National University of Singapore, Singapore.
Am J Otolaryngol. 2013 Jul-Aug;34(4):357-61. doi: 10.1016/j.amjoto.2013.01.002. Epub 2013 Jan 30.
Keratocystic odontogenic tumors (KCOTs) are cystic tumours originating from the dental lamina of the maxilla and mandible that are lined with keratinized epithelium. While benign, they can be locally destructive and have a high recurrence rate despite treatment. Rarely, KCOTs may undergo malignant transformation into Primary Intraosseous Squamous Cell Carcinoma (PIOSCC).
This study reports the clinical findings, radiological scans and histopathology of 2 patients with KCOTs that underwent malignant transformation into PIOSCC.
A comprehensive literature review was performed to similar reports documenting the malignant transformation of KCOTs. The potential for KCOTs to undergo malignant change should prompt oral maxillofacial surgeons and otolaryngologists to exercise a high index of suspicion when treating these lesions. Patients persisting with unresolved disease after treatment should be investigated for malignant transformation. Detailed histopathological examination of KCOT specimens is recommended to detect small foci of SCC which may be present in the epithelium.
牙源性角化囊性瘤(KCOTs)是起源于上颌和下颌牙板的囊性肿瘤,由角化的上皮衬里。虽然是良性的,但它们具有局部破坏性,并且尽管经过治疗,复发率仍很高。罕见情况下,KCOT 可能发生恶性转化为原发性骨内鳞状细胞癌(PIOSCC)。
本研究报告了 2 例 KCOT 发生恶性转化为 PIOSCC 的患者的临床发现、影像学扫描和组织病理学。
对类似文献进行了全面的文献回顾,这些文献记录了 KCOT 的恶性转化。KCOT 发生恶性变化的可能性提示口腔颌面外科医生和耳鼻喉科医生在治疗这些病变时应保持高度怀疑。治疗后持续存在未解决疾病的患者应调查恶性转化。建议对 KCOT 标本进行详细的组织病理学检查,以检测上皮中可能存在的 SCC 小灶。