Professor and Head, Department of Dentistry and Oral-Maxillo-Facial Surgery, Faculty of Medicine, Oita University, Oita, Japan.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Nov;116(5):e393-8. doi: 10.1016/j.oooo.2013.02.020. Epub 2013 May 3.
This is a case report on a solid variant of keratocystic odontogenic tumor arising in the mandible, which aggressively infiltrated into the cancelous spaces and involved the periosteal connective tissue of the mandible. The patient was a 57-year-old woman with an ill-defined radiolucent lesion having a moth-eaten pattern in the left molar region of the mandible. Computed tomography scans revealed that the tumor penetrated the buccal cortical plate of the mandible. Histologically, the lesion was characterized by multicystic spaces lined with a thin layer of keratinizing squamous epithelium, which contained basal cells with palisaded hyperchromatic nuclei. Lumina were filled with concentric layers of parakeratin. An additional feature was the appearance of a conspicuous clear cell component showing intraluminal papillary proliferation or forming small cord-like nests in the fibrous stroma. The patient underwent segmental mandibulectomy followed by reconstruction using a titanium plate. A 20-year follow-up revealed no recurrence of the tumor.
这是一份关于下颌骨中角化囊性牙源性肿瘤实性变体的病例报告，该肿瘤具有侵袭性，向松质骨间隙浸润，并累及下颌骨的骨膜结缔组织。患者为 57 岁女性，在左侧磨牙区的下颌骨有一界限不清的透光性病变，呈虫蚀状。计算机断层扫描显示肿瘤穿透下颌骨颊侧皮质板。组织学上，病变的特征是多房囊性空间，内衬一层薄的角化鳞状上皮，其中包含具有栅栏状嗜碱性核的基底细胞。管腔充满同心层状的角化不良。另一个特征是出现明显的透明细胞成分，表现为腔内乳头状增生，或在纤维基质中形成小的索状巢。患者接受了下颌骨节段切除术，随后使用钛板进行重建。20 年的随访未发现肿瘤复发。
