Jayasooriya Primali Rukmal, Rambukewella Inoka Krishanthi, Tilakaratne Wanninayake Mudiyanselage, Mendis Balapuwaduge Ranjit Rigobert Nihal, Lombardi Tommaso
Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka.
Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia.
Diagnostics (Basel). 2019 Dec 20;10(1):3. doi: 10.3390/diagnostics10010003.
The objective of the study is to present the clinico-pathological features of cystic and classic adenomatoid odontogenic tumors (AOTs) in order to identify the differences between the two variants of AOT.
The study sample comprised of 41 AOTs, which were categorized into cystic and classic AOTs. Cystic AOTs are diagnosed as such when macroscopic and microscopic evidence of a cyst is present together with histopathological criteria of AOT (WHO-2017).
The study sample comprised of eleven cystic and thirty classic AOTs. Eight cystic AOTs were regarded as arising from dentigerous cysts as these lesions were attached to the cemento-enamel junction of the impacted teeth. Though not statistically significant, in contrast to classic AOTs which showed female predilection, cystic AOTs were more prevalent in males. Cystic AOTs tend to present as significantly larger lesions compared to classic AOTs (p < 0.02). In both cystic and classic AOTs, duct-like structures and epithelial whorls were the two most prominent histopathological features present in the majority of tumors. Two AOTs with massive amounts of dentinoid occurred in the mandible and presented as large lesions that eroded cortical bone. None of the 12 patients with follow-up information presented with recurrences.
Except for the size of the lesion, no significant clinico-pathological differences were observed between cystic and classic AOTs. Therefore the cystic AOTs can be considered as a variant of AOT with enucleation, simple excision, or radical excision as the treatment of choice depending on the extent of the lesion, similar to classic AOTs.
本研究的目的是呈现囊性和经典型牙源性腺样瘤（AOT）的临床病理特征，以确定AOT两种变体之间的差异。
研究样本包括41例AOT，分为囊性AOT和经典型AOT。当存在囊肿的宏观和微观证据以及AOT的组织病理学标准（WHO - 2017）时，诊断为囊性AOT。
研究样本包括11例囊性AOT和30例经典型AOT。8例囊性AOT被认为起源于含牙囊肿，因为这些病变附着于阻生牙的牙骨质 - 釉质界。与表现出女性偏好的经典型AOT相比，囊性AOT在男性中更为常见，尽管差异无统计学意义。与经典型AOT相比，囊性AOT往往表现为明显更大的病变（p < 0.02）。在囊性和经典型AOT中，导管样结构和上皮漩涡是大多数肿瘤中存在的两个最突出的组织病理学特征。下颌骨出现2例大量牙本质样物质的AOT，表现为侵蚀皮质骨的大病变。12例有随访信息的患者均未出现复发。
除病变大小外，囊性和经典型AOT之间未观察到明显的临床病理差异。因此，囊性AOT可被视为AOT的一种变体，与经典型AOT类似，根据病变范围，可选择摘除、单纯切除或根治性切除作为治疗方法。
