颌骨造釉细胞癌5例报告

<正> 颌骨造釉细胞癌临床较少见。1972年～1985年我科收治5例颌骨造釉细胞癌,现报告如下: 讨论一、病因及临床表现:造釉细胞癌的发病年龄,好发部位及性别与造釉细胞瘤无明显差异。本组病例男3例;女2例,年龄在32～52岁之间。发生在下颌骨者3例;上颌骨者2例。该肿瘤多数患者表现为局部肿胀,疼痛或压痛,牙齿松动,功能障碍。本组病例有1例侵犯翼腭凹,引起张口受限。     

上颌骨造釉细胞瘤术后复发和转移

上颌骨造釉细胞瘤术后复发和转移杨明达，夏婉贞，陈关福，平飞云，孙才均，陈军造釉细胞瘤是临床上较常见的牙源性肿瘤，浙医大二院口腔科自１９５６年至１９９１年１２月共收治造釉细胞瘤１２８例，其中上颌骨１１例，下颌骨１１７例。１１例上颌造釉细胞瘤中有５例术后...     

恶性造釉细胞瘤和造釉细胞癌的病理学研究

为探讨恶性造釉细胞瘤和造釉细胞癌的临床病理特点，及两个名称的自然历史和意义，我们对２４例恶性造釉细胞瘤（造釉细胞癌）的临床病理资料进行了研究，并对两个名称各自的实质进行了探讨。结果：其组织病理特点为滤泡周边细胞增生，可呈乳头状突向间质，核增大中度异型，核深染或呈空泡状，核分裂相增加，星网状细胞消失被肉瘤样细胞取代。其中１９例５～３０年随访结果为：１１例生存；３例１次复发，３例２次复发（其中１例复发后死亡），１例４次复发后死亡，１例１３年无复发死于它病。结果提示：“恶性造釉细胞瘤”这一名称更为科学。     

造釉细胞癌 附4例报告

造釉细胞癌(或称恶性造釉细胞瘤)是一种较罕见的牙源性恶性肿瘤,由良性造釉细胞瘤恶变而来。1961～1983年我科经治4例颌骨造釉细胞癌,现报告如下: 病例报告例1:女,17岁,住院号:13074,患者入院前二年曾在他院行“颌骨囊肿刮除术”,术后包块迅速长大,伴局部疼痛和出血。     

上颌骨造釉细胞瘤——一种具有潜在致死性的新生物

造釉细胞瘤是在釉质形成前,起源于牙胚上皮成份的良性肿瘤,约占颌骨囊肿和肿瘤的1%。其中80 %发生于下颌骨,发生于上颌骨者占20%。肿瘤在上颌骨的分布是,磨牙区47%,鼻底和鼻窦15%,前磨牙区和尖牙区各9%,腭部2%。此种肿瘤多见于40岁左右成年人。男女及种族间无差别。有些作者报道,黑人男性的发病率较高。上颌骨造釉细胞瘤容易误诊,往往在发病数年后才予治疗。这是因为,肿瘤位于颌骨中心,通常缺乏或甚少出现早期症状。发生于下颌骨者,最常表现为无痛性肿块,而发生于上颌骨者,则通常表现为鼻塞,面部     

上颌骨造釉细胞瘤术后软组织复发并多瘤发病一例报告

最近我们诊治一例上颌骨造釉细胞瘤术后发生咽旁间隙颞下窝及翼腭窝软组织复发,此外,该病者曾先后患有肾上腺嗜铬细胞瘤、卵巢畸胎瘤及颈动脉体瘤。因文献上未见有类似报导,现报告如下: 病例:温××,女,45岁,1980年因“左上颌,骨造釉细胞瘤”手术摘除,1982年肿瘤复发行“左上颌骨次全切除术”。     

外周性造釉细胞瘤1例报告

外周性造釉细胞瘤１例报告外周性造釉细胞瘤,也称骨外或软组织造釉细胞瘤,是一种罕见的牙源性肿瘤。现将我科收治１例报告如下：患者男性,６０岁,住院号２９０２８３。右上牙龈无痛性肿块４月,于１９９３年５月２７日入院。４月前发现右上前牙唇侧一黄豆大肿块,渐进...     

促纤维组织增生型造釉细胞瘤一例

促纤维组织增生型造釉细胞瘤一例曾祥利，陈卫民，王燕秋造釉细胞瘤是一种常见的上皮性牙源性肿瘤。绝大多数发生在下颌骨，上颌骨少见。组织学上可分为五型，但世界卫生组织１９９２年在牙源性肿瘤分类中提出一种新的类型——促纤维组织增生型造釉细胞瘤（Ｄｅｓｍｏｐｌ...     

带蒂颊脂垫修复上颌骨切除后创面22例

1997年以来 ,我们应用带蒂颊脂垫修复上颌骨切除后创面 2 2例 ,取得良好的临床效果。　　作者单位 :4730 13河南省南阳市口腔医院一、临床资料本组 2 2例 ,男 14例 ,女 8例。年龄 13岁～ 6 7岁。上颌窦癌 4例 ,上颌牙龈癌 3例 ,上颌骨鳞癌 1例 ,上颌骨纤维肉瘤 1例 ,腭部鳞癌 3例 ,腭部白斑恶变 1例 ,腭部恶性混合瘤2例 ,腭部混合瘤恶变 1例 ,腭部粘液表皮样癌 2例 ,上颌骨粘液瘤 1例 ,上颌骨造釉细胞瘤 2例。上颌骨切除范围 :一侧上颌骨部分切除 4例 ,一侧上颌骨次全切除 13例 ,一侧上颌骨全切除 5例。带蒂颊脂垫修复上颌骨切除后创面的部…     

复发颌骨造釉细胞瘤——22例复习

造釉细胞瘤在颌骨囊肿和肿瘤中占的比例并不大,仅1%左右。它可发生于任何年龄,但多见于30～50岁,多发生在下颌且无性别差异。造釉细胞瘤呈限局性侵犯,如切除不彻底易于复发。造釉细胞瘤初期治疗的方法很多,有刮除、摘除、烧灼、颌骨节段切除及放疗等,但是都不太理想,复发率达50%。本文讨论的是我们经治的22例复发颌骨造釉细胞瘤。临床资料:我们在1961～1976年的16年中共经治了174例颌骨造釉细胞瘤。有22例经病理证实为复发的造釉细胞瘤,其中3例是在其它医院进行的初期手术,以后来我院就诊的。所有22例均进行了手术治疗。     

Recurrent ameloblastoma of the jaws: A follow-up study

Twenty-six cases of recurrent ameloblastoma of the jaws within a 15-year period are presented. They represent 8.9% of all cases of ameloblastoma seen in this period. The highest incidence was found in the third decade of life. There is a higher incidence of recurrences in the mandible (16/26) as compared to the maxilla (6/26). Over 80% of the recurrences presented within five years of primary surgery, emphasising the need for adequate and intensive follow-up during this critical period. Three patients whose lesions were operated on in the mandible showed similar lesions in the maxilla after a period of time. Conservative procedures at primary surgery produced the most recurrences. The cure rate for surgery of maxillary ameloblastoma was comparatively poor. The need for good visibility, adequate access and radical surgery in maxillary ameloblastoma is stressed.     

颌骨恶性成釉细胞瘤10例报道

目的：探讨恶性成釉细胞瘤的临床表现、X线特征及治疗方法。方法：复习上海第二医科大学附属第九人民医院口腔颌面外科1991～2003年以来收治的10例恶性成釉细胞瘤(均经病理证实)患者，随访1～8a，对临床表现、诊断、治疗效果等进行回顾性分析。结果：10例患者中，男性5例，女性5例；年龄最大60岁，最小22岁；上颌骨4例，下颌骨6例。除2例自动放弃手术治疗外，其余均行颌骨部分切除，改良根治性或肩胛舌骨上颈淋巴清扫术，同期皮瓣修复，创口愈合良好。获得随访者，外观及功能恢复满意，无复发。结论：恶性成釉细胞瘤是一种低度恶性肿瘤，手术是其唯一根治方法。     

Ameloblastic carcinoma: case report and review

The histologic classification for odontogenic carcinomas is still under revision; thus, the differentiation between the terms "malignant ameloblastoma" and "ameloblastic carcinoma" has not been definitely stated. Nevertheless, it is recommended to reserve the former for those lesions that, in spite of an apparently innocuous histology, have given origin to metastatic growths, and to apply the latter for those ameloblastomas in which there is histologic evidence of malignancy in the primary, recurrent or metastatic lesions. A case of an ameloblastic carcinoma in the mandible is presented. Histologically, it was characterized by areas with features of a typical ameloblastoma and areas with anaplastic appearances.     

Desmoplastic ameloblastoma featuring basal cell ameloblastoma: a case report

The desmoplastic ameloblastoma is a histological variant of ameloblastoma. The neoplastic epithelial islands seen in desmoplastic ameloblastoma are small and ameloblastic cells are rare. Basal cell ameloblastoma is also a rare variant of ameloblastoma, in which the tumor is composed of more primitive cells and has even fewer features of peripheral palisading. This report describes the case of a 17-year-old female with an ameloblastoma in the right anterior maxilla. Orthopantomography and computed tomography showed a well-defined lesion in the right maxilla. A partial maxillectomy for tumor resection was performed under general anesthesia. Histologically, ameloblastic tumor cells were seen with dense collagenous stroma and the tumor cells showed primarily basal cell variants of ameloblastoma. After 7 years of follow-up, clinical and radiographic examinations have revealed no evidences of recurrence.     

Ameloblastoma: Biological profile of 3677 cases

Available literature on ameloblastoma of the jaw was reviewed, including publications from 1960 to 1993, and compared to the latest larger review, published by Small and Waldron in 1955.The average age of patients with ameloblastoma is 36 years. In developing countries ameloblastomas occur in younger patients. Men and women are equally affected. Women are 4 years younger than men when ameloblastomas first occur, and the tumours appear to be larger in females. Dominant clinical symptoms such as painless swelling and slow growth are non-characteristic. The ratio of ameloblastoma of the mandible to maxilla is 5 to 1. Ameloblastomas of the mandible occur 12 years earlier than those of the maxilla. Ameloblastomas occur most frequently in the molar region of the mandible. In Blacks, ameloblastomas occur more frequently in the anterior region of the jaws. Radiologically, 50% of ameloblastomas appear as multilocular radiolucent lesions with sharp delineation. Histologically, one-third are plexiform, one-third follicular; other variants such as acanthomatous ameloblastoma occur in older patients. Two percent of ameloblastomas are peripheral tumours. Unicystic ameloblastomas occurring in younger patients have been found in 6%.Detailed data on 345 patients with ameloblastoma were evaluated for clarification of therapeutic approaches. Chemotherapy and radiation seem to be contraindicated. Ameloblastomas of the maxilla should be treated as radically as possible, ameloblastomas of the mandible should also be treated radically. However, ameloblastomas which radiologically appear as unilocular lesions may be treated conservatively (enucleation, curettage), whenever all areas of the cystic lumen are controllable intraoperatively. Unicystic ameloblastomas occurring in patients 15 years younger than those with multisystic ameloblastoma may be treated conservatively except in cases with invasion of epithelium into the cyst wall. Different recurrence rates have been found for histological variants of the ameloblastoma. Follicular ameloblastomas appear to recur more often than the plexiform type. Unicystic ameloblastomas reveal lower recurrence rates than “non-unicystic” ameloblastomas. The peripheral type of ameloblastoma may be excised, since conservative therapy results in low recurrence rates. Postoperative follow-up is most important in the therapy of ameloblastoma, because more than 50% of all recurrences occur within 5 years postoperatively.     

Expression of tenascin and nucleolar organizer region in ameloblastoma and ameloblastic fibroma

J Oral Pathol Med (2010) 39 : 223–229 Background: The aim of this study was to assess the expression, distribution and comparison of tenascin, a glycoprotein of the extracellular matrix in ameloblastoma and ameloblastic fibroma, both odontogenic neoplasms with diverse biological behavior and to understand the proliferative activity by using the morphometric analysis. Methods: Paraffin embedded tissue from 25 cases of odontogenic tumors i.e., ameloblastoma (n = 15) and ameloblastic fibroma (n = 10) were used. The expression of tenascin was evaluated using immunohistochemistry. Morphometric analysis of nucleolar organizer regions (NORs) from ameloblastoma and ameloblastic fibroma was carried out by silver staining. Results: A heterogeneous expression of tenascin was found in ameloblastoma which was mainly localized at the epithelial–mesenchymal interface and a patchy distribution was observed in the stroma (80%), while strong positivity was observed in the stroma and at the basement membrane zone of ameloblastic fibroma (100%). argyrophilic nucleolar organizer regions (AgNORs) revealed higher mean counts in ameloblastoma (3.093 ± 0.902) when compared with those of ameloblastic fibroma (1.553 ± 0.250). Ameloblastoma presented more than two NORs (two to five) per nucleus in majority of the cells, while ameloblastic fibroma exhibited only one NORs per nucleus. Conclusions: Expression of tenascin in these neoplasms suggest that it could play a role in epithelial‐ mesenchymal interaction, while AgNORs reveal that ameloblastomas are more aggressive when compared with ameloblastic fibromas.     

Ameloblastomas: a regional Latin-American multicentric study

AIM: To classify 163 ameloblastoma cases according to the new WHO Classification of Odontogenic Tumours (2005) and analyse their clinical and microscopic features. METHODS: We studied the clinico-pathological features of 163 ameloblastoma cases from nine regional Latin-American institutions from Mexico and Guatemala. RESULTS: Ameloblastomas comprised 22.7% of all odontogenic tumours. The mean age was 41.4 years for solid ameloblastoma (SA) and 26.3 years for unicystic ameloblastoma (UA) (P < 0.001) and both sexes were almost equally affected. The mandible was mainly affected for both UA and SA. The mean size was 6.2 cm for SA and 6.3 cm for UA cases. The recurrence rate was 21.7% for SA and 12.6% for UA. UA was twice as more frequent than the solid variant. CONCLUSIONS: In this study we found that UA was frequently misdiagnosed as SA; however, there are enough clinical and microscopic features that allow for an accurate differentiation between both types of ameloblastoma that should be recognized for surgical and prognostic purposes. In this study, SA was not found in patients younger than 20 years, UA had a constant myxoid stroma while mature connective tissue was more frequently associated with the solid type.     

109例成釉细胞瘤患者复发相关因素分析研究

目的　探讨成釉细胞瘤临床特征、病理类型及治疗方法与其复发之间的关系。方法　对109例成釉细胞瘤患者的临床病理特征及术后随访资料进行回顾性研究。采用Kaplan-meier方法及Cox回归分析,分析各相关因素与患者复发之间的相关关系,并绘制相关因素下的生存曲线。结果　发生于上颌骨者的复发率为50%,高于下颌骨的26.7%（P=0.004）。病程大于12个月者的复发率高于小于12个月者（P=0.002）。刮除术治疗组的复发率为50.9%（27/53）;切除术（包括方块切除、节段性切除及颌骨半切除）治疗组的复发率为7.1%（4/56）,不同术式间的复发率有显著性差异(P<0.001)。109例成釉细胞瘤患者中,实性型复发率为28.8%(23/80),单囊型复发率为27.6%(8/29),两者无显著性差异（P>0.05）;在实性型成釉细胞瘤中,病理类型与复发有关,其中,丛状型预后较好（P<0.05）。结论　发病部位、病程长短、手术方式及病理类型是影响成釉细胞瘤复发的相关因素,设计治疗方案时,应根据患者的临床特征及病理类型等因素综合考虑。     

Ameloblastoma and its relationship to ameloblastic fibroma: their histogenesis based on an unusual case and review of the literature.

The present paper describes the relationship between ameloblastoma and ameloblastic fibroma deduced from a case diagnosed as "ameloblastoma combined with ameloblastic fibroma" arising in the mandible of a 5-year-old boy. Histologically, the tumor consisted of ameloblastoma in the central area and ameloblastic fibroma in the peripheral area; it clinically fits the characteristics of ameloblastic fibroma based on predominant age, manner of growth, and encapsulation. We reviewed the literature and discussed the relationship between ameloblastoma a ameloblastic fibroma in terms of tumorigenesis. It is assumed that ameloblastic fibroma can also be transformed into ameloblastoma, if the succeeding hard tissues are not formed, and the collagenous connective tissue substituting for the stromal mesenchymal tissue is formed by the inductive effect of the epithelial strands or other unknown factors. Several possibilities relative to the pathogenesis of ameloblastoma have been proposed by oral pathologists; however, to our knowledge, "ameloblastic fibroma can be transformed into ameloblastoma" has not hitherto been reported. The case we experienced here may be thought as an intermediate tumor pattern between ameloblastic fibroma and ameloblastoma.