Abstract：
Adenoid ameloblastoma is a hybrid odontogenic tumour showing histopathological features of both ameloblastoma and adenomatoid odontogenic tumour (AOT), with approximately 40 cases reported in the literature. The aims of the report are to illustrate the diagnostic challenges of adenoid ameloblastoma using three new cases and to analyze evidence in literature to consider adenoid ameloblastoma as a new sub type of ameloblastoma. A literature review was performed with the key words-adenoid ameloblastoma, hybrid/composite odontogenic tumours, hybrid ameloblastoma and adenomatoid odontogenic tumour, ameloblastoma with inductive changes, dentinoid and dentinoma to select the cases compatible with the diagnosis of adenoid ameloblastoma. Out of the 40 cases reported in literature, 31 cases with sufficient information and 3 new cases were analyzed. Out of the 34 adenoid ameloblastomas majority of tumours (76.5%) occurred in adults with age ranging from 25 to 55 years. Slight female predilection with a male:female ratio of 0.9:1 was observed. Approximately, 64.7% occurred in the mandible. Radiologically, 82.4% of adenoid ameloblastomas presented as radiolucent lesions while 47.1% occurred with ill-defined margins and cortical perforation at diagnosis. Histopathologically, 70.8% of tumours presented as plexiform ameloblastomas, while duct like structures/glandular structures were the commonest feature supportive of adenomatoid odontogenic tumour observed in overwhelming majority of 95.9% of adenoid ameloblastomas. 91.6% of tumours showed inductive change in the form of dentinoid. Further, 45.4% of the tumours developed at least one recurrence following surgical excision. The report presents literature review based evidence to show the existence of adenoid ameloblastoma, which is demographically similar to conventional ameloblastoma but with histopathological differences and presenting with higher rate/multiple recurrences, indicating its biological aggressiveness. Thus, we would like to propose the inclusion of adenoid ameloblastoma as a sub type of ameloblastoma in the next revision of the WHO odontogenic tumour classification.
摘要：
腺样成釉细胞瘤是一种杂合牙源性肿瘤，显示成釉细胞瘤和腺瘤样牙源性肿瘤（AOT）的组织病理学特征，文献报道了大约40例。该报告的目的是使用三个新病例说明腺样体成釉细胞瘤的诊断挑战，并分析文献中的证据，将腺样体成釉细胞瘤视为成釉细胞瘤的新亚型。对关键词腺样体成釉细胞瘤进行了文献综述，杂合/复合牙源性肿瘤，杂合成釉细胞瘤和腺瘤样牙源性肿瘤，成釉细胞瘤具有诱导性变化，选择与牙本质和牙本质瘤诊断相符的病例。在文献报道的40例病例中，对31例资料充足的病例和3例新病例进行分析。在34例腺样成釉细胞瘤中，大多数肿瘤（76.5％）发生在年龄为25至55岁的成年人中。观察到轻度女性偏爱，男女比例为0.9：1。大约,64.7%发生在下颌骨。放射学上,82.4％的腺样成釉细胞瘤表现为射线可透性病变，而47.1％的患者在诊断时出现边缘不明确和皮质穿孔。组织病理学,70.8%的肿瘤表现为丛状成釉细胞瘤，而导管样结构/腺体结构是支持腺瘤样牙源性肿瘤的最常见特征，在95.9％的腺样成釉细胞瘤中观察到。91.6％的肿瘤显示出牙样形式的诱导性变化。Further,45.4％的肿瘤在手术切除后至少复发一次。该报告提供了基于文献综述的证据来显示腺样体成釉细胞瘤的存在，其在人口统计学上与常规成釉细胞瘤相似，但具有组织病理学差异，并表现为更高的发生率/多次复发，表明其生物攻击性。因此，我们建议在下一次修订的WHO牙源性肿瘤分类中，将腺样成釉细胞瘤作为成釉细胞瘤的亚型。
