Unicystic

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  • 文章类型: Case Reports
    成釉细胞瘤(DA)是一种上皮牙源性肿瘤,是成釉细胞瘤的一种罕见变体。它于1984年由Eversole首次描述。在世界卫生组织(WHO)牙源性肿瘤的分类(2005年)中,DA被认为是与常规/多囊性成釉细胞瘤不同的实体。DA在临床上有惊人的不同,放射学,与成釉细胞瘤的其他变体相比,以及组织病理学表现。我们在这里报告了一名50岁女性患者的极为罕见的“混合DA”,该患者无痛性硬肿胀累及右后下颌骨,并有详细的临床病史,不寻常的影像学和组织病理学表现。组织病理学显示毛囊形式的牙源性上皮,成釉细胞瘤与囊性变性,在某些地方和其他地方,鳞状上皮化生被致密的纤维细胞基质压缩,提示增生和骨组织形成。还回顾了文献,并讨论了DA中囊变和骨组织形成的病因的可能解释。
    Desmoplastic ameloblastoma (DA) is an epithelial odontogenic tumor and a rare variant of ameloblastoma. It was first described by Eversole in 1984. In the World Health Organization (WHO) classification of odontogenic tumors (2005), DA has been considered as a distinct entity from conventional/multicystic ameloblastoma. DA differs strikingly in its clinical, radiological, and histopathological presentation when compared to other variants of ameloblastoma. We report here an extremely rare \"Hybrid DA\" in a 50-year-old female patient with painless hard swelling involving right posterior mandible with detailed clinical history, an unusual radiographic and histopathological presentation. Histopathology revealed odontogenic epithelium in the form of follicles, ameloblastoma with cystic degeneration, and squamous metaplasia at places and elsewhere there were odosntogenic islands compressed by dense fibrocellular stroma suggestive of desmoplasia along with osseous tissue formation. Also review of the literature and possible explanation of etiopathogenesis of cystic change and osseous tissue formation in DA are discussed.
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  • 文章类型: Journal Article
    目的:本研究旨在评估单囊性成釉细胞瘤年轻患者的临床疗效,通过各种保守治疗方式,如袋袋化,骨刮除术和帮助建立合理的治疗指南。
    方法:有15例单囊性成釉细胞瘤患者,在过去的6年(2010-2015年)中,他向我们部门介绍了所有患者中选择的保守治疗方法。此外,增加了一项关于2001年至2015年过去15年中青年年龄组(<20岁)单囊性成釉细胞瘤治疗研究的系统文献综述.
    结果:注意到保守治疗后骨再生更快,由于年轻和成长潜力。平均随访4年,顺利的二次愈合,在任何病例中均未发现复发的临床或影像学证据,也未发现明显的畸形.
    结论:单囊性成釉细胞瘤是良性的,年轻的局部侵袭性牙源性肿瘤可以在牙齿形成阶段发展,因此它的早期开始和大量增殖在这个年龄段并不少见,因此,它可以长成一个巨大的病变,导致显著的发病率。保守性手术治疗可能是降低发病率并增加年轻人群中继发愈合和骨再生的可能性的可行选择。
    OBJECTIVE: The study intends to evaluate the clinical outcome of treating young patients of unicystic ameloblastoma, by various conservative treatment modalities such as marsupialization, enucleation with bone curettage and aid in establishing sound treatment guidelines.
    METHODS: A case series of fifteen patients is presented of unicystic ameloblastoma, who presented to our Department over the past 6 years (2010-2015) and conservative method of treatment elected in all the patients. Also, a methodical literature review of studies discussing treatment of unicystic ameloblastoma in young age group (<20 years) patients over the last 15 years from 2001 to 2015 is added.
    RESULTS: Faster osseous regeneration after conservative treatment was noted, owing to the young age and growth potential. Over a mean follow-up of 4 years, uneventful secondary healing, no clinical or radiographic evidence of recurrence and no apparent deformity were noted in any of the cases.
    CONCLUSIONS: Unicystic ameloblastoma is a benign, locally invasive odontogenic neoplasm of young age which can develop during the stage of tooth formation and hence its early inception and vast proliferation is not uncommon in this age group, due to which it can grow into a huge lesion causing significant morbidity. Conservative surgical management may be a viable option to reduce morbidity and increase the probability of uneventful secondary healing and bone regeneration in the younger population.
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  • 文章类型: Journal Article
    OBJECTIVE: To assess the cases of ameloblastoma retrospectively for various parameters.
    METHODS: Ninety-one previously reported cases of ameloblastoma from Government Dental College and Hospitals, Nagpur, were included in this study. Data were collected considering parameters such as age, sex, symptoms, radiographic, histopathology, treatment modalities, and recurrence. Our findings were also compared with world literature.
    RESULTS: The average age was 32.5 years. Mostly men complained of an asymptomatic swelling and duration of less than one year. Posterior segment and vertical ramus of mandible was the frequently involved site. Radiographically, multilocular appearance was noted more than 60% of the cases. Plexiform and unicystic ameloblastoma occurred frequently. Surgery was the treatment of choice in this review. Recurrence was noted in more than 10% of the cases.
    CONCLUSIONS: There are variations in our review in comparison to reported literature.
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  • 文章类型: Case Reports
    成釉细胞瘤是最常见的牙源性肿瘤。这种肿瘤有各种类型,临床医生对正确的分类仍然存在混淆。多囊性成釉细胞瘤是最常见的亚型,而单囊性成釉细胞瘤可以被认为是固体或多囊性的变体。该亚型被认为是具有可变复发率的侵袭性较小的肿瘤。然而,它的频率经常被低估。本文的目的是以我们不寻常的临床病例为起点,回顾有关单囊性成釉细胞瘤的最新文献,以说明这一讨论。一名30岁的男子一直抱怨下颌骨左侧的前磨牙和磨牙区域有轻微疼痛,他在我们部门接受了检查。X射线显示具有不透射线的边缘的单眼放射图像。第一个组织学诊断是牙源性囊肿。连续的组织学评估显示,在角膜结缔组织中存在成釉细胞上皮岛。我们认为我们的病例报告为成釉细胞瘤的诊断方法提供了新的见解。我们同意作者的观点,他们指出,单个小活检通常不足以正确诊断成纤维细胞瘤。此外,根据我们的经验,应该记住成釉细胞瘤有时可能会有不寻常的表现,这一事实应该促使外科医生和病理学家仔细考虑每个病变。
    Ameloblastoma is the most common tumor of odontogenic origin. There are various types of this tumor and confusion still exists among the clinicians about the correct classification. Multicystic ameloblastoma is the most frequent subtype while unicystic ameloblastoma can be considered as a variant of the solid or multycistic. This subtype is considered as a less aggressive tumor with a variable recurrence rate. However, its frequency is often underestimated. The aim of this article is reviewing the recent literature about unicystic ameloblastoma using our unusual clinical case as a starting point to illustrate this discussion. A 30-year-old man who had been complaining of slight pain in the premolar and molar area of the left side of mandible had a check up at our department. X-rays revealed a unilocular radiotrasparency with radiopaque margins. The first histological diagnosis was an odontogenic cyst. Successive histological evaluations revealed that ameloblastic epithelial islands were present in lassus connective tissue. We think that our case report provides new insights into the approach to the ameloblastoma diagnosis. We agree with authors who have pointed out that a single small biopsy may often be inadequate for the correct diagnosis of amelobastoma. Moreover, in the light of our experience, it should be kept in mind that ameloblastomas may have sometimes unusual presentations and this fact should induce surgeons and pathologists to consider carefully each lesion.
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  • 文章类型: Case Reports
    The term unicystic ameloblastoma (UA) refers to those cystic lesions that show clinical, radiographic, or gross features of a jaw cyst, but on histologic examination show a typical ameloblastomatous epithelium lining part of the cyst cavity, with or without luminal and/or mural tumor growth. Although the histology suggests that cystic ameloblastomas follow a biologically low-grade course, recent evidence suggests that they may often behave clinically as aggressive tumors. This is supported by the high incidence of cortical perforation, tooth resorption, increase in lesion size, bony destruction, and a high rate of recurrence after simple enucleation. Here, the authors present a case report on unicystic variant of ameloblastoma in the maxilla. An attempt has been made to emphasize that it can involve the maxillary jaw, which is rarely affected and could be more aggressive than previously thought. A literature review on the topic has been added along with the case report. It is important to remember that a proper and timely diagnosis of the character and extent of a UA (with a thorough histopathologic examination of the entire specimen) can help in the overall long-term well-being of the patient.
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