背景:成釉细胞纤维瘤和成釉细胞纤维肉瘤是罕见的牙源性肿瘤,在出现硬组织产生的病例的分类中存在争议:成釉细胞性纤维腺瘤(AFD)和成釉细胞性纤维牙瘤(AFO)。这些病例目前被认为是“发展中的牙瘤”(错构瘤性病变)。
目的:分析这些病变的临床病理特征,并讨论2017年世界卫生组织分类的变化。
方法:在PubMed/MEDLINE数据库中进行了电子文献检索。对英语文献进行了电子搜索,最后一次更新于2020年9月在PubMed/MEDLINE数据库中使用以下术语:“成釉细胞性纤维瘤”,\“成釉细胞纤维质腺瘤\”,\“成釉细胞纤维牙瘤\”,\"成釉细胞肉瘤\",“成釉细胞纤维肉瘤”,“成釉细胞纤维质肉瘤”,“成釉细胞纤维牙肉瘤”和“牙源性癌肉瘤”。纳入标准为牙源性肿瘤系列,病例报告和系统评价提供了足够的临床,放射学和显微镜文件,以确认诊断。
结果:数据库搜索策略产生了947篇论文。专注于其他主题的文章,不是英文的文章,重复的文章,不符合纳入标准的文章被排除在外.最后,本综述包括96种出版物,以描述和讨论搜索实体的主要特征。AFO和AFD的几个方面,比如生物学行为,发生的年龄,大量的硬组织,以及恶性转化为牙源性肉瘤的可能性,支持大多数报告病例的肿瘤性质。考虑到临床,射线照相,具有硬组织产生的牙源性病变的组织病理学和分子特征,我们建议通过保留经典使用的术语,这些类型的病变应继续被视为牙源性肿瘤。
结论:该建议将与未来的临床,微观,和分子研究,以更好地了解这些有趣的牙源性肿瘤的生物学。
BACKGROUND: Ameloblastic fibromas and ameloblastic fibrosarcomas are rare odontogenic tumors, and controversy exists in the classification of cases presenting hard-tissue production: Ameloblastic fibrodentinoma (AFD) and ameloblastic fibro-odontoma (AFO). These cases are currently considered \"developing odontomas\" (hamartomatous lesions).
OBJECTIVE: To analyze the clinicopathologic features of these lesions and discuss the changes in the 2017 World Health Organization classification.
METHODS: An electronic literature search was performed in the PubMed/MEDLINE database. An electronic search of the English language literature was performed and last updated in September 2020 in the PubMed/MEDLINE database using the following terms: \"ameloblastic fibroma\", \"ameloblastic fibrodentinoma\", \"ameloblastic fibro-odontoma\", \"ameloblastic sarcoma\", \"ameloblastic fibrosarcoma\", \"ameloblastic fibrodentinosarcoma\", \"ameloblastic fibroodontosarcoma\" and \"odontogenic carcinosarcoma\". The inclusion criteria were odontogenic tumor series, case reports and systematic reviews that provided sufficient clinical, radiological and microscopic documentation to confirm the diagnosis.
RESULTS: The database search strategy resulted in 947 papers. Articles focusing on other topics, articles that were not in English, duplicate articles, and articles without fulfilling the inclusion criteria were excluded. Finally, 96 publications were included in this
review to describe and discuss the main features of the searched entities. Several aspects of AFO and AFD, such as biological behavior, age of occurrence, amount of hard tissue, and potential for malignant transformation into odontogenic sarcomas, support the neoplastic nature in most of the reported cases. Considering the clinical, radiographic, histopathological and molecular characteristics of odontogenic lesions with hard tissue production, we suggest that these types of lesions should continue to be recognized as odontogenic tumors by maintaining the classically used terms.
CONCLUSIONS: This recommendation will be relevant for future clinical, microscopic, and molecular studies to better understand the biology of these interesting odontogenic tumors.