Central granular cell odontogenic tumor: a systematic review

Central granular cell odontogenic tumor (CGCOT) is a rare benign odontogenic neoplasm reported with various terms and is not included in the 2005 WHO classification of odontogenic tumors. It shows a predilection for middle‐aged women, usually presenting as an asymptomatic swelling of the mandibular premolar–molar region. Radiographic manifestations include unilocular or multilocular radiolucent lesion, but mixed density lesions can also occur. Histopathology shows sheets and lobules of round to polygonal cells with abundant eosinophilic, granular cytoplasm and eccentrically placed nuclei. Immunohistochemical and ultrastructural features suggest the histiocytic origin of granular cells. The neoplasm does not exhibit an aggressive biological behavior and hence enucleation or curettage ensuring complete removal remains the treatment of choice. We present a systematic review on clinical, radiological, histopathological, immunohistochemical and treatment aspect of CGCOT. Published articles were identified through a literature search using online databases (PubMed, MEDLINE, Scopus) and cross‐references for papers published from the year 1950 to March 2013. From a total of 37 papers, 26 (38 cases) were extracted from the database for systematic review.     

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颗粒细胞瘤(granular cell tumor,GCT)曾称为颗粒细胞"肌母细胞瘤"(granular cell"myoblastoma"),是涎腺肿瘤中少见的一种良性神经性肿瘤,可发生于全身各部位,颌面部常见于舌.可单发也可多发[1].国内外对GCT的相关文献报道较少,现报告我院收治的腮腺良性颗粒细胞瘤1例.     

上颌骨骨巨细胞瘤（附病例报告）

骨巨细胞瘤是一种具有局部侵袭性、恶性潜能的病变;可能来源于未分化间充质细胞;按照间质细胞和多核巨细胞的异型程度分为三级;采用外科手术治疗是首选。发生于上颌骨者较罕见,一般选择肿瘤外扩大切除上颌骨,（同期行骨移植或二期赝复体修复）。     

先天性颗粒细胞龈瘤的临床病理分析

目的 探讨先天性颗粒细胞龈瘤的临床特征和病理学特点,为临床诊断、鉴别诊断及治疗提供参考。 方法 回顾性分析2008年2月—2022年3月就诊于浙江大学医学院附属儿童医院的9例先天性颗粒细胞龈瘤病例,对其临床特点、病理学特点、治疗、预后等进行总结。 结果 9例患者均为女性,就诊年龄1~38 d,上颌3例、下颌6例,6例在母亲孕28~39周B超发现,3例出生时发现,肿瘤直径0.5~3.5 cm,肿物均有蒂与牙槽嵴相连。1例局麻下手术切除,其余8例全麻下手术切除,随访1个月~12年,愈合良好无复发,其中2例相应部位乳牙过早萌出。病理检查结果均为先天性颗粒细胞龈瘤。 结论 先天性颗粒细胞龈瘤是良性肿瘤,预后良好,一般不复发。母亲孕期B超是早期发现先天性颗粒细胞龈瘤的重要手段,病理学检查对先天性颗粒细胞龈瘤的诊断具有关键作用,一般手术切除肿瘤即可,无需扩大切除。     

Immunohistochemical study of congenital gingival granular cell tumor (congenital epulis)

The congenital gingival granular cell tumor (CGGT) or congenital epulis is a rare lesion of unknown origin found only in newborn infants. The tumor consists mainly of large eosinophilic granular cells arranged in solid nests that are separated by thin fibrovascular areas. In addition, there are some spindle-shaped cells and medium-sized polygonal cells (so-called interstitial cells) among the neoplastic granular cells. Three CGGTs were investigated with a panel of poly- and monoclonal antibodies, using immunoperoxidase methods on formalin fixed paraffin embedded sections. Neoplastic granular cells of these three cases show cytoplasmic staining for neuron-specific enolase (NSE) and vimentin. However, all other reactions were negative. Our results suggest that the lesion may be derived from uncommitted nerve-related mesenchymal cells. On the other hand, interstitial cells show strong S-100 protein-, cytokeratin-, vimentin-, and NSE-immunostainings, and these cells are consistent with neuroendocrine nature. The presence of a biphasic cell population with granular cells and interstitial cells must be considered the main immunohistochemical feature.     

Central granular cell odontogenic tumor of the maxilla

The central granular cell odontogenic tumor (CGCOT) is a rare benign odontogenic neoplasm composed of varying amounts of large eosinophilic granular cells and apparently inactive odontogenic epithelium. It tends to occur as a small asymptomatic swelling in the posterior region of the mandible with nonaggressive appearance. We report an unusual case of CGCOT in the maxillary region with clinical features of malignancy. The patient underwent surgical treatment, and the 2-year follow-up revealed no signs of recurrence. Central granular cell odontogenic tumor is a very rare condition with few cases reported, especially in the maxillary region. This case highlights the possibility of aggressive behavior by these lesions.     

Granular cell tumor of the oral cavity: updated immunohistochemical profile

Background:  Granular cell tumor (GCT) is a benign lesion that occurs at different body sites with preponderance to the oral cavity. It is generally believed to be of schwann cell/neural cell origin. We used a large panel of both traditional and recently developed antibodies in an attempt to trace the origin of GCTs on the basis of their immunoprofile.
Methods:  The patients' demographic data and the cytological and architectural features of the lesions were analyzed in a large series of oral GCTs ( n  = 68). Forty-two lesions were also submitted to a panel of immunohistochemical stains with antibodies against S-100, CD-68 (KP-1 and PG-M1), vimentin, calretinin, NKI/C3, PGP9.5, p75/NGFR and inhibin-α.
Results:  The tongue was the most common location of oral GCTs (81%). The granular cells demonstrated a wide array of cytological features in terms of cell shape and position of the nucleus. In addition, the lesions showed different architectural patterns, including 'infiltration' with satellite nodules. Interestingly, no recurrences were reported, even in lesions that were not completely excised. Granular cells were usually found to be strongly and diffusely positive for p75, vimentin, calretinin and NKI/C3, inhibin-α, PGP9.5, and S-100.
Conclusions:  Immunoreactivity of the granular cells to a broad panel of antibodies that characterize different tissues does not confirm any particular cell type for the histogenetic origin of GCTs. Furthermore, GCTs could be regarded as lesions that reflect a local metabolic or reactive change rather than a true neoplasm.     

Immunolocalization of cell signaling molecules in the granular cell ameloblastoma

BACKGROUND: Bone morphogenic protein (BMP) and Wnt signaling pathway molecules play important roles in cytodifferentiation and cell proliferation. We attempted to localize these signaling molecules in the granular cell ameloblastoma. MATERIALS AND METHODS: Four samples of paraffin-embedded ameloblastoma with granular cells were studied. Immunohistochemistry was performed to detect basement membrane type heparan sulfate (HS) (JM403), cell surface type HS (10E4), heparanase, Wnt-5a, Wnt-2, beta-catenin, and BMP-4. RESULTS: In all four samples, strong expression of beta-catenin and Wnt-5a was detected within the granular cells, while BMP-4 expression was weak and Wnt-2 was negative. Immunoreactivities of basement membrane type HS, cell surface type HS, and heparanase were variable within granular cells in ameloblastoma. CONCLUSION: Granular cells in ameloblastoma exhibit abnormal biological behaviors, particularly synthesis and secretion of protein. Synthesis of signaling molecules is upregulated, but secretion is arrested in some cases, while both are lost in other cases.     

上颌窦癌术后颌骨缺损即时修复

目的:研究上颌窦癌手术后即刻修复使患者面容恢复和早期功能重建。方法:在颌骨切除前首先了解病人病情及手术范围。常规取印模,根据制备好的模型,参考X线片在模型上画出手术切除范围。用石膏刻刀削去手术区的石膏及石膏牙齿,使其形成一定的缺陷空腔。一侧颌骨切除,制作修复体首先要选择2-3个正常牙齿作固位,可制做成铸造钴铬合金卡环,也可弯制不锈钢卡环。双侧颌骨全切,修复体过大可制成空腔,高度过高可制成义颌和义齿两部分。结果:上颌窦癌术后即刻修复26例,其中上颌骨全切12例,半侧及部分颌骨切除的14例,共26例。不但早期恢复了患者的咀嚼功能,也给患者心理上减轻一定的负担,获得满意效果。结论:上颌窦癌术后即刻修复,是行之有效的治疗方法。     

口腔颗粒细胞瘤14例临床病理分析

目的 回顾性分析14例口腔颗粒细胞瘤(OGCT)的临床特征并行组织学分型及增殖活性检测。方法 收集1970至2003年武汉大学口腔医学院口腔病理科OGCT存档资料14例，分析其临床及组织病理学特征并随访，应用免疫组化方法行S-100、NSE及Ki-67染色。结果 OGCT好发于舌部(13／14)，患者平均年龄32．6岁(年龄范围11～50岁)。男：女为1：2．5。镜下观察所有肿瘤由多边形瘤细胞组成，胞质中有丰富的嗜酸性颗粒，且S-100及NSE染色阳性。14例OGCT中11例良性，3例细胞不典型性。3例良性OGCT呈膨胀性生长，其余8例良性及3例细胞不典型性病例均为侵袭性生长。少数肿瘤细胞Ki-67染色阳性。随访的10例中1例肿瘤细胞明显呈不典型性者复发并死亡，9例无复发。结论 大多数OGCT为良性，极少数具有潜在恶性，应注意随访。少数肿瘤细胞Ki-67阳性提示该肿瘤具有较低的增殖活性。     

颊部颗粒细胞瘤1例并文献复习

报告1例颊部颗粒细胞瘤。患者女,38岁。右侧面颊部肿物1月余。组织病理学显示瘤细胞由纤维组织分割呈巢状,细胞呈多边形,胞质丰富,嗜酸性。免疫组化染色Vimentin及S-100蛋白阳性,提示肿瘤来源于雪旺细胞。     

Multicentric granular cell tumor: report of a patient with oral and cutaneous lesions

Granular cell tumor (GCT) is an uncommon benign neoplasm of soft tissue that characteristically affects the oral cavity, with increased frequency in the tongue. In this paper, we report a multicentric GCT affecting a 41-year-old black woman, with nodules in perineum, groin, vulva, tongue and lip. Some of these lesions were surgically resected, but in a six-year follow-up, new primary lesions and recurrences were observed. In addition, the patient opted to do not remove some of these lesions, but there were not significant intercurrences. In view of the present findings, aspects related to clinical presentation, multiplicity, malignant potential, and treatment of GCT are discussed.     

Chondrosarcoma of the maxilla. Case report

Chondrosarcoma is a rare malignant neoplasm of the jaws. The diagnosis of this lesion is mainly based on the histopathological appearance. A case of chondrosarcoma of the maxilla is reported. The origin of this rare tumour in the maxilla, a bone with exclusive membranous ossification, is discussed.     

Chondrosarcoma of the maxilla. Case report

Chondrosarcoma is a rare malignant neoplasm of the jaws. The diagnosis of this lesion is mainly based on the histopathological appearance. A case of chondrosarcoma of the maxilla is reported. The origin of this rare tumour in the maxilla, a bone with exclusive membranous ossification, is discussed.     

Immunohistochemical and ultrastructural investigation of apoptotic cell death in granular cell ameloblastoma

Apoptotic cell death in granular cell ameloblastomas was examined by immunohistochemistry using anti-single-stranded DNA (ssDNA) antibody and transmission electron microscopy. Routinely prepared sections of granular cell ameloblastomas showed various quantities of granular cells with some apoptotic nuclear fragments. Immunoreactivity for ssDNA was higher in granular cells than in other neoplastic cells. Ultrastructural examination revealed abundant lysosomes in the cytoplasm of granular cells. Numerous apoptotic cell fragments with condensed nuclei in granular cell clusters were phagocytosed by adjacent granular cells. On immunohistochemical characterization of cellular differentiation, granular cells were positive for cytokeratin, CD68, lysozyme and alpha-1-antichymotrypsin, but negative for vimentin, desmin, S-100 protein, neuron-specific enolase and CD15, indicating epithelial origin and lysosomal aggregation. These features suggest that the cytoplasmic granularity in granular cell ameloblastomas might be caused by increased apoptotic cell death of neoplastic cells and associated phagocytosis by neighboring neoplastic cells.     

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目的探讨舌肌内巨大颗粒细胞瘤的临床特点。方法对中国医科大学口腔医学院口腔颌面外科2003—2004年收治的2例舌肌内颗粒细胞瘤患者的临床资料进行回顾性分析,结合文献探讨其临床特征、组织病理学特点、诊断及治疗。结果2例患者均为年轻女性,肿物均位于舌肌内,直径约5cm,为无痛性,病程为渐进性。组织学特点为无明显被膜,瘤细胞体积较大,呈圆形,胞浆丰富,可见较多嗜伊红均质细颗粒,过碘酸-希夫(PAS)染色阳性,瘤细胞呈巢状或腺泡状生长。手术切除后均无复发。结论舌肌内颗粒细胞瘤为良性病变,切除后不易复发。     

Clear cell variant of calcigying epithelia odontogenic tumor (CEOT) in the maxilla: report of a cse with immunohistochemical and ultrastructural investigations

A rare case of clear cell variant of calcifying epithelial odontogenic tumor is presented with immunohistochemical and ultrastructural investigations. A 14-year-old Japanese girl was admitted with a complaint of swelling in the right posterior maxilla. Radiological examination showed a well-circumscribed radiolucent lesion located close to the impacted third molar. After only a partial tumor excision, the tumor recurred 13 years later. It appeared radiologically as an irregular radiodensity, and a subtotal maxillectomy was performed. Histological examination showed sheets and/or strands composed almost entirely of clear vacuolated epithelial cells in a stroma containing intercellular amyloid-like material and calcification. Histochemical and ultrastructural analysis detected cytoplasmic glycogen granules in the clear cells, and positive immunoreactivities for cytokeratins 8, 13 and 19; filaggrin and anti-ameloblastoma antibodies suggested an odontogenic epithelial origin.     

Ameloblastoma of the maxilla. Case report

A basal cell maxillary ameloblastoma became obvious as an asymptomatic swelling of the left buccal sulcus and alveolar process, although a large extension into the maxillary sinus up to the nasal conchae and the orbital floor had already occurred. The painless and slow growth of the lesion, the thin bone of the upper jaws, the adjacent cavities and the vital structures are the main factors for delay in recognition and thus the potentially lethal result of a maxillary ameloblastoma. A review of location, age, sex and race predilection, clinical course, radiographic appearance, histological types and treatment methods in made.