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The calcifying epithelial odontogenic tumour (CEOT), or Pindborg tumour, is a rare, benign odontogenic tumour. CEOT is usually asymptomatic and an incidental radiological finding, often presenting as a mandibular radiolucency with flecks of calcific material. We report an unusual case of CEOT in the left posterior maxilla of a 46-year-old male that was associated with an unerupted tooth. The tumour in this case caused non-specific sinus symptoms and appeared radiographically similar to an odontoma or ossifying fibroma due to its dense calcific contents. Diagnosis was confirmed histologically following surgical removal of the lesion, which showed classic CEOT histomorphology. We report this case to highlight the unusual clinico-radiologic presentation and illustrate the diagnostic difficulties that can occur with radiolucent and/or radiopaque lesions in the jaws.

This paper discusses the range of recurrent oral ulceration which affects the oral mucosa. Types of ulceration covered in this paper include traumatic, infective, aphthous, ulceration related to the oral dermatoses, drug-induced, ulceration as a manifestation of systemic disease and ulceration indicating malignancy. Aspects of the aetiology, diagnosis and management of common oral recurrent ulcerative conditions are reviewed from a clinical perspective as an aid to practising dentists.

The clinical photograph (Fig. 1) shows the obvious labial gingival enlargement in the area of the mandibular anterior teeth, extending to the incisal edges of these teeth. In addition, multiple focal areas of pigmentation on the lips, erythema of the lower labial mucosa, an area of ulceration at the gingival margin, and generalised facial pallor are noted. Further useful information would include a history of the presenting complaint, signs and symptoms, including systemic involvement; whether there was any observed spontaneous haemorrhage from the gingiva; the onset of gingival enlargement as gradual or sudden; and changes in size or nature of the lesions. A thorough medical history including current medications, allergies and systems review, in particular a history of organ transplant, diabetes mellitus, epilepsy and gastrointestinal signs and symptoms may contribute to forming at a differential diagnosis. A family history should also be taken, including congenital or hereditary conditions, and enquiry about similar lesions affecting the patient’s siblings. The dental history would reveal her attendance record as well as oral hygiene habits. Further extra-oral examination should include palpation for regional lymphadenopathy, observation of any obvious facial swelling or asymmetry and trismus. In addition, extra-oral ecchymosis or petechiae, as well as any cutaneous lesions should be noted. Intra-orally, abnormalities of tooth number, size and structure should be noted, as well as whether the dentition was consistent with the age and development of the patient. Additional soft tissue examination should note any areas of spontaneous bleeding, bleeding on probing, tenderness to palpation, as well presence and location of other lesions including areas of petechiae or ecchymosis. Signs of possible underlying bony involvement should be recorded, as well as the standard of oral hygiene. The differential diagnoses of chronic generalised gingival enlargement in a paediatric patient can be classified according to aetiopathogenesis. Congenital and hereditary conditions include hereditary gingival fibromatosis, various lysosomal storage diseases, primary amyloidosis, and other inherited conditions. In general, the appearance of the gingival enlargement in these disorders is more bulbous and fibrous than the friable, erythematous enlargement noted in this patient. In addition, inherited and congenital causes of gingival enlargement would usually become apparent once the patient’s medical history was taken, however genetic testing may be used to confirm any genetic abnormality. M. J. Aldred (&) A. A. Talacko A. K. Gordon Dorevitch Pathology, 18 Banksia Street, Heidelberg, Melbourne, VIC 3084, Australia e-mail: michael.aldred@sctelco.net.au