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保守治疗方法:采用减压手术治疗下颌骨大型单囊性成釉细胞瘤。

Conservative approach: using decompression procedure for management of a large unicystic ameloblastoma of the mandible.

作者信息

Xavier Samuel Porfirio, de Mello-Filho Francisco Veríssimo, Rodrigues Willian Caetano, Sonoda Celso Koogi, de Melo Willian Morais

机构信息

From the *Department of Oral and Maxillofacial Surgery and Periodontics, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo; †Department of Craniomaxillofacial Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo; and ‡Department of Surgery and Integrated Clinic, Araçatuba Dental School, Universidade Estadual Paulista Júlio de Mesquita Filho-UNESP, Araçatuba, São Paulo, Brazil.

出版信息

J Craniofac Surg. 2014 May;25(3):1012-4. doi: 10.1097/SCS.0000000000000716.

Abstract

Ameloblastoma is a relatively uncommon benign odontogenic tumor, which is locally aggressive and has a high tendency to recur, despite its benign histopathologic features. This pathology can be classified into 4 groups: unicystic, solid or multicystic, peripheral, and malignant. There are 3 variants of unicystic ameloblastoma, as luminal, intraluminal, and mural. Therefore, in mural ameloblastoma, the fibrous wall of the cyst is infiltrated with tumor nodules, and for this reason it is considered the most aggressive variant of unicystic ameloblastomas. Various treatment techniques for ameloblastomas have been proposed, which include decompression, enucleation/curettage, sclerotizing solution, cryosurgery, marginal resection, and aggressive resection. Literature shows treatment of this lesion continues to be a subject of intense interest and some controversy. Thus, the authors aimed to describe a case of a mural unicystic ameloblastoma of follicular subtype in a 19-year-old subject who was successfully treated using conservative approaches, as decompression. The patient has been followed up for 3 years, and has remained clinically and radiographically disease-free.

摘要

成釉细胞瘤是一种相对罕见的良性牙源性肿瘤,尽管其组织病理学特征为良性,但具有局部侵袭性且复发倾向较高。这种病理类型可分为4组:单囊性、实性或多囊性、外周性和恶性。单囊性成釉细胞瘤有3种变体,即腔内型、管内型和壁型。因此,在壁型成釉细胞瘤中,囊肿的纤维壁被肿瘤结节浸润,因此它被认为是单囊性成釉细胞瘤中最具侵袭性的变体。已经提出了多种治疗成釉细胞瘤的技术,包括减压、摘除/刮除、硬化剂溶液、冷冻手术、边缘切除和根治性切除。文献表明,对这种病变的治疗仍然是一个备受关注且存在一些争议的话题。因此,作者旨在描述一例19岁患者的滤泡亚型壁型单囊性成釉细胞瘤病例,该患者采用减压等保守方法成功治疗。患者已随访3年,临床和影像学检查均无疾病复发。

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