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手术减压治疗牙源性钙化囊性瘤的有效性

Effectiveness of surgical decompression in the treatment of a calcifying cystic odontogenic tumor.

作者信息

da Silva Yuri Slusarenko, Queiroz Adalmir Gonzaga Dos Santos, Ferraz Flávio Wellington da Silva, Pinto Décio Dos Santos, Nunes Fabio Daumas, Elias Fernando Mellhem

机构信息

Department of Dentistry - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil.

Department of Oral Pathology - Faculdade de Odontologia - Universidade de São Paulo, São Paulo/SP - Brazil.

出版信息

Autops Case Rep. 2014 Mar 30;4(4):43-49. doi: 10.4322/acr.2014.038. eCollection 2014 Oct-Dec.

Abstract

The calcifying odontogenic cystic tumor (CCOT) is a benign lesion of odontogenic origin characterized by an ameloblastoma-like epithelium with ghost cells that may calcify. Despite broadly considered as a cyst, some investigators prefer to classify it as a neoplasm. Clinically, it occurs predominantly during the third decade of life. No difference in gender prevalence has been observed nor predilection of the lesion between maxilla and mandible. The most affected region extends from the incisor tooth to bicuspids. The classic treatment of the lesion is full excision, although a different approach may be determined by the possible association with another odontogenic tumor. Depending on the tumor size and the vicinity with important structures, decompression may be undertaken before its complete removal. The present report describes a case of CCOT with large proportions, located at the right maxilla and extending to the maxillary sinus, nasal cavity, and orbital floor. The treatment option was surgical decompression as the initial procedure, with satisfactory outcome. After partial remission, the lesion was fully removed, and the post-operative follow-up was uneventful.

摘要

钙化牙源性囊性肿瘤(CCOT)是一种牙源性良性病变,其特征为具有可能发生钙化的影细胞的成釉细胞瘤样上皮。尽管广泛认为它是一种囊肿,但一些研究者更倾向将其归类为肿瘤。临床上,它主要发生在生命的第三个十年。未观察到性别患病率差异,且该病变在上颌骨和下颌骨之间也无偏好。最常受累区域从切牙延伸至双尖牙。该病变的经典治疗方法是完整切除,不过可能因与另一种牙源性肿瘤的关联而确定不同的治疗方法。根据肿瘤大小以及与重要结构的邻近程度,在完全切除之前可进行减压。本报告描述了一例位于右上颌骨且延伸至上颌窦、鼻腔和眶底的大比例CCOT病例。治疗选择是首先进行手术减压,结果令人满意。部分缓解后,病变被完全切除,术后随访无异常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0bd/5443132/b00324fd4098/autopsy-04-04043-g01.jpg

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