Sclerosing odontogenic carcinoma in the mandible
Sclerosing odontogenic carcinoma in the mandible
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DOI：
10.1016/j.ajoms.2018.03.007
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发表时间：
2018-09-01
影响因子：
0.4
通讯作者：
Ando, Tomohiro
中科院分区：
文献类型：
--
作者：
Kataoka, Toshiyuki;Fukada, Kenji;Ando, Tomohiro
我们报告一例无症状的硬化性牙源性癌在一个68岁的妇女。在下颌前部区域观察到隆起，隆起迅速增加，无临床症状。在电脑断层扫描，放射性骨溶解病变被确定在中央门齿尖的下颌骨，和唇皮质骨消失。磁振造影显示在牙槽区域外有一内部不均匀的圆形肿块。活检标本的病理评估没有导致明确的诊断，但良性牙源性肿瘤被怀疑。用4颗切牙将肿瘤整块切除。肿瘤的茎部附着于牙槽骨，但主要位于骨外。手术标本的组织学检查显示，上皮下有一个包膜，无细胞浸润，细胞质呈立方形或多边形，在硬化基质中形成一个小圆圈或多边形。一个类似的肿瘤分散在牙槽骨。免疫组织学上，肿瘤呈细胞角蛋白（AE 1/AE 3）和p63阳性，仅观察到少量Ki-67阳性细胞（约1%）。本病例的肿瘤与以往分类中的牙源性肿瘤不一致。根据先前的发现，临床表现和免疫组织学的结果，最终诊断为硬化性牙源性癌。术后5年无复发或转移。
We report a case of an asymptomatic sclerosing odontogenic carcinoma in a 68-year-old woman. A bulge was noted in the anterior mandibular region, and it increased rapidly without clinical symptoms. On computed tomography, a radiolucent osteolytic lesion was identified in the central incisor apex of the mandible, and the labial cortical bone disappeared. Magnetic resonance imaging showed an internal heterogeneous circular mass outside the alveolar region. Pathological assessment of a biopsy specimen did not lead to a definitive diagnosis, but a benign odontogenic tumor was suspected. The tumor was resected en bloc with 4 incisors. The stem of the tumor was attached to the alveolar bone, but it was mainly outside the bone. Histopathological examination of the surgical specimen showed a capsule under the epithelium and no cellular atypia with bland cytoplasmic cuboidal or polygonal epithelial cells forming a small circle or polygon in the sclerosing stroma. A similar tumor was scattered in the alveolar bone. Immunohistologically, the tumor was positive for cytokeratin (AE1/AE3) and p63, and only a small number of Ki-67-positive cells were noted (approximately 1%). The tumor in our case was not consistent with odontogenic tumors in previous classifications. Based on previous findings, clinical behavior and immunohistological findings, the final diagnosis was a sclerosing odontogenic carcinoma. There has been no recurrence or metastasis 5 years after surgery.