Mosqueda-Taylor Adalberto, Neville Brad W, Tatemoto Yukihiro, Ogawa Ikuko, Takata Takashi
Departamento de Atención a la Salud, Universidad Autónoma Metropolitana Xochimilco, Calzada del Hueso 1100, Col. Villa Quietud, 04960, Mexico, D.F., Mexico,
Head Neck Pathol. 2014 Dec;8(4):421-31. doi: 10.1007/s12105-014-0586-9. Epub 2014 Nov 20.
Dentinoid is an integral part of some odontogenic tumors. This article describes the clinico-pathological features of three cases of odontogenic carcinomas with dentinoid (OCD). A comparison of these with previously reported cases of dentinoid-producing epithelial odontogenic tumors allowed us to identify another six cases that may be considered as examples of OCD. Six cases occurred in the mandible and three in the maxilla, all developing behind the canines. There was no sex predilection (five men and four women; age range 14-61 years, mean 38.1). Pain or discomfort was mentioned in five cases, four of which showed tooth resorption. All cases appeared initially as well-defined radiolucencies, five of which showed variable amounts of calcified material. Recurrences were recorded in three instances, but no evidence of metastasis has been found. Seven cases were composed predominantly or entirely of clear cells, usually with minimal cellular atypia and variable mitotic activity; however, in all cases there was evidence of tumor infiltration into adjacent tissues, including the presence of perineural invasion in two tumors. Those cases in which no reference was made to the presence of clear cells exhibited evident mitotic activity and cellular pleomorphism. The epithelium in OCD does not produce buds or enamel organ-like structures such as those found in ameloblastic fibro-dentinoma and this tumor does not contain a mesenchyme-like connective tissue resembling dental papilla as observed in several mixed odontogenic tumors. Based on the existing data and the present series of cases, OCD appears to represent a distinct entity.
类牙本质是一些牙源性肿瘤的组成部分。本文描述了三例伴有类牙本质的牙源性癌（OCD）的临床病理特征。将这些病例与先前报道的产生类牙本质的上皮性牙源性肿瘤病例进行比较，使我们能够识别出另外六例可被视为OCD的病例。六例发生在下颌骨，三例发生在上颌骨，均发生在尖牙后方。无性别倾向（五名男性和四名女性；年龄范围14 - 61岁，平均38.1岁）。五例提到有疼痛或不适，其中四例显示牙齿吸收。所有病例最初均表现为边界清晰的透射区，其中五例显示有不同量的钙化物质。有三例记录到复发，但未发现转移证据。七例主要或完全由透明细胞组成，通常细胞异型性最小，有不同程度的有丝分裂活性；然而，所有病例均有肿瘤浸润至相邻组织的证据，包括两例肿瘤中有神经周围浸润。那些未提及有透明细胞的病例表现出明显的有丝分裂活性和细胞多形性。OCD中的上皮不产生芽或成釉器样结构，如成釉细胞纤维牙本质瘤中所见，并且该肿瘤不像几种混合性牙源性肿瘤那样含有类似牙乳头的间充质样结缔组织。基于现有数据和本系列病例，OCD似乎代表一种独特的实体。
