Li Bo, Long Xing, Wang Shiping, Cheng Yong, Chen Xinming
Department of Oral Radiology, School and Hospital of Stomatology, Wuhan University, Wuhan City, China.
J Oral Maxillofac Surg. 2011 Aug;69(8):2173-85. doi: 10.1016/j.joms.2010.09.015. Epub 2011 Feb 1.
To evaluate the clinical and radiologic features of desmoplastic ameloblastoma (DA).
Twenty-four cases of DA among Chinese patients were analyzed retrospectively. The clinical and radiologic features of DA at present, as reported in the English-language literature, were reviewed and its radiologic characteristics critically evaluated.
This study included 23 cases of intraosseous lesions and 1 case of extraosseous lesion. Clinically, DA is mainly located in the anterior and/or the premolar region of the jaw, with a slight male prominence. Among 23 intraosseous lesions, 9 cases occurred in the maxilla and 14 occurred in the mandible. Radiographically, 69.6% (16 of 23) exhibited ill-defined borders. Root displacement occurred in 47.9% of patients (11 of 23) and root resorption occurred in 8.7% of patients (2 of 23). Three radiologic presentations of DA were identified as follows: type I, which is both radiolucent and radiopaque in appearance (osteofibrosis type); type II, which has a completely radiolucent appearance (radiolucent type); and type III, which is both radiolucent and radiopaque in appearance combined with a large radiolucent change (compound type). The osteofibrosis type (14 cases) is the most common pattern, and the compound type is the least common (only 3 cases).
DA has a potentially aggressive behavior. Moreover, it exhibits 3 different radiologic characteristics. Although DA should be differentiated from osteofibrosis lesions frequently described in the literature, some uncommon radiographic patterns should be considered in the differential diagnosis of this rare odontogenic tumor.
评估促结缔组织增生性成釉细胞瘤(DA)的临床和影像学特征。
回顾性分析24例中国患者的DA病例。复习英文文献中目前报道的DA的临床和影像学特征,并对其影像学特征进行严格评估。
本研究包括23例骨内病变和1例骨外病变。临床上,DA主要位于颌骨的前部和/或前磨牙区,男性略多见。在23例骨内病变中,9例发生在上颌骨,14例发生在下颌骨。影像学上,69.6%(23例中的16例)边界不清。47.9%的患者(23例中的11例)出现牙根移位,8.7%的患者(23例中的2例)出现牙根吸收。DA的三种影像学表现如下:I型,表现为透射性和阻射性并存(骨纤维性型);II型,表现为完全透射性(透射性型);III型,表现为透射性和阻射性并存并伴有大片透射性改变(复合型)。骨纤维性型(14例)是最常见的类型,复合型最少见(仅3例)。
DA具有潜在侵袭性。此外,它表现出三种不同的影像学特征。尽管DA应与文献中经常描述的骨纤维性病变相鉴别,但在诊断这种罕见的牙源性肿瘤时,应考虑一些不常见的影像学表现。