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透明细胞牙源性癌:诊断与治疗的困境

Clear cell odontogenic carcinoma: a diagnostic and therapeutic dilemma.

作者信息

Avninder Singh, Rakheja Dinesh, Bhatnagar Amar

机构信息

Institute of Pathology-ICMR, Safdarjung Hospital Campus, New Delhi, India.

出版信息

World J Surg Oncol. 2006 Dec 12;4:91. doi: 10.1186/1477-7819-4-91.

Abstract

BACKGROUND

Clear cell odontogenic carcinoma is a rare odontogenic tumor occurring in the anterior region of the mandible in 5th-7th decades and shows a female preponderance. It is potentially aggressive, capable of frequent recurrences and loco-regional and distant metastases.

CASE PRESENTATION

A 45-year-old woman presented with a radiolucent left mandibular swelling associated with loss of teeth. Left cervical lymph nodes were enlarged on palpation. The patient underwent resection of the tumor but consequent to resected margins being positive for tumor cells underwent left hemimandibulectomy with ipsilateral functional neck dissection and was free of recurrence at 8 months follow-up.

CONCLUSION

Clear cell odontogenic carcinoma should be considered in the differential diagnosis of jaw tumors with conspicuous clear cell component. Curettage or conservative resection inevitably results in recurrences and/or metastasis and more radical resection is warranted in these tumors, especially when they are large and show soft tissue invasion.

摘要

背景

透明细胞牙源性癌是一种罕见的牙源性肿瘤,好发于5至7十年间下颌骨前部,女性多见。它具有潜在侵袭性,易频繁复发,并可发生局部区域和远处转移。

病例报告

一名45岁女性,出现左侧下颌骨放射性透光性肿胀并伴有牙齿缺失。触诊发现左侧颈部淋巴结肿大。患者接受了肿瘤切除术,但由于切除边缘肿瘤细胞呈阳性,随后接受了左侧半侧下颌骨切除术及同侧功能性颈清扫术,随访8个月无复发。

结论

对于具有明显透明细胞成分的颌骨肿瘤进行鉴别诊断时应考虑透明细胞牙源性癌。刮除术或保守切除术不可避免地会导致复发和/或转移,对于这些肿瘤尤其是肿瘤较大且有软组织侵犯时,更应进行根治性切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/756a/1705808/0cb5b5e5dd2e/1477-7819-4-91-1.jpg

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