在伴有p53基因突变的成釉细胞瘤中发生的成釉细胞癌：一例报告
Ameloblastic carcinoma developing in preexisting ameloblastoma with a mutation of the p53 gene: a case report.
作者信息
Nobusawa Aiko, Sano Takaaki, Yokoo Satoshi, Oyama Tetsunari
机构信息
Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan; Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
出版信息
Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Nov;118(5):e146-50. doi: 10.1016/j.oooo.2014.03.021. Epub 2014 Apr 8.
OBJECTIVE
Ameloblastic carcinoma is a rare malignant odontogenic tumor. Here we present a case of a large ameloblastic carcinoma, which developed in a preexisting ameloblastoma in the right submandibular region.
STUDY DESIGN
The patient was an 84-year-old woman who had received several surgical procedures for ameloblastoma, including a segmental mandibulectomy. The dimensions of the tumor were 12 × 8 × 5 cm, and both benign ameloblastoma and ameloblastic carcinoma were observed histologically. Based on histologic diagnosis, immunohistochemical staining and sequence analysis for p53 were performed.
RESULTS
Overexpression of p53 was observed only in the ameloblastic carcinoma. Additionally, a mutation of the p53 gene (TP53) in exon 5 was found by sequence analysis in the ameloblastic carcinoma.
CONCLUSIONS
This is the first case of ameloblastic carcinoma with a mutation of the p53 gene that has been associated with carcinomatous transformation.
目的
成釉细胞癌是一种罕见的牙源性恶性肿瘤。在此，我们报告一例发生于右下颌下区原有成釉细胞瘤基础上的巨大成釉细胞癌病例。
研究设计
患者为一名84岁女性，曾因成釉细胞瘤接受过多次外科手术，包括下颌骨部分切除术。肿瘤大小为12×8×5 cm，组织学观察发现既有良性成釉细胞瘤成分，也有成釉细胞癌成分。基于组织学诊断，进行了p53的免疫组化染色和序列分析。
结果
仅在成釉细胞癌中观察到p53过表达。此外，通过序列分析在成釉细胞癌中发现p53基因（TP53）第5外显子发生突变。
结论
这是首例与癌变相关的p53基因发生突变的成釉细胞癌病例。
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