Unicystic

独木舟
  • 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
    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: Editorial
    暂无摘要。
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  • 文章类型: Case Reports
    囊性部分分化肾母细胞瘤(CPDN)患者的病例迄今已有报道,在所有这些肿瘤中都表现为多囊性肾肿瘤。它是肾母细胞瘤的一种特殊病理类型。这里,我们报告了首例儿童中的单纯性CPDN病例.该患者被诊断为单纯性肾囊肿,并接受了腹腔镜剥脱术。在病理切片中发现了幼稚的肾单位,确诊为CPDN。然后,患者接受了根治性肾切除术和六个周期的术后化疗。随访2年无复发或转移。表现为单囊性肾肿瘤的小儿CPDN对诊断提出了新的挑战,鉴别诊断,和治疗单囊性肾肿瘤。
    Cases of patients with cystic partially differentiated nephroblastoma (CPDN) have been reported to date, which presented as polycystic renal tumor in all of them. It is a special pathological type of nephroblastoma. Here, we report the first case of a unicystic CPDN in a child. The patient was diagnosed with a simple renal cyst and underwent laparoscopic decortication. The naive nephron was found in the pathological section, and the diagnosis of CPDN was confirmed. The patient then underwent a radical nephrectomy and six cycles of postoperative chemotherapy. There was no recurrence or metastasis after 2 years of follow-up. Pediatric CPDN presenting as a unicystic renal tumor poses a new challenge to the diagnosis, differential diagnosis, and treatment of unicystic renal tumor.
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  • 文章类型: Journal Article
    单囊性成釉细胞瘤(UA)是成釉细胞瘤的一种罕见变体,其行为与成釉细胞瘤(SMA)的固体多囊性变体完全不同;此外,UA的组织学亚组在增殖方面也表现出不同的行为。本多中心研究旨在介绍单囊性成釉细胞瘤(UA)的临床病理特征,并比较两种流行的组织学分类系统。从印度北部的四所牙科教学学校中检索到80例令人满意的UA病例,并对其临床病理参数进行了评估。使用改良的Reichart和Philipsen系统以及Marx和Stern系统对病例进行分类,然后比较观察者之间的变异性。结果采用SPSS软件进行分析。平均发病年龄为30.79±16.49岁。男性人数超过女性(M:F::1.67:1)。大多数病例发生在第三个十年,不分性别。大多数病例发现于下颌骨的体角支区域。修改后的Reichart和Philipsen分类产生了更好的观察者间一致性(kappa值0.845)。修改后的Reichart和Philipsen分类可产生更好的评分者之间的一致性,并且易于在口腔病理学家中复制。更简单,手术外科医生可以很容易地理解它,以获得更好的治疗结果。
    Unicystic ameloblastoma (UA) is an uncommon variant of ameloblastoma and behaves totally different from the solid multicystic variant of ameloblastoma (SMA); furthermore the histological subgroups of UA also show varied behavior regarding proliferation. The present multi-centric study was designed to present the clinicopathological features of unicystic ameloblastoma (UA) and to compare the two popular histological classifications systems. 80 satisfactory cases of UA were retrieved and evaluated for clinicopathological parameters from four teaching dental schools of North India. The cases were classified using modified Reichart and Philipsen system and Marx and Stern system followed by comparison of inter-observer variability. The results were analyzed using SPSS software. The mean age of occurrence was 30.79 ± 16.49 years. Males outnumbered females (M:F::1.67:1). The majority of cases occurred in the third decade irrespective of the gender. Most cases were found in body-angle-ramus region of the mandible. The modified Reichart and Philipsen classification yielded better interobserver agreement (kappa value 0.845). The modified Reichart and Philipsen classification yields better inter-rater agreement and is easy to reproduce amongst oral pathologists. Being simpler it may easily be understood by the operating surgeon for better treatment outcome.
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  • 文章类型: Case Reports
    目的:成釉细胞瘤是一种局部侵袭性良性肿瘤,通常发生在下颌骨。虽然已经报道了多囊性或丛状变异的巨大成釉细胞瘤,作者报告了一例罕见的腔内变异的巨大单囊性成釉细胞瘤,通过房室切除术治疗,并计划延迟重建。
    方法:一名46岁的男性患者向口腔外科门诊部报告,左侧下颌骨区域肿胀2年。他接受了阿育吠陀治疗,但没有改善。出现时病变的大小约为9×12cm。
    方法:房室切除并计划进行二次重建,经过适当的随访期。
    结论:虽然正在探索保守治疗作为单囊性成釉细胞瘤的治疗选择,无论巨大病变的组织病理学亚型如何,切除仍是治疗标准.
    OBJECTIVE: Ameloblastoma is a locally aggressive benign tumor, commonly occurring in the mandible. While giant ameloblastoma of multicystic or plexiform variant have been reported, the authors report a rare case of giant unicystic ameloblastoma of luminal variant, which was treated by compartmental resection and planned for delayed reconstruction.
    METHODS: A 46 year old male patient reported to the oral surgery out-patient department with a swelling of the left side mandible region of 2 years duration. He had undergone ayurvedic treatment for the same with no improvement. The size of the lesion on presenting was approximately 9 × 12 cm.
    METHODS: Compartmental resection with plan for secondary reconstruction, after adequate follow up period.
    CONCLUSIONS: While conservative management is being explored as a treatment option for unicystic ameloblastoma, resection is still the standard of care regardless of the histopathological subtype for giant lesions.
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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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