Department of Oral and Maxillofacial surgery R R Dental College and Hospital Opposite Umra Railway Station 313015, Umarda, Udaipur, Rajasthan
Med Oral Patol Oral Cir Bucal. 2021 Mar 1;26(2):e246-e255. doi: 10.4317/medoral.24152.
Desmoplastic Ameloblastoma (DA) is a rare, true neoplasm of jaws with reported incidence of 4-13% among other variants of Ameloblastoma, however this appears distinct than the classic Ameloblastoma in anatomical distribution and clinical presentation. This is often mistaken as a fibro-osseous lesion because of its similar radiological appearance.
To describe the clinical, radiographic and histopathological characteristics through a series of new cases of histologically proven DA including a case of an exceptionally large, recurrent lesion along with retrospective analysis of cases from literature available for an improved understanding of the behaviour and prognosis of DA. A total of 50 cases were analysed for the anatomical distribution, radiographic presentation and management. Out of the 50 cases, 47 cases were from the English literature reported from 2011 to 2019 and 3 were new cases.
DA showed a slight male predilection (male: female=1.17:1) with a predominance in the fourth and fifth decade of life. Mandibular involvement (52%) was more commonly seen with a marked tendency for the anterior region. Radiographically, most of the lesions presented mixed radiopacity with radiolucency(80%) and root displacement was observed in only 70.27 % cases. Recurrence rate of 26 .47 % was observed. Cases treated with resection resulted in lesser recurrence as compared to those treated with enucleation and curettage.
DA is distinguished by a peculiar display of clinicalopathological parameters. DA has tendency of local disposition and propensity of recurrence, which thus necessitates its aggressive management. It is not possible to conclude or report on the aggressive/recurrent nature and appropriate treatment modality for DA due to inadequate follow-up results.
促结缔组织增生型成釉细胞瘤(DA)是一种罕见的颌骨真性肿瘤,在成釉细胞瘤的其他变异型中发病率为 4-13%,但在解剖分布和临床表现上与经典成釉细胞瘤明显不同。由于其影像学表现相似,常被误诊为纤维骨性病变。
通过一系列经组织学证实的 DA 新病例,描述其临床、影像学和组织病理学特征,包括一例罕见的、复发性巨大病变,并对文献中的病例进行回顾性分析,以更好地了解 DA 的行为和预后。共分析了 50 例病例的解剖分布、影像学表现和治疗方法。这 50 例中,47 例来自 2011 年至 2019 年的英文文献报道,3 例为新病例。
DA 表现出轻微的男性偏好(男:女=1.17:1),发病高峰在第四和第五个十年。下颌骨受累(52%)更为常见,且在前区有明显的倾向。影像学上,大多数病变表现为混合密度,伴透亮区(80%),仅 70.27%的病例观察到牙根移位。观察到 26.47%的复发率。与单纯切除相比,单纯囊内刮除和分块切除术的复发率更高。
DA 的临床病理参数表现独特。DA 具有局部倾向和复发倾向,因此需要积极治疗。由于缺乏随访结果,无法对 DA 的侵袭性/复发性性质和适当的治疗方式做出结论或报告。