牙源性角化囊性瘤恶变1例

牙源性角化囊性瘤（KCOT）是一种常见的颌骨牙源性囊性病损,临床上牙源性角化囊性瘤复发常见,而恶变较少见。本文报道1例由牙源性角化囊性瘤恶变为原发性骨内鳞状细胞癌的病例。     

Cystic variant of calcifying epithelial odontogenic tumor

The calcifying epithelial odontogenic tumor is a rare benign odontogenic neoplasm of the jaw. Clinically, calcifying epithelial odontogenic tumor manifests as an intraosseous lesion (central type) in the majority of cases (95%). Extraosseous or peripheral lesions account for less than 5% of cases. Calcifying epithelial odontogenic tumor can be associated with an impacted tooth and give a radiographic simulation of dentigerous cyst. Most calcifying epithelial odontogenic tumors are solid in nature, histopathologically, and might have few cyst-like spaces within them. However, a true cystic calcifying epithelial odontogenic tumor is a rare possibility. We describe a case of a true cystic variant of calcifying epithelial odontogenic tumor in a 30-year-old male, which to our knowledge, is only the second reported case.     

Adenomatoid odontogenic tumour: A case report

Adenomatoid odontogenic tumour (AOT) is a rare benign odontogenic tumour characterized by a progressively slow growing pattern and symptomless behavior. The differential diagnosis between AOT and other odontogenic tumours, such as ameloblastoma, should be well conducted in order to avoid extensive ablative surgery. This report presents an unusual case of an 11-year-old male patient who referred to the oral surgeon due to a significant painless gingival swelling in the anterior mandible. A panoramic X-ray revealed a round radiolucid image of an intraosseous lesion with well defined boards and related to the left lateral incisor and left canine. The Computerized Tomography was performed and the sagittal sections revealed a tooth image in contact with the inferior board of the tumour. Additionally, the coronal sections showed the presence of a tooth inside the lesion. Several calcifying nodules could be distinguished within the cystic area. The clinical diagnostic hypothesis was of calcifying epithelium odontogenic tumour but the histological sections were consistent with AOT. The tumour was enucleated under local anesthesia. After one year follow-up there were no signs of reoccurrence. With respect to the distinguishing tumour enlargement and localization in the lower jaw, the reported case is an uncommon example of AOT.     

Variants of the adenomatoid odontogenic tumor with a note on tumor origin

Three rare variants of the adenomatoid odontogenic tumor (AOT) are described. A follicular AOT associated with an impacted and displaced 28, an extra-follicular variant mimicking a radicular cyst around the apex of 23 and a peripheral (epulis-like) variant exhibiting a periodontal bone defect palatal to 21. On reappraisal of the origin and pathogenesis of the AOT, it would seem that this tumor or hamartomatous lesion is derived from odontogenic epithelium of the dental lamina complex or its remnants.     

A case of multiple AOT‐like jawbone lesions in a young patient – a new odontogenic entity?

We assessed the immunohistochemical profile of an unusual case of multiple similarly looking tumors in the jawbone of a young patient. Histologically, the tumors exhibited features of adenomatoid odontogenic tumor (AOT) and adenomatoid dentinoma but showed no resemblance to any other defined odontogenic tumor entities. They expressed high amounts of cytokeratin (CK) 8 and 14 together with some Vimentin. A small rim of peripheral cells showed CK 5, 17, and 19 reactivity. Also, these lesions expressed some bcl-2 as well as p53 and Ki67. Histologically and immunohistochemically, the unusual multiple lesions differed in details from a simultaneously examined group of 24 classical AOT cases, suggesting that they may represent a hitherto less well-defined odontogenic tumor entity.     

Immunoprofile of the adenomatoid odontogenic tumor

This study was focused on the immunohistochemical profile of the adenomatoid odontogenic tumor. A Pub/Medline search revealed a number of immunohistochemical studies including cytokeratin profiles, extracellular matrix proteins, Integrins, ameloblast‐associated proteins resorption regulators (RANK, RANKL), p53, PCNA, MDM2 protein, cyclin D1, Ki‐67, Bcl‐2 metallothionein, metalloproteinases, D56 hepatocyte growth factor, c‐met, DNA methyltransferase, podoplanin, TGF‐βI, Smad‐2/3, Smad‐I‐5/‐8, Smad 4, beta‐ catenin, calretinin, and clonality. Careful interpretation of the findings indicates that the adenomatoid odontogenic tumor may be more of a hamartomatous than neoplastic nature.     

牙源性角化囊性瘤恶变1例

牙源性角化囊性瘤（KCOT）有潜在的侵袭性和较高的术后复发率,但恶变却很罕见。本文报道1例KCOT术后多次复发及感染,最终恶变为鳞状细胞癌的病例,并结合文献对其进行临床病理分析。     

Adenomatoid odontogenic tumor: biologic profile based on 499 cases

Topographically, the AOT occurs in peripheral and central variants, the latter further in follicular (with embedded tooth) and extrafollicular (no embedded tooth) types. The AOT is slow growing with few or no symptoms. Tumor growth may cause displacement of teeth rather than root resorption. The follicular AOT mimics a follicular cyst, the extrafollicular a residual or "globulo-maxillary" cyst and the peripheral a gingival fibroma. All variants of AOT show identical histologic features. The central variants account for 97.2%, 73.0% of which are follicular. The follicular variant (M:F ratio 1 to 1.9) is three times as frequent as the extrafollicular. The follicular variant is diagnosed earlier in life (mean age 17 yr) than the extrafollicular (mean age 24 yr). 53.1% of all variants occur within the teens (13-19 yr). Follicular AOT is associated with one embedded tooth in 93.2%. Maxillary permanent canines account for 41.7% and all four canines for 60.1% of AOT-associated embedded teeth. Ranking four among the odontogenic tumors the AOT is not a particularly rare tumor. Conservative surgical excision is the treatment of choice. Documented recurrences have not been reported.     

Expression of extracellular matrix proteins in adenomatoid odontogenic tumor

J Oral Pathol Med (2010) 39 : 230–235 Altered expression of extracellular matrix (ECM) components has been reported in several pathologies; however, few ECM proteins have been evaluated in adenomatoid odontogenic tumor (AOT). The aim of this study was to analyze the expression and distribution of the ECM proteoglycans: biglycan and decorin; and glycoproteins: osteonectin, osteopontin, bone sialoprotein and osteocalcin in the AOT. Three‐micrometer sections from paraffin‐embedded specimens were evaluated employing a streptavidin–biotin immunohistochemical method with the antibodies against the proteins previously cited. Only the osteonectin was expressed in the epithelial cells. The eosinophilic amorphous material and the connective tissue showed expression of all components studied. The calcification foci expressed only osteopontin. In conclusion, the low expression of the components studied in neoplastic epithelial cells suggests that the epithelial cells act probably as stimulators of the expression by the stroma, which in turn can act as agonist or antagonist of the tumor growth. These results suggest that the components studied probably have a key role in the biological behavior of the AOT.     

Calcifying epithelial odontogenic tumor of the maxilla with ulcerative stomatitis: a case report

Calcifying epithelial odontogenic tumor (CEOT) is a rare benign odontogenic tumor, known as Pindborg tumor. Although ulcer formation was reported in one previously involving the peripheral maxilla, such change of the overlying mucosa has been reported in intraosseous CEOT. We report maxillary CEOT in a patient who complained of spontaneous pain due to extensive ulcer formation of the oral mucosa.     

牙源性腺样瘤的临床病理及其分子表达研究

牙源性腺样瘤(AOT)是一种良性肿瘤或错构瘤,对其性质及起源问题尚存在争论.本文就牙源性腺样瘤的临床病理、治疗、生物大分子在牙源性腺样瘤中的表达及起源方面的近期研究进展作一综述.     

骨外型牙源性钙化上皮瘤1例报告

牙源性钙化上皮瘤是一种良性肿瘤，也称Pindborg瘤，可分为骨内型和骨外型2种，主要发生于颌骨内，偶见于颌骨外。本文报告1例发生于口底的牙源性钙化上皮瘤，其临床症状与口底皮样囊肿相似．术后经组织病理学确诊，主要组织病理学特征是嗜酸性环状钙化团块。因其具有局部侵袭性，为避免复发，提倡完整切除肿物。     

Squamous odontogenic tumor

The clinical, radiographic, histologic and some immunohistochemical findings in a case of squamous odontogenic tumor (SOT) in a 56-yr-old woman are described. SOT appears to be of benign nature, most probably originating from the epithelial rests of Malassez.     

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提要：外周性牙源性肿瘤又称骨外型牙源性肿瘤或软组织牙源性肿瘤,主要发生在牙龈,包括牙源性真性肿瘤及错构瘤。外周性牙源性肿瘤约占所有牙源性肿瘤的4%左右,英文文献表明其中外周性牙源性纤维瘤最多见,其次是外周性成釉细胞瘤及外周性牙源性钙化囊性瘤。外周性牙源性肿瘤临床上容易与牙龈发生的炎症性或反应性病变相混淆,明确诊断依赖组织病理学检查。外周性牙源性肿瘤不包括骨内型牙源性肿瘤穿破骨皮质侵犯牙龈。外周性牙源性肿瘤预后普遍好于相应的骨内型肿瘤,但切除不彻底仍可复发,建议长期随访。     

Clear cell odontogenic tumor in the mandible: report of a case with duct-like appearances and dentinoid induction

A case of clear-cell odontogenic tumor with unusual histological features is presented. A 61-year-old Japanese man was admitted because of swelling of the left premolar-molar region of the mandible. Radiological examination revealed a multilocular radiolucency with irregular margins. Histological examination of the resected specimen showed infiltrative proliferation of both clear and eosinophilic cells into the adjacent soft tissue without encapsulation, suggesting the malignant potential of the tumor. The tumor cells sporadically formed cystic lesions. In addition, several tumor cell nests showed duct-like characteristics, and many eosinophilic dentin-like structures were attached to the tumor cell nests, suggesting the potential for epithelial-mesenchymal induction. Histochemically, the clear tumor cells possessed cytoplasmic glycogen granules. Both clear and eosinophilic tumor cells showed positive immunoreactivities for cytokeratin 19, epithelial membrane antigen and filaggrin, indicating an odontogenic epithelial origin.     

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.     

Adenomatoid odontogenic tumorlike lesion in a male Wistar rat

An odontogenic tumor in the maxilla of a male Wistar rat is described. The tumor consisted of large epithelial areas with peripheral palissading and with juxtaepithelial material resembling dentin. The neoplastic odontogenic epithelium seems capable of inducing peridental mesenchyme to form a kind of dental hard tissue normally not present at that site.     

牙源性钙化上皮瘤2例

牙源性钙化上皮瘤（CEOT）是一种具有局部浸润性生长特点的良性牙源性上皮性肿瘤,可分为骨内型（中央型）、骨外型（外周型）两种,后者罕见。本文报道2例牙源性钙化上皮瘤,并结合文献探讨其临床、影像表现特点。