Economopouloy P, Elefteriadis E
Faculty of Dentistry, University of Athens.
Odontostomatol Proodos. 1990 Oct;44(5):351-60.
A case of peripheral ameloblastoma is presented which was located in the right maxillary tuberosity area in a 52-year-old caucasian male. The lesion was asymptomatic and presented as a reddish sessile mass of soft tissue, 1.5 cm in diameter, with a granular surface and firm texture (Fig. 1). There was no radiologic evidence of bone involvement (Fig. 2). A clinical diagnosis of squamous cell carcinoma was made and a biopsy was taken. The microscopical examination revealed the presence of ameloblastomatous tissue exhibiting numerous areas of continuity with the surface epithelium (Fig. 3). The tumor showed a mixed follicular (Fig. 4) and plexiform (Fig. 5) pattern and was accompanied by a mild lymphocytic infiltrate (Fig. 3). A partial maxillectomy was performed and the histopathological examination of the surgical specimen confirmed the diagnosis of peripheral ameloblastoma. A primary basaloid pattern of the tumor was identified (Fig. 6) but a search for acanthomatous areas was proved fruitless. Some epithelial islands showed peripheral columnar cells with apically polarized nuclei (Fig. 7). The space between the border of the tumor (Fig. 8) and the underlying bone was filled with dense connective tissue and contained two isolated tumor follicles with cystic change (Fig. 9). The thorough examination of the co-existed bone did not reveal any areas of tumor invasion. Finally, the oral epithelium adjacent to the tumor exhibited elongated and slender rete ridges (Fig. 10). One and a half year post-operatively, no signs of recurrence could be detected.
本文报告一例外周性成釉细胞瘤,患者为一名52岁的白种男性,病变位于右上颌结节区。该病变无症状,表现为直径1.5厘米的红色无蒂软组织肿块,表面呈颗粒状,质地坚硬(图1)。影像学检查未发现骨受累证据(图2)。临床诊断为鳞状细胞癌并进行了活检。显微镜检查显示存在成釉细胞瘤组织,与表面上皮有多处连续(图3)。肿瘤呈滤泡型(图4)和丛状型(图5)混合模式,并伴有轻度淋巴细胞浸润(图3)。进行了部分上颌骨切除术,手术标本的组织病理学检查证实了外周性成釉细胞瘤的诊断。肿瘤的主要基底样模式被识别(图6),但未发现棘皮瘤样区域。一些上皮岛显示周边柱状细胞,核呈顶端极化(图7)。肿瘤边界(图8)与下方骨之间的间隙充满致密结缔组织,并包含两个有囊性变的孤立肿瘤滤泡(图9)。对共存骨的彻底检查未发现任何肿瘤侵犯区域。最后,肿瘤相邻的口腔上皮表现出延长且细长的 rete 嵴(图10)。术后一年半,未检测到复发迹象。