Ameloblastic fibroma

成釉细胞纤维瘤
  • 文章类型: Journal Article
    该病例报告旨在描述一种罕见的良性下颌骨肿瘤,并评估最新评论的结果。2017年1月至2023年8月。介绍一个详细的临床病例,这项研究提高了我们对诊断和治疗方面的理解,最终改善临床实践中类似病例的管理。正交图(OPG)显示从支中线延伸的明确的单眼射线可透性,牙齿47和48浸没在下颌骨的底部。在本案中,使用PLANMECAROMEXISPROMAX®三维(3D)最大锥束计算机断层扫描(CBCT)装置进行3D检查.优选口内方法,并通过使用W&H®DentalwerkBürmoosGmbHPiezomed压电装置创建骨窗来完全切除肿瘤,骨板用4个MEDARTIS®微孔板固定,一个主要的皮瓣关闭。采用PANORAMIC1000,3DHISTECHLtd®装置进行组织学研究。牙源性肿瘤很少见,通常无症状,经常在常规射线照相检查中偶然发现。这些良性病变大多数在完全切除后愈合良好,需要长期随访。一旦确诊,成釉细胞纤维瘤(AF)应立即治疗,以避免恶变。
    This case report aimed to describe a rare benign mandibular tumour and assess the outcomes of the most recent reviews, between January 2017 and August 2023. Presenting a detailed clinical case, this study advances our understanding of the diagnostic and therapeutic aspects, ultimately improving the management of similar cases in clinical practice. Orthopantomogram (OPG) revealed a well-defined unilocular radiolucency extending from the midline of the ramus and teeth 47 and 48 were submerged at the base of the mandible. In the presented case, a PLANMECA ROMEXIS PROMAX® three-dimensional (3D) maximum (MAX) cone-beam computed tomography (CBCT) device was used for the 3D examination. An intraoral approach was preferred and the tumour was removed in toto by creating a bone window using a W&H® Dentalwerk Bürmoos GmbH Piezomed piezoelectric device, and the bone plates were fixed with 4 MEDARTIS® microplates, with a primary flap closure. A PANORAMIC 1000, 3DHISTECH Ltd® device was employed for the histological investigation. Odontogenic tumours are rare and typically asymptomatic, often discovered incidentally during routine radiographic examinations. Most of these benign lesions heal well after complete excision and require long-term follow-up. Once diagnosed, ameloblastic fibroma (AF) should be treated immediately to avoid malignant transformation.
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  • 文章类型: Case Reports
    成釉细胞纤维瘤(AF)是Kruse于1891年首次描述的一种罕见的良性牙源性肿瘤。虽然报道的年龄范围很广,大多数病例出现在生命的头二十年,大多数病例在20岁之前被诊断出来。据报道,成釉细胞纤维瘤的组织病理学表现存在差异。在这个案例报告中,我们介绍了一名8岁男性患者的成釉细胞纤维瘤,其广泛的牙样形成累及下颌骨,临床上表现为侵袭性病变。
    Ameloblastic fibroma (AF) is a rare benign odontogenic tumour first described by Kruse in 1891. Although reported in a wide age range, most of the cases are seen in the first two decades of life with majority of cases being diagnosed before the age of 20 years. There are reported variations in the histopathological presentation of ameloblastic fibroma. In this case report, we present a case of ameloblastic fibroma with extensive dentinoid formation involving the mandible in an 8-year-old male patient which clinically presented as an aggressive lesion.
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  • 文章类型: Journal Article
    提出了一只6个月大的完整雄性Dalmatian混合小狗,用于评估由于可疑囊肿和未萌出的左上颌犬齿而引起的左上颌肿胀。切除未萌出的左上颌尖牙(204)并摘除囊肿,然后进行组织学分析,确定上颌骨肿胀是囊性成釉细胞纤维瘤。成釉细胞纤维瘤在伴侣动物中很少见,据作者所知,这是在狗中报道的第一个囊性变异。临床,射线照相,锥形束计算机断层扫描,并讨论了该病例的组织学发现,并将其与先前记录的人类和家畜病例的发现进行了比较。
    A 6-month-old intact male Dalmatian mix puppy was presented for the evaluation of left maxillary swelling due to a suspected cyst and an unerupted left maxillary canine tooth. Removal of the unerupted left maxillary canine tooth (204) and enucleation of the cyst was performed, followed by histological analysis, which identified the maxillary swelling to be a cystic ameloblastic fibroma. Ameloblastic fibromas are rare in companion animals, and to the best of the authors\' knowledge, this is the first cystic variant reported in dogs. The clinical, radiographic, cone beam computed tomography, and histological findings of this case are discussed and compared with the findings of previously documented human and domestic animal cases.
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  • 文章类型: Case Reports
    成釉细胞纤维肉瘤(AFS)被认为是由成釉细胞纤维瘤(AF)的发育不良引起的恶性进展。这两种肿瘤都极为罕见,只有少数病例在科学文献中报道。值得注意的是,已经在成釉细胞瘤中发现了BRAF突变,提示成釉细胞形态和BRAF突变之间的联系,因为AF被认为是导致AFS的前兆肿瘤。在这项研究中,我们介绍了一例25岁男性的AFS病例.肿瘤组织进行了分子分析,特别是下一代测序(NGS)使用Oncomine综合检测系统v3。分析显示TP53和RB基因的致病性突变,以及NTRK1、MDM4和BRAF中的拷贝数增益。此外,我们提供了对先前报道的107例AFS病例分析的文献发现的总结。我们的发现表明存在一种独特的分子亚型,强调对这些患者进行全面分子检测的重要性。
    Ameloblastic fibrosarcoma (AFS) is considered a malignant progression resulting from dysplastic changes in an ameloblastic fibroma (AF). Both tumors are extremely rare, with only a few cases reported in the scientific literature. Notably, BRAF mutations have been identified in ameloblastomas, suggesting a connection between ameloblastic morphology and BRAF mutations, as AF is believed to be the precursor neoplasm leading to AFS. In this study, we present a case of AFS in a 25-year-old male. The tumor tissue underwent molecular analysis, specifically next-generation sequencing (NGS) using the Oncomine Comprehensive Assay v3 System. The analysis revealed pathogenic mutations in TP53 and RB genes, as well as copy number gains in NTRK1, MDM4, and BRAF. Additionally, we provide a summary of the literature\'s findings from the analysis of 107 previously reported AFS cases. Our findings suggest the existence of a molecularly distinct subtype, emphasizing the importance of comprehensive molecular testing for these patients.
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  • 文章类型: Review
    背景:成釉细胞纤维性牙本质瘤被认为是一种罕见的,良性,混合牙源性肿瘤,主要发生在生命的第1-2个十年中的下颌骨后部。尽管成釉细胞纤维性牙本质瘤的临床行为与成釉细胞性纤维瘤相似,关于成釉细胞纤维性牙本质瘤是正在发展中的错构瘤性牙本质瘤还是像成釉细胞性纤维瘤一样的成釉细胞性牙本质瘤存在争议。然而,了解这种罕见肿瘤的组织病理学是很重要的。
    方法:一例11岁男性儿童下颌骨后部肿胀的病例报告。影像学检查显示多房性病变,与受影响的左下第二前磨牙相关的放射密度混合。做了切开活检,显微镜检查显示,在原始的外间充质基质中,成釉细胞样细胞和中央星状网样细胞排列的牙源性卵泡的索和巢,并带有类牙质材料和骨凝蛋白。诊断为成釉细胞纤维性牙本质瘤。手术切除了病灶,患者随访1年,无复发证据.
    结论:报道这种罕见的实体澄清了关于其性质和早期诊断与未萌出牙齿相关的病变的重要性的争论,表明其在早期治疗和预后中的有效性。
    BACKGROUND: Ameloblastic fibro-dentinoma is considered a rare, benign, mixed odontogenic tumor that occurs mainly in the posterior mandible in the 1st-2nd decade of life. Although the clinical behavior of Ameloblastic fibro-dentinoma is similar to that of ameloblastic fibroma, there is a debate about whether Ameloblastic fibro-dentinoma is a developing hamartomatous odontoma or a separate neoplastic odontogenic tumor like ameloblastic fibroma. However, it is important to understand the histopathogenesis of this rare tumor.
    METHODS: A case report presenting an 11-year-old male child with a swelling in the posterior mandible. Radiographic examination revealed a multilocular lesion with mixed radiodensity related to the impacted lower left second premolar tooth. Incisional biopsy was done, and microscopic examination revealed cords and nests of odontogenic follicles lined by ameloblast-like cells and central stellate reticulum-like cells in the primitive ecto-mesenchymal stroma with areas of dentinoid material and osteodentin. The diagnosis was ameloblastic fibro-dentinoma. Surgical excision of the lesion was done, and the patient was followed up for 1 year without evidence of recurrence.
    CONCLUSIONS: Reporting such a rare entity clarifies the debate about its nature and the importance of early diagnosis of lesions that are associated with unerupted teeth showing how it is effective in early management and prognosis.
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  • 文章类型: Journal Article
    具有两种或多种形态上不同成分的杂合牙源性病变的发生是一种罕见现象,并提出了诊断挑战。我们的目的是研究临床,放射学,以及杂合牙源性病变的病理特征和行为,提高对这些罕见病变的认识.
    回顾了2012年1月1日至2020年12月31日之间诊断的混合牙源性病变的苏木精和伊红载玻片。从患者的医疗记录中获得人口统计学和放射学信息。
    8例诊断为平均年龄19.1岁,男女比例为1:1.7。与上颌骨(n=3)相比,下颌骨的受累更为普遍(n=5)。所有患者出现肿胀,持续时间平均为9.75个月(3-25个月)。出血,牙齿松动,5、3、3和2例报告了疼痛和面部不对称,分别。放射学上,7例分界良好,75%的病例(n=6)是射线可透的,平均放射学大小为4.8cm。所有患者均仅接受手术治疗。5例(62.5%)行摘除术和刮宫术,而局部切除,全块切除术和节段性下颌骨切除术各1例。组织学上,骨化性纤维瘤/骨质骨化纤维瘤是最多的病变,5例(62%),其次是巨细胞肉芽肿样病变(GCG),中央和外周巨细胞肉芽肿(n=3),腺瘤样牙源性肿瘤(AOT)(n=2),和DC(n=2),成釉细胞纤维瘤(AF)(n=1),成釉细胞瘤(n=1),牙源性钙化囊肿(COC)(n=1),和复杂的牙瘤(n=1)。在有可用数据的情况下(n=7),手术4-99个月后(平均:32.9)没有发现复发的证据。长期主诉包括面部不对称(n=2)和疼痛(n=1)。
    大多数混合牙源性病变会在生命的第二个十年中影响年轻女性,并且通常显示COF和OF为混合成分。保守的管理方法似乎足够了。
    UNASSIGNED: The occurrence of hybrid odontogenic lesions with two or more morphologically distinct components is a rare phenomenon and poses a diagnostic challenge. We aimed to study the clinical, radiological, and pathological features and behavior of hybrid odontogenic lesions, to enhance awareness about these rare lesions.
    UNASSIGNED: Hematoxylin and Eosin slides of hybrid odontogenic lesions diagnosed between January 01, 2012 and December 31, 2020, were reviewed. Demographic and radiological information were obtained from the patient\'s medical records.
    UNASSIGNED: 8 cases were diagnosed with a mean age of 19.1 years and male to female ratio of 1:1.7. Involvement of mandible was more common (n = 5) as compared to maxilla (n = 3). All patients presented with swelling for an average of 9.75 months (3-25 months) duration. Bleeding, loose teeth, pain and facial asymmetry were reported in 5,3, 3, and 2 cases, respectively. Radiologically, 7 cases were well demarcated, 75% cases (n = 6) were radiolucent, and average radiological size was 4.8 cm. All patients were managed with surgery alone. 5 cases (62.5%) underwent enucleation and curettage, while local excision, en-block resection and segmental mandibulectomy were performed in 1 case each. Histologically, ossifying fibroma/cemento-ossifyiong fibroma were the most lesion, occurring in 5 cases (62%), followed by giant cell granuloma like lesions (GCG) i.e., central and peripheral giant cell granuloma (n = 3), Adenomatoid Odontogenic tumor (AOT) (n = 2), and DC (n = 2), ameloblastic fibroma (AF) (n = 1), Ameloblastoma (n = 1), calcifying odontogenic cyst (COC) (n = 1), and complex odontoma (n = 1). No evidence of recurrence was noted after 4-99 months of surgery (mean: 32.9) in cases with available data (n = 7). Long-term complaints included facial asymmetry (n = 2) and pain (n = 1).
    UNASSIGNED: Most hybrid odontogenic lesions affect young females in the second decade of life and commonly show COF and OF as hybrid components. A conservative approach to management appears adequate.
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  • 文章类型: Case Reports
    成釉细胞纤维瘤是一种罕见的混合牙源性良性肿瘤,可发生在下颌骨或上颌骨,但大多数发生在下颌骨的后部。它可以在外周或中心出现,大多数病例主要发生在生命的前二十年,并且主要影响男性患者。其特征是上皮岛和线浸没在外植体中,与牙乳头和釉质器官相似,但没有实际的硬组织形成。成釉细胞纤维瘤是一种罕见的牙源性肿瘤,由上皮和间质组织组成。最近的报道表明,该病变具有高复发率(18%)和复发性成釉细胞纤维瘤转化为成釉细胞纤维肉瘤的可能性更大(45%)。一名34岁的男性患者出现右下颌后部区域疼痛和肿胀。存在口腔内扩张的颊皮质板,肿胀压痛。口外检查显示右侧面部不对称。鉴于影像学和临床表现,考虑牙源性角化囊肿或复发性成釉细胞瘤的临时诊断。在获得知情同意和一般系统评估后,在全身麻醉下摘除病灶,并进行活检,证实诊断为成釉细胞性纤维瘤。成釉细胞纤维瘤是一种混合的牙源性肿瘤,由牙源性外植体组成,类似于牙乳头,上皮链和巢类似于牙层和釉质器官,但没有牙齿硬组织形成。牙源性肿瘤,成虫,成釉细胞瘤,颌骨肿瘤。
    Ameloblastic fibroma is a rare mixed odontogenic benign tumor that can occur in either mandible or maxilla but mostly it is found in posterior region of mandible. It can present either peripherally or centrally with a majority of the cases predominantly occurring in first two decades of life and mostly affects male patients. It is characterized by epithelial islands and cords submerged in ectomesenchyme that bear resemblance to the dental papilla and enamel organ but without actual hard tissue formation. Ameloblastic fibroma is a rare odontogenic tumor consisting of neoplastic epithelial and mesenchymal tissues. Recent reports have suggested that this lesion has the potential for high recurrence (18%) and greater chances of recurrent Ameloblastic fibroma transforming into Ameloblastic fibrosarcoma (45%). A 34-year-old male patient presented with pain and swelling in right mandibular posterior region. Intraorally expansion of buccal cortical plate with tenderness over swelling was present. Extraoral examination revealed facial asymmetry on right side. In view of imaging and clinical findings, provisional diagnosis of Odontogenic Keratocyst or Recurrent Ameloblastoma was considered. After obtaining informed consent and general systemic evaluation, the lesion was enucleated under general anesthesia and biopsied which confirmed the diagnosis of Ameloblastic fibroma. Ameloblastic fibroma is a mixed odontogenic tumor composed of odontogenic ectomesenchyme resembling dental papilla with epithelial strands and nests similar to the dental lamina and enamel organ, but with no dental hard tissue formation. Odontogenic tumors, Ameloblasts, Ameloblastoma, Jaw neoplasm.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    牙源性肿瘤表现出独特的组织病理学特征,被认为是由发育中的牙胚的生发组织产生的,有效地将其解剖起源限制在颌骨的牙齿支撑区域和直接相关的口腔软组织。位于猫皮肤的异位牙源性肿瘤,兔子,人类挑战这些假设。在这里,我们描述了临床,病态,和6种自发发生的牙源性样肿瘤的免疫组织化学特征,这些肿瘤出现在客户拥有的宠物兔的脸颊的皮肤组织中,包括成釉细胞瘤样(n=3),成釉细胞纤维瘤样(n=2),成釉细胞癌样肿瘤(n=1)。微观上,所有脸颊肿瘤都以肿瘤上皮为特征,表现出牙源性建筑结构(丛状丝带,吻合小梁,卵泡,囊肿,和不规则结构,具有圆形的葡萄状突起)和1个或多个主要牙源性上皮特征(基底栅栏,底基底核,和中央星状网状细胞)。Pancytokeratin,这些牙源性样病变的细胞角蛋白5/6,细胞角蛋白14和波形蛋白免疫组织化学模式与颌骨相关成釉细胞瘤最相似,与皮肤成纤维细胞瘤不同。所有肿瘤都被狭窄切除,以及具有临床随访信息的病变,手术切除后1~7个月无复发证据.尽管有证据表明这些兔脸颊的牙源性样瘤可能来自转化的牙胚的异位休息,这些病变的组织发生仍未解决。
    Odontogenic neoplasms demonstrate unique histopathological features and are thought to arise from the germinal tissues of the developing tooth germ, effectively restricting their anatomic origin to the tooth-bearing regions of the jaw and directly associated soft tissues of the oral cavity. Ectopic odontogenic-like neoplasms located in the skin of cats, rabbits, and human beings challenge these assumptions. Here we describe the clinical, pathological, and immunohistochemical features of 6 spontaneously occurring odontogenic-like neoplasms arising in the cutaneous tissue of the cheek in client-owned pet rabbits, including ameloblastoma-like (n = 3), ameloblastic fibroma-like (n = 2), and ameloblastic carcinoma-like neoplasms (n = 1). Microscopically, all the cheek tumors featured neoplastic epithelium exhibiting odontogenic architectural structures (plexiform ribbons, anastomosing trabeculae, follicles, cysts, and irregular structures with rounded botryoid protuberances) and 1 or more cardinal odontogenic epithelial features (basal palisading, antibasilar nuclei, and central stellate reticulum-like cells). The pancytokeratin, cytokeratin 5/6, cytokeratin 14, and vimentin immunohistochemical patterns of these odontogenic-like lesions were most similar to those of jaw-associated ameloblastoma and differed from those of cutaneous trichoblastoma. All neoplasms were narrowly excised, and for lesions with clinical follow-up information, none had evidence of recurrence 1-7 months after surgical removal. Although evidence suggests that these odontogenic-like tumors of the rabbit cheek may be derived from ectopic rests of transformed tooth germ, the histogenesis of these lesions remains unresolved.
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  • 文章类型: Case Reports
    成釉细胞纤维肉瘤(AFS)是一种极为罕见的恶性牙源性肿瘤。它由良性牙源性上皮组成,类似成釉细胞瘤,和表现出纤维肉瘤特征的间质部分。颌骨中这种病变的发展要么是从头发生的,要么是由已有文献记载的成釉细胞纤维瘤引起的。颌内最常见的受影响部位是后下颌骨。这些肿瘤显示出局部侵袭性和高复发倾向。我们介绍了一例33岁的女性患者,其右后下颌骨肿胀2个月,并且在过去6个月中同一区域进行性感觉异常。患者的病史显示,在与当前肿胀相同的区域,一年前接受了成釉细胞纤维瘤手术摘除术。对肿胀的检查显示,从前磨牙到磨牙区域的溃疡生长为6×4.5cm。初步调查涉及肿胀的活检,据报道,这是肉瘤,对其进行了右半可食性切除术和选择性颈清扫术。手术后,切除标本的最终组织病理学报告为AFS.手术一年后,患者在临床和放射学上无疾病。考虑到这些肿瘤的侵袭性,通过活检进行准确的诊断至关重要,这被认为是黄金标准的诊断证据,以便外科医生计划适当的治疗决定。与成釉细胞瘤或成釉细胞纤维瘤等更常见的良性对应物相比,了解这种罕见实体及其组织学特征至关重要,因为后者涉及保守治疗方法,而前者只能通过积极切除治疗。
    Ameloblastic fibrosarcoma (AFS) is an extremely rare malignant odontogenic tumor. It is composed of benign odontogenic epithelium, resembling that of ameloblastoma, and a mesenchymal part exhibiting features of fibrosarcoma. The development of this lesion in the jaws is either de novo or from preexisting ameloblastic fibroma which has been well documented. The most commonly affected site within the jaw is the posterior mandible. These tumors show local aggressiveness and a high tendency to recur. We present a case of a 33-year-old female patient with swelling of the right posterior mandible for 2 months and progressive paresthesia of the same region for the past 6 months. Patient\'s history revealed undergoing surgical enucleation for ameloblastic fibroma before a year in the same region as current swelling. Examination of the swelling revealed an ulceroprolifeartive Growth of 6 × 4.5 cm extending from premolar to molar region. Primary investigation involved biopsy of the swelling, which was reported as sarcoma for which resection of the right hemimandible and selective neck dissection was performed. Following surgery, the final histopathology report of the resected specimen was reported to be AFS. One year after the surgical procedure, the patient is clinically and radiologically disease-free. Considering the aggressive nature of these tumors, it is vital to give an accurate diagnosis through biopsy, which is considered as gold standard diagnostic evidence, so that the surgeon plans the appropriate therapeutic decision. Knowledge of this rare entity and its histologic features as opposed to the more common benign counterparts such as ameloblastoma or ameloblastic fibroma is crucial as the latter involves a conservative treatment approach while the former can only be treated through aggressive resections.
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