Reichart P A, Jundt G
Abteilung Oralchirurgie und Zahnärztliche Röntgenologie, Charité-Universitätsmedizin Berlin.
Pathologe. 2008 May;29(3):189-98. doi: 10.1007/s00292-008-0996-0. Epub 2008 Mar 29.
Benign "mixed"odontogenic tumors consist of an epithelial and ectomesenchymal tumor component, distinguishing them from pure epithelial and pure ectomesenchymal odontogenic tumors. In addition, they may have the ability to produce dentin, enamel or cementum. Therefore, they can sometimes already be differentiated radiologically from epithelial odontogenic tumors. Some of the mixed odontogenic lesions are regarded as true tumors (ameloblastic fibroma, odontoameloblastoma, dentinogenic ghost cell tumor), while others are assumed to represent hamartomatous lesions (complex and compound odontoma, probably also ameloblastic fibrodentinoma and ameloblastic fibroodontoma). Preceded by keratocystic odontogenic tumor, complex and compound odontomas are the second most common odontogenic tumors, while other members of the "mixed" odontogenic tumor group are far less frequently diagnosed. Odontoameloblastoma and dentinogenic ghost cell tumors are locally aggressive lesions that require total resection. All other lesions of this group are treated by local excision. Since ameloblastic fibrosarcoma may evolve from ameloblastic fibroma, patients with ameloblastic fibroma should remain in long-term follow-up.
良性“混合性”牙源性肿瘤由上皮和外间充质肿瘤成分组成,这使其有别于纯上皮性和纯外间充质性牙源性肿瘤。此外,它们可能具有生成牙本质、釉质或牙骨质的能力。因此,它们有时在影像学上就可与上皮性牙源性肿瘤相鉴别。一些混合性牙源性病变被视为真性肿瘤(成釉细胞纤维瘤、牙釉质成釉细胞瘤、牙本质生成性影细胞瘤),而其他一些则被认为是错构瘤性病变(复合性和组合性牙瘤,可能还有成釉细胞纤维牙本质瘤和成釉细胞纤维-牙瘤)。在角化囊性牙源性肿瘤之后,复合性和组合性牙瘤是第二常见的牙源性肿瘤,而“混合性”牙源性肿瘤组的其他成员诊断频率要低得多。牙釉质成釉细胞瘤和牙本质生成性影细胞瘤是具有局部侵袭性的病变,需要进行根治性切除。该组的所有其他病变均采用局部切除术治疗。由于成釉细胞纤维肉瘤可能由成釉细胞纤维瘤演变而来,成釉细胞纤维瘤患者应接受长期随访。