Krishnapillai Rekha, Angadi Punnya V
Department of Oral and Maxillofacial Pathology and Microbiology, Shri Dharmasthala Manjuna theshwara College of Dental Sciences and Hospital, Dharwad, Karnataka, India.
Quintessence Int. 2010 May;41(5):e90-100.
Ameloblastomas in Indians have rarely been studied. The present study was undertaken to retrospectively compare the clinical, radiologic, and histopathologic features of 73 cases of ameloblastoma in Indians.
Biopsy records of 73 histologically diagnosed cases of ameloblastoma over an 18-year period were retrieved and analyzed for age, sex, site distribution, clinical presentation, radiologic features, and histopathology. These cases were also evaluated for recurrence.
Ameloblastoma accounted for 60.3% of all odontogenic tumors in this study, with a mean age of presentation of 30.2 years. A slight male predilection and predominant occurrence in the mandibular molar-ramus area were noted. Radiologically, ameloblastoma presented as either unilocular or multilocular radiolucency, with a significant age difference noted between unilocular and multilocular lesions. Interestingly, findings such as cortical plate expansion, perforation, and involvement of the temporomandibular joint were more frequent in females. The most common histologic type in contrast to other studies was unicystic ameloblastoma followed by follicular and acanthomatous ameloblastoma. Specific correlations between histologic type and age, sex, site, and radiologic features were also observed. Recurrence was seen in 13.3% of patients, predominantly in males, in the molar-ramus area, and the common histologic type was follicular ameloblastoma followed by unicystic ameloblastoma.
The finding of unicystic ameloblastoma being the second most common recurrent variant of ameloblastoma, especially when associated with cyst wall invasion or intramural proliferation, may warrant a more aggressive treatment than traditional enucleation/curettage for this entity to prevent recurrence.
印度人中的成釉细胞瘤很少被研究。本研究旨在回顾性比较73例印度人成釉细胞瘤的临床、放射学和组织病理学特征。
检索并分析了18年间73例经组织学诊断为成釉细胞瘤的活检记录,包括年龄、性别、部位分布、临床表现、放射学特征和组织病理学。还对这些病例的复发情况进行了评估。
在本研究中,成釉细胞瘤占所有牙源性肿瘤的60.3%,平均发病年龄为30.2岁。注意到有轻微的男性偏好,且主要发生在下颌磨牙-升支区域。放射学上,成釉细胞瘤表现为单房或多房透光区,单房和多房病变之间存在显著的年龄差异。有趣的是,皮质板扩张、穿孔和颞下颌关节受累等表现在女性中更为常见。与其他研究相比,最常见的组织学类型是单囊性成釉细胞瘤,其次是滤泡性和棘皮瘤样成釉细胞瘤。还观察到组织学类型与年龄、性别、部位和放射学特征之间的特定相关性。13.3%的患者出现复发,主要为男性,位于磨牙-升支区域,常见的组织学类型是滤泡性成釉细胞瘤,其次是单囊性成釉细胞瘤。
单囊性成釉细胞瘤是成釉细胞瘤第二常见的复发变体,尤其是当与囊壁侵犯或壁内增殖相关时,可能需要比传统的摘除/刮除术更积极的治疗来预防复发。