Li Bin-Bin, Xie Xiao-Yan, Jia Sheng-Nan
Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, People's Republic of China.
J Craniofac Surg. 2013 Jan;24(1):e100-1. doi: 10.1097/SCS.0b013e3182799005.
Adenomatoid odontogenic tumor (AOT) is a relatively rare odontogenic tumor that is exclusively odontogenic epithelium in origin. We present a rare case of an AOT in a patient with fibro-osseous reaction in the surrounding tissue. A 22-year-old woman complained of gradual swelling of the right maxillary for 1 month. Radiography showed a well-defined radiolucent lesion with root resorption of the involved teeth. The biopsy revealed a primarily cystic lesion surrounded by a solid portion. Microscopically, the cystic part mainly consisted of epithelial cells organized in solid nodules, whorls, and rosettes, typically characteristic of AOT. But the surrounding solid portion showed cellular fibroconnective tissue stroma with prominent calcified spherules corresponding to ossicles and cementicles, characteristic of ossifying fibroma. The presence of a prominent fibro-osseous reaction in our case is unique. To our knowledge, these findings have not been observed in the previous reports of AOT. It could well represent a cellular cystic wall with metaplastic ossification, rather than a benign fibro-osseous neoplasm such as ossifying fibroma. The tumor had no recurrence after local resection at 5-year follow-up.
腺牙源性肿瘤（AOT）是一种相对罕见的牙源性肿瘤，其起源完全为牙源性上皮。我们报告了一例罕见的AOT病例，该患者周围组织伴有纤维骨反应。一名22岁女性主诉右侧上颌逐渐肿胀1个月。影像学检查显示一个边界清晰的透射性病变，累及牙齿牙根吸收。活检显示主要为囊性病变，周围有实性部分。显微镜下，囊性部分主要由排列成实性结节、漩涡状和玫瑰花结状的上皮细胞组成，这是AOT的典型特征。但周围的实性部分显示为细胞性纤维结缔组织基质，伴有与骨小体和牙骨质小体相对应的显著钙化小球，这是骨化性纤维瘤的特征。我们病例中显著的纤维骨反应是独特的。据我们所知，在之前的AOT报告中尚未观察到这些发现。它很可能代表一种具有化生骨化的细胞性囊壁，而不是像骨化性纤维瘤这样的良性纤维骨肿瘤。该肿瘤在局部切除后5年随访未复发。
