Odontogenic fibroma

牙源性纤维瘤
  • 文章类型: Journal Article
    四只骆驼(Camelusdromedarius)被送往费萨尔国王大学的兽医教学医院,上颌肿块。在射线照片上,肿块为多囊性,上颌骨扩张。肿瘤经组织病理学检查诊断为常规成釉细胞瘤,骨内鳞状细胞癌2例,和伴有骨化的中央牙源性纤维瘤。就作者所知,这是骆驼成釉细胞瘤的第一份报告,骆驼上颌鳞状细胞癌的第一次详细描述,以及任何动物物种的中央牙源性纤维瘤的第一份报告。
    Four camels (Camelus dromedarius) presented to the Veterinary Teaching Hospital at King Faisal University with maxillary masses. On radiographs, the masses were multicystic and expanded the maxillary bone. The tumors were diagnosed by histopathologic examination as conventional ameloblastoma, two cases as intraosseous squamous cell carcinoma, and central odontogenic fibroma with ossification. To the authors\' knowledge, this is the first report of ameloblastoma in a camel, the first detailed description of maxillary squamous cell carcinoma in camels, and the first report of central odontogenic fibroma in any animal species.
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  • 文章类型: Review
    背景:世界卫生组织(WHO)关于牙源性和颌面骨肿瘤的章节为这些肿瘤的诊断提供了全球参考。在第五版中,纳入共识定义和制定必要和理想的诊断标准有助于提高对不同实体的认识.这些是关键的增强,因为牙源性肿瘤的诊断主要基于组织形态学,并结合临床和影像学表现。
    方法:审查。
    结果:尽管有成釉细胞瘤的诊断标准,腺样成釉细胞瘤,和牙本质鬼细胞瘤,这些肿瘤的一部分继续显示重叠的组织学特征,这可能导致误诊.准确的分类可能是具有挑战性的小活检,但可能通过完善现有的诊断标准和在特定病例中使用免疫组织化学和/或分子技术来增强。很明显,钙化上皮牙源性肿瘤的非钙化朗格汉斯细胞丰富亚型和牙源性纤维瘤的淀粉样蛋白丰富变体的临床和组织学特征融合为单个肿瘤描述。此外,这个肿瘤显示出显著的临床,组织学上与位于上颌骨的硬化性牙源性癌的子集重叠。良性神经周受累与神经周受累是牙源性肿瘤中一个未充分开发的概念,需要澄清以减少与硬化性牙源性癌的诊断混淆。
    结论:虽然在WHO章节中讨论了围绕分类和离散肿瘤实体的有争议的问题,歧义不可避免地仍然存在。这篇综述将研究几组牙源性肿瘤,以突出持续的知识差距,未满足的需求和未解决的争议。
    BACKGROUND: The World Health Organization\'s (WHO) chapter on odontogenic and maxillofacial bone tumors provides a global reference for diagnosis of these tumors. In the fifth edition, the inclusion of consensus definitions and development of essential and desirable diagnostic criteria help improve recognition of distinct entities. These are key enhancements since the diagnosis of odontogenic tumors is largely based on histomorphology which is taken in combination with clinical and radiographic appearances.
    METHODS: Review.
    RESULTS: Despite delineation of diagnostic criteria for ameloblastoma, adenoid ameloblastoma, and dentinogenic ghost cell tumor, a subset of these tumors continues to show overlapping histological features that can potentially lead to misdiagnosis. Accurate classification may be challenging on small biopsies, but potentially enhanced by refining existing diagnostic criteria and utilization of immunohistochemistry and/or molecular techniques in a specific cases. It has become clear that the clinical and histologic features of the non-calcifying Langerhans cell-rich subtype of calcifying epithelial odontogenic tumor and the amyloid-rich variant of odontogenic fibroma converge into a single tumor description. In addition, this tumor shows remarkable clinical, histological overlap with a subset of sclerosing odontogenic carcinoma located in the maxilla. Benign perineural involvement vs perineural invasion is an underexplored concept in odontogenic neoplasia and warrants clarification to reduce diagnostic confusion with sclerosing odontogenic carcinoma.
    CONCLUSIONS: While controversial issues surrounding classification and discrete tumor entities are addressed in the WHO chapter, ambiguities inevitably remain. This review will examine several groups of odontogenic tumors to highlight persistent knowledge gaps, unmet needs and unresolved controversies.
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  • 文章类型: Journal Article
    背景:颗粒细胞牙源性纤维瘤(GCOF)是一种罕见的牙源性肿瘤,随着时间的推移有不同的名称。这项研究的目的是回顾科学文献中有关GCOF的所有可用数据,所有报告病例的摘要和新病例的报告。
    方法:本综述遵循PRISMA指南进行。截至2022年11月,进行了电子搜索。
    结果:纳入报告53例病例的39项研究。GCOF是牙源性肿瘤中的一种罕见肿瘤,在中年和白人女性中患病率较高。这种病变主要发生在下颌骨的后部。此外,基于临床,射线照相,和组织病理学特征,保守治疗是报告最多的选择,2例报告复发.
    结论:由于尚未解决的组织发生,GCOF仍然存在争议。
    BACKGROUND: Granular Cell Odontogenic Fibroma (GCOF) is a rare odontogenic neoplasm reported over time with different names. The purpose of this study is to review all available data on the GCOF in the scientific literature, with a summary of all reported cases and a report of a new case.
    METHODS: This review was conducted following the PRISMA guidelines. An electronic search was performed up to November 2022.
    RESULTS: Thirty-nine studies reporting fifty-three cases were included. GCOF is a rare neoplasm among the odontogenic tumors, with a higher prevalence in women of the middle-aged and white population. This lesion occurs mostly on the posterior region of the mandible. Furthermore, based on clinical, radiographic, and histopathologic features, conservative treatment was the most reported choice with recurrence reported in two cases.
    CONCLUSIONS: GCOF remains controversial due to the still unsolved histogenesis.
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    文章类型: Case Reports
    BACKGROUND: Odontogenic fibroma (OF) is a rare benign tumor of mesenchymal odontogenic tissue with variable global incidence. Two variants comprising extraosseous /peripheral (POF) and intraosseous /central (COF) have been identified based on the anatomical origin of the tumor. OF isslow growing, and often asymptomatic with characteristic radiographic appearance of a unilocular or multilocular cyst frequently associated with unerupted or displaced teeth while histologically, varying amount of inactive odontogenic epithelium embedded in a mature relatively dense collagenous stroma is diagnostic. The absence of odontogenic epithelium does not exclude the diagnosis of odontogenic fibroma.
    METHODS: A 15 months old female presented with 3 months history of left lower jaw swelling which showed aggressive growth following incisional biopsy. Parents said lesion was noticed for the first time as pinpoint on the submandibular area and was too small to warrant any worries. Initial radiograph revealed absence of bony involvement but the second showed evidence of bony involvement. An impression of soft tissue sarcoma was made and incisional biopsy was sent for pathological diagnosis which revealed peripheral odontogenic fibroma. The rapidity of growth following incisional biopsy bellied a benign lesion.
    CONCLUSIONS: An aggressive odontogenic fibroma with multifocal points in a 15months old girl.
    BACKGROUND: Le fibrome odontogène (FO) est une tumeur bénigne rare du tissu odontogène mésenchymateu dont l’incidence globale est variable. Deux variantes comprenant des fibromes extra-osseux /périphérique (POF) et intra-osseuse / centrale (COF) ont été identifiés en fonction de l’origine anatomique de la tumeur. La POF est à croissance lente, et souvent asymptomatique avec l’apparence radiographique caractéristique d’un kyste uniloculaire ou multiloculaire fréquemment associé à des dents non érigées ou déplacées alors que histologiquement, une quantité variable d’épithélium inactif noyé dans un stroma collagène mature relativement dense est le diagnostic. L’absence d’épithélium odontogène n’exclut pas le diagnostic de fibrome odontogène.
    UNASSIGNED: Une femme de 15 mois a présenté un gonflement de la mâchoire inférieure gauche depuis 3 mois de gonflement de la mâchoire inférieure gauche qui a montré une croissance agressive après une biopsie incisionnelle. Les parents ont déclaré que la lésion avait été remarquée pour la première fois sur forme de point d’épingle dans la zone submandibulaire et était trop petite pour justifier une quelconque inquiétude. La radiographie initiale a révélé l’absence d’atteinte osseuse mais la seconde a montré des signes d’atteinte osseuse. Une impression de sarcome des tissus mous et une biopsie incisionnelle a été envoyée pour un diagnostic pathologique qui a révélé un fibrome odontogène périphérique. La rapidité de la croissance après la biopsie incisionnelle a fait croire à une lésion bénigne.
    CONCLUSIONS: Un fibrome odontogène agressif avec des points multifocaux chez une jeune fille de 15 mois.
    UNASSIGNED: Fibrome odontogène, Périphérique, Central, Agressif.
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  • 文章类型: Case Reports
    结节性硬化症(TSC)是一种常染色体显性遗传性疾病,其特征是系统性错构瘤和多种系统性特征。TSC1和TSC2是致病基因,和智力低下,癫痫发作,面部血管纤维瘤在许多患有该疾病的患者中发展。本文报道了一例TSC患者发展为下颌骨中央牙源性纤维瘤的病例。该患者是一名21岁的妇女,她在右下侧切牙和犬齿区域的唇牙龈肿胀。牙科X线照相显示具有清晰边界的多房射线可透过区域。右下侧切牙和犬齿与病变连续,因此全部切除。病变被包裹并容易解剖。免疫组织学染色诊断为无上皮成分的牙源性纤维瘤。TSC1/2基因突变导致PI3K-AKT通路下游哺乳动物雷帕霉素靶蛋白(mTOR)的异常激活。该患者的牙源性纤维瘤mTOR阳性,提示牙源性纤维瘤的发展是mTOR异常激活的结果,如血管纤维瘤。介绍了该患者的临床过程,并讨论了中央牙源性纤维瘤的发展机制。
    Tuberous sclerosis complex (TSC) is an autosomal dominant inherited disease characterized by systemic hamartoma and diverse systemic features. TSC1 and TSC2 are the causative genes, and mental retardation, epileptic seizures, and facial angiofibroma develop in many patients with the disease. The case of a patient with TSC who developed a central odontogenic fibroma of the mandible is reported here. The patient was a 21-year-old woman who was referred with a swelling of the labial gingiva in the region of the right lower lateral incisor and canine. Dental radiography revealed a multilocular radiolucent region with a clear boundary. The right lower lateral incisor and canine were continuous with the lesion and thus were excised en bloc. The lesion was encapsulated and easily dissected. The diagnosis on immunohistological staining was odontogenic fibroma without an epithelial component. TSC1/2 gene mutation causes abnormal activation of mammalian target of rapamycin (mTOR) downstream of the PI3K-AKT pathway. The odontogenic fibroma in this patient was positive for mTOR, suggesting that the development of the odontogenic fibroma was the result of abnormal activation of mTOR, as in angiofibroma. The clinical course of this patient is presented and the developmental mechanism of central odontogenic fibroma is discussed.
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    文章类型: Case Reports
    口腔是通常继发于恶性肿瘤的转移性疾病的罕见部位。我们遇到了一种罕见的病例,其中下颌骨转移是诊断乳腺癌的第一个临床体征,没有任何影像学检查结果。一个49岁的绝经前妇女,被转诊到伊玛目侯赛因医院肿瘤内科,ShahidBeheshti医科大学,德黑兰,2014年,伊朗出现了左下颌和颞骨的疼痛和压痛,以及左下唇和下巴的感觉异常。下颌骨CT无明显发现。四个月后,她因左乳房疼痛4周和肿胀恶化而被转诊,疼痛和感觉异常。乳房检查显示左乳房有一个2厘米的硬结节。根据她的病史和组织病理学研究,怀疑有乳腺转移癌.她接受了放化疗,从而完全缓解了症状并缓解了疾病。在口腔中存在模棱两可的体征,例如下颌疼痛或感觉异常时,建议对恶性肿瘤进行诊断性检查。
    The oral cavity is uncommon site for metastatic disease usually discovered secondary to malignancy. We encountered with a rare case in which metastasis to mandibular bone was the first clinical sign in the diagnosis of breast cancer without any radiographic findings. A 49-yr-old premenopausal woman, was referred to the Department of Medical Oncology of Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran in 2014, presented with pain and tenderness in the left mandibular and temporal bone and paresthesia of the lower left lip and chin. CT scan of mandible showed no significant finding. Four months later, she was referred with complaints left breast pain for 4 wk and worsening swelling, pain and paresthesia. Breast examination revealed a 2 cm firm nodule on the left breast. Based on her medical history and histopathological study, metastatic carcinoma of the breast was suspected. She has received chemoradiotherapy that led to complete relief of her symptoms and remission of the disease. In the presence of an ambiguous sign in oral cavity such as jaw pain or paresthesia, diagnostic examination of malignancy is recommended.
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  • DOI:
    文章类型: Case Reports
    牙源性纤维瘤(OF)被认为是不寻常的,良性间充质肿瘤和所有牙源性肿瘤中最鲜为人知的病变之一。肿瘤的发病率从0%到5.5%。WHO将它们分为骨内或中枢和骨外或外周变异。它主要由成纤维细胞组织组成,其无活性的牙源性上皮数量不一致。病变的生长缓慢,皮质扩张,上颌骨前段和下颌骨后段相同。放射学上,多房射线不透性是最常见的发现,少数病例与牙根吸收或移位有关。微观上,典型地发现了成熟的胶原纤维和许多成纤维细胞以及牙源性上皮岛。中央牙源性纤维瘤对手术摘除术反应良好,没有恶性或复发的趋势。在这里,我们报告了一名18岁的男性上颌骨后部牙源性纤维瘤患者的罕见病例报告。
    Odontogenic fibroma (OF) is considered an unusual, benign mesenchymal neoplasm and one of the most little-understood lesions amongst all odontogenic neoplasms. The incidence rate of the tumor is from 0% to 5.5%. WHO classified them into intraosseous or central and extraosseous or peripheral variants. It chiefly consists of fibroblastic tissue with an inconsistent amount of inactive appearing odontogenic epithelium. The lesion has a slow growth along with cortical expansion with equal predilection in the anterior maxilla and posterior mandible. Radiologically, multilocular radiolucency is the most frequent finding with few cases being associated with root resorption or displacement. Microscopically, mature collagen fibers and numerous fibroblasts along with odontogenic epithelial islands are characteristically found. Central Odontogenic Fibroma responds well to surgical enucleation with no tendency for malignancy or recurrence. Here we report a rare case report of an 18 yr old male patient with Odontogenic fibroma of the posterior maxilla.
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  • 文章类型: Case Reports
    Cherubism是一种罕见的常染色体显性疾病,影响颌骨,并由编码定位到染色体4p16.3的衔接蛋白SH3BP2的基因突变引起。Cherubism的特征是上颌骨和下颌骨中对称发展的骨病变。病变已在影像学和组织病理学上得到充分描述。这里,我们介绍了一个患有胆碱病的家庭,其两个成员具有牙源性肿瘤增殖,并伴有持续性中央巨细胞病变(CGCL)。具体来说,先证者,一个25岁的男性,出现了一种放射状的病变,其组织学特征是与CGCL成分相关的中央牙源性纤维瘤样增殖,而他的母亲,在57岁时,被诊断为原发性骨内牙源性癌,伴有良性纤维骨性病变。在两名患者中,病变均发生在下颌骨前部,并伴有临床肿大。儿子接受了切开活检,没有接受其他治疗。由于广泛的肿瘤,他的母亲接受了广泛的下颌骨切除术。儿子有两个患有经典天使症的受影响儿童,而第三个5岁的孩子则没有表现出这种疾病的任何特征。三个受影响成员的突变分析导致SH3BP2中杂合突变的鉴定(c.1244G>C;p.Arg415Pro)。据我们所知,到目前为止,在文献中还没有报道过与牙源性肿瘤病变的联系,因此表明了小天使症与牙齿发育紊乱之间的关系。
    Cherubism is a rare autosomal dominant condition affecting the jaws and caused by mutations in the gene encoding for the adapter protein SH3BP2 that maps to chromosome 4p16.3. Cherubism is characterized by symmetrically developing bone lesions in the maxilla and mandible. The lesions have been radiographically and histopathologically well-described. Here, we present a family with cherubism with two of its members featuring odontogenic tumorous proliferations in association with persistent central giant cell lesions (CGCL). Specifically, the proband, a 25-year-old male, developed a radiolucent lesion characterized histologically by central odontogenic fibroma-like proliferation in association with a CGCL component, while his mother, at age 57, was diagnosed with primary intraosseous odontogenic carcinoma with areas of benign fibro-osseous lesions. In both patients the lesions occurred in the anterior mandible and presented with clinical enlargement. The son underwent incisional biopsy and did not have additional treatment. His mother underwent extensive mandibulectomy due to widespread tumor. The son has two affected children with classic cherubism while a third child at age 5, had not shown any features of the disease. Mutation analysis of three affected members resulted in the identification of a heterozygous mutation in SH3BP2 (c.1244G>C; p.Arg415Pro). To the best of our knowledge, association of cherubism with odontogenic neoplastic lesions has hitherto not been reported in the literature, thus suggesting a relationship between cherubism with disturbed odontogenesis.
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  • 文章类型: Case Reports
    Central odontogenic fibroma (COF) is an uncommon tumor that accounts for 0.1% of all odontogenic tumors; it has been defined as a benign neoplasm of the jaw. Clinically, the lesion grows slowly and leads to cortical expansion. Radiologically, the most common finding is multilocular radiolucency. The lesions are associated with the crown of an unerupted molar, premolar, or incisor tooth and in some cases, with root resorption or displacement. Histologically, the lesion is characterized by mature collagen fibers and numerous fibroblasts. COF responds well to surgical enucleation with no tendency for malignancy or recurrence. We report a case of a 15-year-old female patient presented with painless swelling of the left side of the maxilla since her childhood. Radiographs revealed an expanding ill-defined radiolucency with a displacement of the adjacent tooth. The impacted tooth was pushed posteriorly. The lesion was removed surgically. There were no postoperative complications.
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  • 文章类型: Case Reports
    Odontogenic fibroma is a benign ectomesenchymal tumor classified as central and peripheral on the basis of its location and as an epithelium rich or epithelium poor based on its histological features. Radiological findings consist of radiolucent areas with well-defined bony margins. The lesion is detected early because of its location and usually treated with surgical excision and curettage. We present a case of giant odontogenic fibroma of right maxilla presenting as gross facial deformity and posing a dual challenge of excising the tumor mass and reconstructing the ensuing defect.
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