Sclerosing odontogenic carcinoma with benign fibro-osseous lesion of the mandible: An extremely rare case report
Sclerosing odontogenic carcinoma with benign fibro-osseous lesion of the mandible: An extremely rare case report
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DOI：
10.1111/j.1440-1827.2010.02583.x
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发表时间：
2010-10-01
影响因子：
2.2
通讯作者：
Suzuki, Yoshio
中科院分区：
文献类型：
--
作者：
Irie, Tarou;Ogawa, Ikuko;Suzuki, Yoshio
本文报告一硬化性牙源性癌合并良性纤维骨质病变之病例。一名67岁的男性在精神区域有感觉异常。计算机断层扫描检测到一个颌内肿块，局灶性膨胀，皮质骨消失，并含有混合的射线可透性和射线不透性。在病理诊断为良性纤维骨质病变，手术切除刮除。显微镜下观察发现，部分切除的组织中有散在的细索状上皮细胞和小巢，并伴有纤维间质。细胞核分裂象和有丝分裂象不明显。最终诊断为BFOL伴牙源性上皮增生和化生。术后8个月，病变复发，进行了下颌骨节段切除术。组织学上，病变主要由纤维-骨成分占据，上皮成分具有不规则形状的病灶。上皮成分大多呈细索或小巢状，并显示明确的神经周围浸润。免疫组化显示上皮细胞p63、细胞角蛋白（CK）6和CK 19阳性，CK 7灶性阳性，波形蛋白阴性。MIB-1阳性细胞核不明显。据我们所知，本报告是第一例SOC合并BFOL。
A case of sclerosing odontogenic carcinoma (SOC) admixed with a benign fibro-osseous lesion (BFOL) is reported herein. A 67-year-old male had paresthesia in the mental region. Computed tomography detected an intragnathic mass that was focally expansile with disappearance of cortical bone, and contained admixed radiolucency and radio-opacity. Under the pathological diagnosis as benign fibro-osseous lesion, it was surgically removed by curettage. Microscopic analysis showed that a few parts of the resected materials contained dispersed thin cords and small nests of epithelial cells accompanied by fibrous stroma. Cellular atypia and mitotic figures were not evident. The diagnosis of BFOL with hyperplastic and metaplastic odontogenic epithelia was ultimately made. Eight months after the operation, the lesion recurred and segmental mandibulectomy was carried out. Histologically, the lesion was predominantly occupied by the fibro-osseous component with irregular-shaped foci of epithelial component. The epithelial component exhibited mostly thin cord or small nest patterns and showed definite perineural infiltration. Immunohistochemically, the epithelial cells were positive for p63, cytokeratin (CK) 6 and CK19, and focally positive for CK7 but negative for vimentin. MIB-1 positive nuclei were inconspicuous. To the best of our knowledge, this report is the first case of SOC with BFOL.