Noguchi Kazuma, Kishimoto Hiromitsu, Yamanegi Koji, Moridera Kuniyasu, Takaoka Kazuki, Urade Masahiro
Department of Oral and Maxillofacial Surgery, Hyogo College of Medicine, Hyogo, Japan
Department of Oral and Maxillofacial Surgery, Hyogo College of Medicine, Hyogo, Japan.
J Surg Case Rep. 2013 May 9;2013(5):rjt033. doi: 10.1093/jscr/rjt033.
Ameloblastoma is the most common odontogenic tumor, but the incidence of its metastasis is extremely low. We report a case of unicystic ameloblastoma metastasizing to the cervical lymph nodes. This patient pointed out a radiolucent cystic lesion with impacted wisdom tooth in the left mandibular region, and recieved enucleation of the cystic lesion and removal of the wisdom tooth. Histopathogical diagnosis was unicystic ameloblastoma. Three years later, this patient complained of a swelling in the left submandibular region. A CT scan showed a bilobed cystic mass measuring 30 mm in diameter compressing the submandibular gland, and we performed extirpation of the mass with the submandibular gland and associated lymph nodes. Histologically, the lesion was cystic and lymph follicles were seen in the cyst-like wall. The laminated epithelium of cyst wall was ameloblastomatous epithelium, and two lymph nodes associated with cystic lesion also included ameloblastomatous epithelium. This is the first report of metastasizing unicystic ameloblastoma.
成釉细胞瘤是最常见的牙源性肿瘤,但其转移发生率极低。我们报告一例单囊性成釉细胞瘤转移至颈部淋巴结的病例。该患者左下颌区域有一含阻生智齿的透射性囊性病变,接受了囊性病变摘除术及智齿拔除术。组织病理学诊断为单囊性成釉细胞瘤。三年后,该患者主诉左下颌下区肿胀。CT扫描显示一个直径30mm的分叶状囊性肿物压迫下颌下腺,我们对该肿物连同下颌下腺及相关淋巴结进行了切除。组织学检查显示,病变呈囊性,囊壁可见淋巴滤泡。囊壁的分层上皮为成釉细胞瘤样上皮,与囊性病变相关的两个淋巴结也含有成釉细胞瘤样上皮。这是单囊性成釉细胞瘤转移的首例报告。