Izadora Fernanda Veiga de Jesus Costa

Objectives: This study aimed to investigate the clinicopathological features of malignant odontogenic tumors (MOTs) and to provide a comprehensive characterization that enhances the current understanding of this disease group. Methods: MOTs were retrieved from six Brazilian oral pathology services between 2007 and 2025. Demographic, clinical and radiographic data were collected from the charts, and the histological H&E-stained sections were revised by two blinded pathologists; previously available immunohistochemical and molecular findings were retrieved and reviewed in selected cases and the diagnosis was established according to the 2022 World Health Organization classification. Results: A total of 53 malignant odontogenic tumors were identified, predominantly affecting the mandible (83%), with a slight male predominance (male-to-female ratio, 1.12:1) and a mean age of 41.4 years. Ameloblastic carcinoma was the most frequent subtype (58.5%), followed by clear cell odontogenic carcinoma (18.9%), ameloblastic fibrosarcoma (13.2%), primary intraosseous carcinoma (7.5%), and ghost cell odontogenic carcinoma (1.9%). Conclusions: This multicenter review summarizes the main features of malignant odontogenic tumors. Although rare, these tumors often exhibit locally aggressive behavior, highlighting the need for early diagnosis, accurate histopathological evaluation, and standardized reporting with long-term follow-up.

Objective: To describe the occurrence and clinicopathological features of odontogenic tumors (OTs) in a multicenter South American study. Methods: This retrospective study reviewed 207,434 biopsies across 20 oral pathology centers in 10 South American countries. All cases were included according to the 2022 World Health Organization (WHO) criteria. Data were analyzed descriptively. Results: A total of 4399 OTs were identified, representing 2.1% of all biopsies assessed in these centers. Most were benign (99.1%), mainly odontoma (38.5%) and ameloblastoma (34%). Malignant tumors were rare (0.9%). Patients had a mean age of 27.8 years, with peak incidence in the second decade, and a slight female predominance (male‐to‐female ratio 1:1.1). Most lesions were asymptomatic (87.8%), intraosseous (97.3%), and located in the mandible (62.5%), especially the posterior region. Radiographically, radiolucent lesions (49.9%) predominated. Tooth displacement (83.3%) and root resorption (82.8%) were frequently reported. Among cases with available data, surgical excision (41.2%) and enucleation (37.3%) were the most common treatments, and recurrence was observed in 20.1%. Conclusions: This multicenter study provides the largest dataset on OTs in South America. The results confirm the predominance of benign lesions and highlight the importance of collaborative studies, offering a basis for future clinical and research initiatives.