Pindborg tumor is a benign neoplasm, which is quite a rare tumor. A calcifying epithelial odontogenic tumor(CEOT) is the other name of the Pindborg tumor. Out of all the odontogenic tumors, pindborg accounts for less than 1%. The location of this tumor is the posterior mandible.
The recurrence rate of the tumor is around 10-15%. There are fewer chances of malignancy with Pindborg tumor. Moreover, the Pindborg etiology is still unknown. Researchers assume that tumor cells are found in the dental lamina, that is in striatum intermedium. Alkaline phosphatase and ATP(adenosine triphosphatase) are present in high levels.
The age range which is commonly affected with the tumor is between 20-60 years. But the chances increase significantly in the 5th decade of life, whether it is male or female. Embedded teeth account for 50% of the Pindborg tumor cases. This tumor is not found in young children.
Pindborg Tumor Appearance
The radiological scans of the Pindborg tumor depict that it is found as unilocular which means it is most abundantly found in the maxilla. These lesions can also be:
- Multilocular
- Radiolucent
- Radio opaque
The scalloped margins are definite in the scan. The margins are not defined properly in about 20% of cases only. An impacted molar is frequently seen with a Pindborg tumor. Calcified streaks can also be seen that arise from central lesions which are usually radio-opaque.
Sometimes there is a cluster of densities around the tooth. Intraosseous and Extraosseous lesions can also be observed with the Pindborg tumor. The neoplastic cells have prominent nucleoli. Histopathological examination of the tumor cells is vital in order to diagnose the tumor. There are chances to improve the quality of life if the Pindborg tumor is diagnosed at an early stage. It is often stated by clinical researchers that Pindborg tumor is an immunological response.
It is recommended to have monthly or yearly radiographic scans to rule out the chances of recurrence.
Pindborg Tumor Symptoms
The most common symptoms often associated with Pindborg tumor are the following:
- Tooth tipping
- Rotation
- Migration
- Nasal airway obstruction
- Epistaxis
- Proptosis is usually experienced with the maxilla
- Grow slowly often painless
- Superficial swelling of the gingiva
- Expansile
- Bony swelling with bone resorption, usually the cortical bone
- Perforation
When the lesion is developed, it is mostly asymptomatic. When you go to a doctor for a radiographic exam, the lesion is diagnosed. The lesion is radiolucent in the initial stage of the tumor. It resembles a dentigerous cyst. The reason behind this is that the impacted tooth is associated with it.
In the second phase of the tumor, intratumoral calcification starts progressing. When it comes to the final stages, the Pindborg tumor presents with symptoms of osseous destruction and calcification. This appears like a honeycomb. The distribution of the lesions is equal in the jaws. The location is usually the anterior side of the mouth.
Pindborg Tumor Causes
There is no known cause of the odontogenic tumor. The benign tumor cells originate from the cells that are responsible for the normal development of teeth. When compared with other tumors, they are nonodontogenic. This means the tumor can develop from other tissues even if they are not linked with jaws or teeth. Genetic syndromes are considered a common cause when it comes to Pindborg tumors.
Sometimes there is a lack of genes that suppress the tumor. This genetic mutation runs in families or in other words inheritance. People should get tested if they have someone in the family suffering from the pindborg or any other odontogenic tumor.
A weak immune system can also result in a Pindborg tumor. Heavy alcohol use and chain-smoking can be leading risk factors for the tumor. The excess mutation of cancerous cells leads to life-threatening symptoms of the Pindborg tumor.
Pindborg Tumor Treatment
The treatment plan of the Pindborg tumor is dependent on several factors. Usually, surgical options are recommended but the location of the neoplasm is important to consider. The size of the tumor should be evaluated by the doctor to suggest treatment therapy.
Enucleation and curettage are the common procedures. This involves the removal of the bone layer which is adjacent to the tumor. Segmental resection or any other aggressive approach should be used if the tumor is in advanced stages. This can lead to discontinuity of the bone as well.
In this case, reconstruction procedures are prescribed. This commonly includes grafting. Transformation into a malignant tumor or cancer is very rare, but there are few chances that patients might progress into the advanced stage of the tumor. A 6-month follow-up is necessary.