Ando Toshinori, Shrestha Madhu, Nakamoto Takashi, Uchisako Kaori, Yamasaki Sachiko, Koizumi Koichi, Ogawa Ikuko, Miyauchi Mutsumi, Takata Takashi
Department of Oral and Maxillofacial Pathobiology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Oral and Maxillofacial Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Pathol Int. 2017 Jul;67(7):365-369. doi: 10.1111/pin.12543. Epub 2017 May 25.
Primordial odontogenic tumor (POT) is a rare lesion in the jaw which has been included as a new entity of benign mixed epithelial and mesenchymal odontogenic tumour in the latest World Health Organization (WHO) classification (2017). Only seven cases have been reported. It typically occurs in the posterior mandible. We report an additional case of POT in the maxilla of an 8-year-old girl presenting with an asymptomatic buccal enlargement. A well-defined, unilocular, radiolucent lesion was observed radiographically. Histologically, the tumor was mostly composed of loose fibrous connective tissue resembling dental papilla and a single layer of columnar epithelium covering the periphery of the tumor. In part, cords or nests of epithelium were present in the mesenchyme close to the periphery. Nestin, a marker of odontogenic ectomesenchyme, was positive in the mesenchymal tumor cells. We finally diagnosed the lesion as POT considering the possibility of other odontogenic tumors like ameloblastic fibroma or developing odontoma as a differential diagnosis. The patient shows no recurrence after 16 months. This case is the first report from Japan using this novel diagnosis POT after it was recognized and defined in the latest WHO classification.
原始牙源性肿瘤(POT)是颌骨中一种罕见的病变,在世界卫生组织(WHO)最新分类(2017年)中被列为良性混合性上皮和间充质牙源性肿瘤的一个新实体。仅报道过7例。它通常发生在下颌后部。我们报告了一例发生在一名8岁女孩上颌骨的POT病例,表现为无症状的颊部膨隆。影像学检查发现一个边界清晰、单房性的透射性病变。组织学上,肿瘤主要由类似牙乳头的疏松纤维结缔组织和覆盖肿瘤周边的单层柱状上皮组成。部分区域,靠近周边的间充质中有上皮条索或巢状结构。巢蛋白是牙源性外间充质的标志物,在间充质肿瘤细胞中呈阳性。考虑到其他牙源性肿瘤如成釉细胞纤维瘤或发育中的牙瘤作为鉴别诊断的可能性,我们最终将该病变诊断为POT。该患者在16个月后未复发。这是日本在WHO最新分类中确认并定义POT后首例使用这一新诊断的报告。