PDF(Pubmed)
Abstract：
BACKGROUND: Recently, a new odontogenic tumor has been described, the so-called adenoid ameloblastoma (AdAM). The aim of this review was to determine the clinical and imaging features of AdAM and to describe its main histopathological findings.
METHODS: The systematic review included published cases with a diagnosis of AdAM in the gnathic bones, which had sufficient clinical, imaging, and histopathological data to confirm its diagnosis. The following histopathological diagnostic criteria were adopted: presence of ameloblastoma-like components, duct-like structures, spiral cellular condensations, and a cribriform architecture.
RESULTS: Fifteen articles, corresponding to 30 cases of AdAM, were selected. Most cases affected men (63.3%), with a slight preference for the mandible (16:14) and the posterior region of gnathic bones was the most commonly affected site. The mean age at diagnosis was 40.8 years. Clinically, the lesions usually presented as a swelling (53.3%) and, radiographically, as a well-defined radiolucency (33.4%). Surgical resection (40%) was the most frequently adopted treatment and recurrence occurred in 30% of cases. Microscopic examination showed cribriform areas in most AdAM cases (93.3%); duct-like structures and spiral cellular condensations were seen in 100% of the cases.
CONCLUSIONS: The small number of reported cases, the existence of erroneous diagnoses, and the adoption of initial conservative management make it difficult to determine whether AdAM has a higher risk of recurrence or more aggressive biological behavior than conventional ameloblastomas.
METHODS: The systematic review included published cases with a diagnosis of AdAM in the gnathic bones, which had sufficient clinical, imaging, and histopathological data to confirm its diagnosis. The following histopathological diagnostic criteria were adopted: presence of ameloblastoma-like components, duct-like structures, spiral cellular condensations, and a cribriform architecture.
RESULTS: Fifteen articles, corresponding to 30 cases of AdAM, were selected. Most cases affected men (63.3%), with a slight preference for the mandible (16:14) and the posterior region of gnathic bones was the most commonly affected site. The mean age at diagnosis was 40.8 years. Clinically, the lesions usually presented as a swelling (53.3%) and, radiographically, as a well-defined radiolucency (33.4%). Surgical resection (40%) was the most frequently adopted treatment and recurrence occurred in 30% of cases. Microscopic examination showed cribriform areas in most AdAM cases (93.3%); duct-like structures and spiral cellular condensations were seen in 100% of the cases.
CONCLUSIONS: The small number of reported cases, the existence of erroneous diagnoses, and the adoption of initial conservative management make it difficult to determine whether AdAM has a higher risk of recurrence or more aggressive biological behavior than conventional ameloblastomas.
摘要：
背景：最近，已经描述了一种新的牙源性肿瘤，所谓的腺样体成釉细胞瘤（AdAM）。这篇综述的目的是确定AdAM的临床和影像学特征，并描述其主要的组织病理学发现。
方法：系统评价包括已发表的在颌骨中诊断为AdAM的病例，有足够的临床，成像,和组织病理学数据来证实其诊断。采用以下组织病理学诊断标准：成釉细胞瘤样成分的存在，管道状结构，螺旋细胞凝聚，和网状建筑。
结果：15篇文章，对应于30例AdAM，被选中。大多数病例影响男性(63.3%),轻微偏爱下颌骨（16：14），颌骨的后部区域是最常见的受影响部位。诊断时的平均年龄为40.8岁。临床上,病变通常表现为肿胀(53.3%)，射线照相，作为一个明确的射线可透性（33.4％）。手术切除（40％）是最常用的治疗方法，30％的病例复发。显微镜检查显示大多数AdAM病例（93.3％）的筛状区域；在100％的病例中可见导管状结构和螺旋细胞凝结。
结论：报告病例数量少，错误诊断的存在，并且采用初始保守治疗使得难以确定AdAM是否比常规成釉细胞瘤具有更高的复发风险或更具侵袭性的生物学行为。
方法：系统评价包括已发表的在颌骨中诊断为AdAM的病例，有足够的临床，成像,和组织病理学数据来证实其诊断。采用以下组织病理学诊断标准：成釉细胞瘤样成分的存在，管道状结构，螺旋细胞凝聚，和网状建筑。
结果：15篇文章，对应于30例AdAM，被选中。大多数病例影响男性(63.3%),轻微偏爱下颌骨（16：14），颌骨的后部区域是最常见的受影响部位。诊断时的平均年龄为40.8岁。临床上,病变通常表现为肿胀(53.3%)，射线照相，作为一个明确的射线可透性（33.4％）。手术切除（40％）是最常用的治疗方法，30％的病例复发。显微镜检查显示大多数AdAM病例（93.3％）的筛状区域；在100％的病例中可见导管状结构和螺旋细胞凝结。
结论：报告病例数量少，错误诊断的存在，并且采用初始保守治疗使得难以确定AdAM是否比常规成釉细胞瘤具有更高的复发风险或更具侵袭性的生物学行为。
