Adenomatoid odontogenic tumor mimicking nasal pathology: A case report on endoscopic endonasal management

Adenomatoid odontogenic tumor (AOT) is a rare benign epithelial odontogenic tumor that typically occurs in young females and is most often associated with an impacted maxillary canine. Although usually managed via transoral enucleation, endoscopic endonasal surgery has emerged as a potential alternative for selected lesions. A 25-year-old woman presented with progressive right-sided nasal obstruction and clear rhinorrhea. Nasal endoscopy revealed a smooth submucosal bulge arising from the right inferior meatus that filled the right nasal cavity. Computed tomography demonstrated a well-defined expansile lesion occupying the right maxillary sinus, containing internal calcifications and an impacted canine tooth. The tumor was completely removed using an endoscopic endonasal approach. Histopathology confirmed the diagnosis of AOT. At the 18-month follow-up, endoscopic examination showed complete healing without recurrence. Endoscopic endonasal surgery offers advantages over transoral approaches in selected cases, including improved visualization, avoidance of oroantral complications, absence of external incisions, and suitability for large maxillary sinus lesions. This case demonstrates the feasibility of complete AOT removal using an endoscopic endonasal approach. Further reports with long-term follow-up are required to clarify indications and outcomes for this technique. • AOT may present as a large maxillary sinus mass with nasal symptoms. • Complete AOT removal was achieved via an endoscopic endonasal approach. • Endoscopic surgery improves visualization and avoids transoral complications. • Endoscopic endonasal surgery is a safe and effective option for selected cases.