumours

Odontogenic sarcomas: Mixed epithelial and mesenchymal odontogenic tumours

Odontogenic cysts of inflammatory origin Mesenchymal odontogenic tumours

1. Odontogenic cysts are included

Classifications simplified Odontogenic mesenchyme:

Odontogenic carcinomas: Odontogenic epithelium only:

1. Odontogenic cysts are included

Odontogenic carcinomas: Epithelial odontogenic tumours

Odontogenic sarcomas: Mixed epithelial and mesenchymal odontogenic tumours

• Primordial odontogenic tumour

• Sclerosing odontogenic carcinoma

Slater LJ, Eftimie LF, Herford AS. (2016). Primordial odontogenic

Mosquedo-Taylor et al. (2014) Histopathology. 65: 606.

Am J Surg Pathol. 2008; 32: 1613 - 1619

8 cases now reported

…a primary intraosseous carcinoma of

…a primary intraosseous carcinoma of

Odontogenic carcinomas: Odontogenic epithelium only:

• Clear cell odontogenic carcinoma Odontogenic epithelium and odontogenic mesenchyme:

• Keratocystic odontogenic tumour

• Calcifying cystic odontogenic tumour

Odontogenic carcinomas: Epithelial odontogenic tumours

• Keratocystic odontogenic tumour

• Calcifying cystic odontogenic tumour

Odontogenic carcinomas: Epithelial odontogenic tumours

Odontogenic cysts of inflammatory origin Mesenchymal odontogenic tumours

• Calcifying odontogenic cyst

Odontogenic carcinomas: Odontogenic epithelium only:

keratocystic odontogenic tumour

Odontogenic carcinomas: Odontogenic epithelium only:

keratocystic odontogenic tumour

• Fibrous dysplasia Odontogenic mesenchyme:

Evidence that it may be a benign neoplasm:

Evidence that it may be a benign neoplasm:

Li TJ. 2011. J Dent Res. 90: 133-142

Li TJ. 2011. J Dent Res. 90: 133-142

Gomes CC, et al., 2009. Oral Oncology 45: 1011-1014

Keratocysts Dentigerous Radicular

Pavelic et al. 2001. J Oral Pathol Med: 30: 569-576

* Barretto et al. 2000. J Dent Res: 79:1418-1422

• Changes only demonstrated by LOH &

Pavelic et al. 2001. J Oral Pathol Med: 30: 569-576

PTCH alterations are neither

Li TJ. 2011. J Dent Res. 90: 133-142

Pogrel & Jordan. J Oral Maxillofac Surg 62:651-655, 2004

Pogrel & Jordan. J Oral Maxillofac Surg 62:651-655, 2004

• Not the behaviour of a neoplasm

Odontogenic Keratocyst re-instated

Further research is needed, but at the

Odontogenic carcinomas: Odontogenic epithelium only:

• Clear cell odontogenic carcinoma Odontogenic epithelium and odontogenic mesenchyme:

‘A benign cystic neoplasm of

‘A locally invasive neoplasm

On the basis of its behaviour and