Ameloblastoma

成釉细胞瘤
  • 文章类型: Letter
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  • 文章类型: Journal Article
    成釉细胞瘤,一种良性但侵袭性的牙源性肿瘤,以其复发和根治性手术的严重发病率而闻名,可能受益于靶向治疗的进步。我们介绍了一例15岁女孩成釉细胞瘤的靶向治疗成功,并回顾了这个问题的文献:抗MAPK靶向治疗成釉细胞瘤安全有效吗?遵守PRISMA准则,并搜索了截至2023年12月的多个数据库,从647条记录中确定了13项相关研究,涵盖23例接受MAPK抑制剂治疗的患者。结果很有希望,因为几乎所有患者都表现出积极的治疗反应,其中4人实现了完全的放射学缓解,其他人则显示出原发性疾病的大幅减少,经常性,和转移性成釉细胞瘤的大小。副作用大多为轻度至中度。这项研究表明,抗MAPK疗法是侵入性手术治疗的重要转变,通过提供一种侵入性较小但有效的治疗替代方案,有可能提高生活质量和临床结局。这种方法可能意味着在治疗这种具有挑战性的肿瘤方面取得了突破,强调需要进一步研究分子靶向治疗。
    Ameloblastoma, a benign yet aggressive odontogenic tumor known for its recurrence and the severe morbidity from radical surgeries, may benefit from advancements in targeted therapy. We present a case of a 15-year-old girl with ameloblastoma successfully treated with targeted therapy and review the literature with this question: Is anti-MAPK targeted therapy safe and effective for treating ameloblastoma? This systematic review was registered in PROSPERO, adhered to PRISMA guidelines, and searched multiple databases up to December 2023, identifying 13 relevant studies out of 647 records, covering 23 patients treated with MAPK inhibitor therapies. The results were promising as nearly all patients showed a positive treatment response, with four achieving complete radiological remission and others showing substantial reductions in primary, recurrent, and metastatic ameloblastoma sizes. Side effects were mostly mild to moderate. This study presents anti-MAPK therapy as a significant shift from invasive surgical treatments, potentially enhancing life quality and clinical outcomes by offering a less invasive yet effective treatment alternative. This approach could signify a breakthrough in managing this challenging tumor, emphasizing the need for further research into molecular-targeted therapies.
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  • 文章类型: Case Reports
    成釉细胞癌是一种罕见的恶性牙源性肿瘤,可进一步分为原发性或继发性,源于先前存在的良性成釉细胞瘤。它影响了三分之二的患者的下颌骨。该病变没有标准的治疗方案,但在大多数情况下,有或没有放射治疗的根治性手术切除报告。在本文中,我们介绍了一例22岁的男性,诊断为下颌骨成釉细胞癌,具有典型的侵袭性和广泛破坏的临床过程。切开的活检的组织病理学检查显示,角化的复层鳞状上皮具有潜在的纤维结缔组织基质。基质是高度粘液瘤,并表现出牙源性上皮岛和慢性炎症细胞浸润。牙源性上皮的交错链显示星状网状细胞和偶尔的鳞状化生区域,具有细胞和核多态性。此外,注意到有丝分裂图。与临床的相关性,射线照相,和组织学特征,该病变被诊断为成釉细胞癌。手术切除病灶,治疗后随访6个月,未发现恶性肿瘤复发。
    Ameloblastic carcinoma is a rare malignant odontogenic tumor that is further classified into being primary or secondary arising from a preexisting benign ameloblastoma. It affects the mandible in two thirds of the patients. There is no standard treatment protocol for this lesion but radicalsurgical excision with or without radiotherapy is reported in the majority of cases. In this paper, we present a case of a 22 year old male diagnosed with Ameloblastic carcinoma of the mandible with a clinical course of typical aggressiveness and extensive destruction. Histopathological examination of the incised biopsy showed a parakeratinized stratified squamous epithelium with underlying fibrous connective tissue stroma. The stroma is highly myxomatous and exhibits islands of odontogenic epithelium and chronic inflammatory cell infiltrates. Interlacing strands of odontogenic epithelium shows stellate reticulum-like cells and occasional areas of squamous metaplasia with cellular and nuclear pleomorphism. In addition, mitotic figures were noted. With the correlation of clinical, radiographic, and histological features, the lesion is diagnosed as ameloblastic carcinoma. The lesion was surgical excised and post-treatment follow-up for 6 months revealed no recurrence of the malignancy.
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  • 文章类型: Case Reports
    唾液腺肿瘤占所有头颈部肿瘤的3%。多形性腺瘤(PA)是最常见的唾液腺肿瘤,主要发生在腮腺,其次是口腔的小唾液腺,然而,下颌骨内PA的发生极为罕见,文献中报道的病例很少。在颌骨内部,这些病变倾向于模仿大型溶骨性病变,这包括诊断挑战。详尽的文献回顾显示仅10例中央多形性腺瘤。我们介绍了一例罕见的原发性PA病例,该病例发生在下颌骨内部,并被暂时诊断为成釉细胞瘤。
    Salivary gland neoplasms account for 3% of all head and neck tumours. Pleomorphic adenoma (PA) is the most common salivary gland tumour that mainly occurs in the parotid gland, followed by minor salivary glands of the oral cavity, however, the occurrence of PA inside the jaw bones is exceedingly rare and very few cases have been reported in the literature. Inside jaw bones these lesions tend to imitate large osteolytic lesions encompass a diagnostic challenge. An exhaustive review of the literature revealed only 10 cases of central pleomorphic adenoma. We present a rare case of primary PA that occurred inside the mandible and was provisionally diagnosed as ameloblastoma.
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  • 文章类型: Case Reports
    有很多良性病变会导致下颌骨肿胀,这些可以分为牙源性和非牙源性病变。在牙源性病变的类别中,成釉细胞瘤是发生最多的病变,起源于上皮细胞元素和牙齿组织的不同发育阶段。成釉细胞瘤由于其患病率和临床特征而成为最严重的牙源性肿瘤。成釉细胞瘤是一个广泛的类别,包括80%的固体多囊性成釉细胞瘤,其中单囊性成釉细胞瘤(UA)变体作为重要的临床病理形式,其余20%与周围成釉细胞瘤变体一起。UA是指临床上看起来像颌骨囊肿的囊性病变,射线照相,或大致但由典型的成釉细胞上皮排列,有或没有腔和/或壁肿瘤的发展,组织学调查。大约5-15%的成釉细胞病变没有转移倾向,这是UA.单一的壁画形式,虽然总体增长缓慢,局部侵入性强,复发率高。由于UA肿瘤表现出非常接近的特征与牙质囊肿,考虑到临床,需要执行一个非常尖锐的鉴别诊断方案来排除其他单囊性牙源性病变,放射学,和生物学特征以及适当的随访,并观察病变的任何复发。这里,我们报告一例21岁的男性下颌骨UA患者并进行文献复习。
    There are plenty of benign lesions that can result in swelling of the mandible, and these can be classified as odontogenic and non-odontogenic lesions. Among the categories of odontogenic lesion, ameloblastoma is the most occurring lesion that takes origin from the epithelial cellular elements and dental tissues in their different stages of development. Ameloblastoma is the most serious odontogenic neoplasm due to its prevalence and clinical characteristics. Ameloblastoma is a broad class which encompasses 80% of solid multicystic type of ameloblastoma with unicystic ameloblastoma (UA) variant included as vital clinicopathological form claiming the rest 20% along with peripheral ameloblastoma variant. UA refers to cystic lesions that seem like jaw cysts clinically, radiographically, or grossly but are lined by typical ameloblastomatous epithelium, with or without luminal and/or mural tumor development, on histologic investigation. Around 5-15% of all ameloblastic lesions do not have a propensity to metastasis, and this is UA. Unicystic mural form, although slow growing overall, is very invasive locally and has a high recurrence rate. As UA tumors show very close features with dentigerous cyst, a very sharp differential diagnosis protocol need to be executed to exclude the other unicystic odontogenic lesions considering the clinical, radiological, and biological characteristics along with proper follow-up and seeing any recurrence of the lesion taking place. Here, we report the case of a twenty-one year male patient with UA of the mandible and review of the literature.
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  • 文章类型: Case Reports
    自1964年以来,颅骨原发性成釉细胞瘤(AM)或成釉细胞癌(AMCa)的报道病例很少。这种罕见情况在特定解剖部位的临床表现和独特特征仍不清楚。我们报告了一例位于额颞叶顶叶区域的颅骨原发性AM恶性转化的病例,并强调了其与文献中报道的其他病例的相似性。
    一名53岁女性患者,有20天的头痛和10天的双侧下肢无力病史。体格检查显示步态缓慢且不稳定。在颅骨成像上,在颅骨的右额叶-颞叶-顶叶区域观察到占位性病变。行右颅骨肿瘤边缘扩张切除术。手术后患者的运动功能恢复正常。术后影像学检查显示10例肿瘤切除。随访影像学检查显示肿瘤复发。患者接受了复发性肿瘤的切除术。术后病理分析显示AM恶变。随访影像学检查显示肿瘤复发。患者接受立体定向放疗。随访影像学检查显示没有肿瘤复发的证据,随后的胸部CT显示没有转移的迹象。
    颅骨的初级AM或AMCa在文献中越来越多地被描述,但是缺乏有关颅骨原发性AM恶性转化的详细报道。这种情况的发病机制尚不清楚。积极的治疗和密切的随访可能是预防疾病复发和恶变的关键。
    UNASSIGNED: Since 1964, there has been a scarcity of reported cases of primary ameloblastoma (AM) or ameloblastic carcinoma (AMCa) of the skull. The clinical presentation and distinctive features of this uncommon condition at specific anatomical sites remain unclear. We report a case of malignant transformation of a primary AM of the skull situated in the frontal-temporal-parietal region and highlight its similarities to other cases reported in the literature.
    UNASSIGNED: A 53-year-old female patient presented with a 20-day history of headaches and bilateral lower limb weakness for 10 days. Physical examination revealed slow and unsteady gait. An occupying lesion was observed in the right frontal-temporal-parietal region of the skull on the Cranial imaging. A right cranial bone tumor margin expansion resection was performed. The patient\'s motor functions recovered normally after surgery. Postoperative imaging examinations showed10 tumor resection. Follow-up imaging examinations showed tumor recurrence. The patient underwent resection of the recurrent tumor. Postoperative pathological analysis revealed malignant transformation of the AM.Follow-up imaging examinations showed tumor recurrence again. The patient was admitted for stereotactic radiotherapy. Follow-up imaging examinations demonstrated no evidence of tumor recurrence and subsequent chest CT revealed no signs of metastasis.
    UNASSIGNED: Primary AM or AMCa of the skull is increasingly being described in the literature, but detailed reports on the malignant transformation of primary AM of the skull are lacking. The pathogenesis of this condition remains unclear. Aggressive treatment and close follow-up may be crucial for preventing disease recurrence and malignant transformation.
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  • 文章类型: Case Reports
    背景技术金刚烷胺瘤是一种罕见的低度恶性骨肿瘤,通常发现于胫骨干骨干和干phy端,与下颌成釉细胞瘤的组织学相似性。复发性金刚瘤的最有效治疗方法尚不清楚。该报告是一名22岁的女性,患有酪氨酸激酶抑制剂帕唑帕尼治疗的复发性胫骨金刚瘤。病例报告我们报告了一例22岁的女性,她因右侧胫骨的可疑骨病变而被转诊到我们中心。骨活检结果与金刚烷瘤一致。整块切除术成功完成,术后无并发症。五年后,发射断层扫描阳性显示,在先前病变区域附近和右腹股沟淋巴结中示踪剂摄取轻度增加。病变和腹股沟淋巴结的活检证实金刚烷瘤复发。由于腹部和盆腔转移,病人接受了手术切除,伴随着阑尾切除术,右输卵管卵巢切除术,术中放射治疗,和腹腔热化疗。随后,患者接受帕唑帕尼治疗4个月;然而,化疗4个月后肿瘤继续恶化.目前,患者正在接受吉西他滨和多西他赛作为二线药物治疗.结论该报告显示,帕唑帕尼作为独立治疗似乎对患者预后没有希望的作用。据我们所知,这是帕唑帕尼治疗金刚烷瘤的第二篇报道。
    BACKGROUND Adamantinoma is a rare low-grade malignant bone tumor, usually found in the tibial diaphysis and metaphysis, with histological similarities to mandibular ameloblastoma. The most effective treatment of recurrent adamantinoma is not yet clear. This report is of a 22-year-old woman with recurrent tibial adamantinoma treated with the tyrosine kinase inhibitor pazopanib. CASE REPORT We report the case of a 22-year-old woman who was referred to our center for a suspicious bone lesion in the right tibia. Bone biopsy findings were consistent with an adamantinoma. En bloc resection was completed successfully, with no postoperative complications. Five years later, a positive emission tomography scan revealed mildly increased tracer uptake near the area of the previous lesion and in the right inguinal lymph node. Biopsies of the lesion and inguinal lymph node confirmed recurrence of the adamantinoma. Due to abdominal and pelvic metastasis, the patient underwent surgical debulking, along with an appendectomy, right salpingo-oophorectomy, intraoperative radiation therapy, and hyperthermic intraperitoneal chemotherapy. Subsequently, the patient was placed on pazopanib for 4 months; however, her tumor continued to worsen after 4 months of chemotherapy. Currently, the patient is receiving gemcitabine and docetaxel as second-line medical therapy. CONCLUSIONS This report showed that pazopanib as standalone treatment does not appear to have promising role on patient outcomes. To the best of our knowledge, this is the second report of pazopanib in the treatment of adamantinoma.
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  • 文章类型: Journal Article
    这项研究的目的是回顾临床,放射学,以及牙质囊肿变质成不同实体的病例的组织学方面,以及对该过程中涉及的分子因素的评论。回顾性地进行了包括8例牙科囊肿的系列研究,并进行了全面的文献综述。包括2例牙质囊肿转化为粘液上皮化生,其中一例在一年后转化为成釉细胞瘤。另外两例报告为棘皮瘤和单囊性成釉细胞瘤,而四个过渡到AOT。对病例和文献进行分子谱分析的完整回顾得出的结论是,牙质囊肿的衬里具有转化为良性牙源性肿瘤的潜力。因此,仔细的临床和组织病理学检查对于正确诊断至关重要。此外,需要对囊性衬里进行彻底的分子理解。
    The objective of this study was to review the clinical, radiologic, and histologic aspects of cases of dentigerous cysts metamorphosing into different entities along with comments on the molecular factors involved in the process. A series comprising 8 cases of dentigerous cysts was performed retrospectively along with a comprehensive literature review. Two cases of dentigerous cyst converting into mucous metaplasia were included, out of which one case was transformed into ameloblastoma after a year. The other two cases were reported as acanthomatous and unicystic ameloblastoma, whereas four transitioned to AOT. The complete review of cases and literature with molecular profiling concluded that the lining of dentigerous cysts has the potential for transforming into benign odontogenic tumors. Therefore, a careful clinical and histopathological examination is crucial for the correct diagnosis. Also, a thorough molecular understanding of the cystic lining is required.
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  • 文章类型: Case Reports
    成釉细胞癌被定义为成釉细胞瘤,其中在原发肿瘤或复发性肿瘤中存在恶性肿瘤的组织学证据,无论其是否已经转移。本质上是侵略性的。
    患者出现与张口受限相关的疼痛性肿胀。
    这是一例复发性成釉细胞癌患者的临床资料。
    切除标本的组织学特征类似成釉细胞癌,构成具有高柱状细胞的细胞学异型性。
    进行肿瘤切除。使用胸大肌肌皮瓣进行重建。
    成釉细胞癌是一种侵袭性肿瘤,构成破坏和远处转移扩散。因此,积极切除是治疗的选择,同时进行长期随访,以提高生活质量。
    UNASSIGNED: Ameloblastic carcinoma is defined as an ameloblastoma in which there is histological evidence of malignancy in primary tumour or recurrent tumour regardless if it has metastasised or not. It is aggressive in nature.
    UNASSIGNED: The patient presented with a painful swelling associated with restricted mouth opening.
    UNASSIGNED: This is the clinical profile of a patient who has presented with a recurrent ameloblastic carcinoma.
    UNASSIGNED: Histological features of the excised specimen resemble ameloblastic carcinoma constituting cytological atypia with tall columnar cells.
    UNASSIGNED: Excision of tumour was done. Reconstruction was done using pectoralis major myocutaneous flap.
    UNASSIGNED: Ameloblastic carcinoma is an aggressive tumour and constitutes destruction and distant metastatic spread. Hence, aggressive resection is the choice of treatment along with a long-term follow-up for better quality of life.
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  • 文章类型: Case Reports
    角膜成纤维细胞瘤(KA)和牙源性角膜囊肿(SOKC)的实体变体是罕见的牙源性病变,他们的关系和差异尚不清楚。本研究描述了一个病例,该病例始于牙源性角化囊肿(OKC),并在复发后转化为SOKC/KA。简而言之,一名26岁的男子出现右脸颊肿胀,被转诊至口腔颌面外科,广岛大学医院(广岛,日本)。在初次访问时,观察到单囊骨渗透从右犬延伸到磨牙,上颌窦和鼻腔。活检后,患者接受了切除手术,并被诊断为OKC.此后,该病变在13年的时间内复发了6次,并显示出与原发病变不同的组织病理学特征,全部由许多角质化囊肿组成,被诊断为SOKC/KA。Ki‑67阳性率约为10%,高于原发病变,但是没有非典型。复发性病变的遗传分析显示,腺瘤性息肉病大肠杆菌和Kirsten大鼠肉瘤病毒癌基因同源物发生突变。这个案子起源于OKC,复发时OKC和KA的形态学特征混合,支持两者之间的共同性和关联性。然而,检测到与OKC和成釉细胞瘤不同的多个突变,提示SOKC/KA与增殖活性增加和高复发率相关。
    Keratoameloblastoma (KA) and solid variant of odontogenic keratocyst (SOKC) are rare odontogenic lesions, and their relationship and differences are unclear. The present study described a case that started as an odontogenic keratocyst (OKC) and transformed to SOKC/KA upon recurrence. Briefly, a 26‑year‑old man presented with swelling in the right cheek and was referred to the Department of Oral and Maxillofacial surgery, Hiroshima University Hospital (Hiroshima, Japan). At the initial visit, unicystic bone permeation was observed extending from the right canine to the molar, maxillary sinus and nasal cavity. After the biopsy, the patient underwent excisional surgery and was diagnosed with OKC. Thereafter, the lesion recurred six times over a period of 13 years and showed different histopathological features from those of the primary lesion, all consisting of numerous cysts with keratinization, which were diagnosed as SOKC/KA. The Ki‑67 positivity rate was ~10%, which was higher than that of the primary lesion, but there was no atypia. Genetic analysis of the recurrent lesion revealed mutations in adenomatous polyposis coli and Kirsten rat sarcoma viral oncogene homolog. This case originated from OKC, and the morphological features of OKC and KA were mixed upon recurrence, supporting the commonality and association between the two. However, multiple mutations different from those of OKC and ameloblastoma were detected, suggesting an association of SOKC/KA with increased proliferative activity and a high recurrence rate.
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