Department of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN, CEP 59056-000, Brazil.
Piracicaba School of Dentistry, State University of Campinas, Piracicaba, São Paulo, Brazil.
Head Neck Pathol. 2023 Sep;17(3):688-696. doi: 10.1007/s12105-023-01574-6. Epub 2023 Aug 4.
Recently, a new odontogenic tumor has been described, the so-called adenoid ameloblastoma (AdAM). The aim of this review was to determine the clinical and imaging features of AdAM and to describe its main histopathological findings.
The systematic review included published cases with a diagnosis of AdAM in the gnathic bones, which had sufficient clinical, imaging, and histopathological data to confirm its diagnosis. The following histopathological diagnostic criteria were adopted: presence of ameloblastoma-like components, duct-like structures, spiral cellular condensations, and a cribriform architecture.
Fifteen articles, corresponding to 30 cases of AdAM, were selected. Most cases affected men (63.3%), with a slight preference for the mandible (16:14) and the posterior region of gnathic bones was the most commonly affected site. The mean age at diagnosis was 40.8 years. Clinically, the lesions usually presented as a swelling (53.3%) and, radiographically, as a well-defined radiolucency (33.4%). Surgical resection (40%) was the most frequently adopted treatment and recurrence occurred in 30% of cases. Microscopic examination showed cribriform areas in most AdAM cases (93.3%); duct-like structures and spiral cellular condensations were seen in 100% of the cases.
The small number of reported cases, the existence of erroneous diagnoses, and the adoption of initial conservative management make it difficult to determine whether AdAM has a higher risk of recurrence or more aggressive biological behavior than conventional ameloblastomas.
最近,一种新的牙源性肿瘤被描述为腺样成釉细胞瘤(AdAM)。本综述的目的是确定 AdAM 的临床和影像学特征,并描述其主要的组织病理学发现。
系统综述包括在颌骨中诊断为 AdAM 的已发表病例,这些病例具有足够的临床、影像学和组织病理学数据来确认其诊断。采用以下组织病理学诊断标准:存在成釉细胞瘤样成分、管状结构、螺旋细胞凝聚和筛状结构。
选择了 15 篇文章,共 30 例 AdAM。大多数病例发生于男性(63.3%),下颌骨略占优势(16:14),颌骨后区是最常受累的部位。诊断时的平均年龄为 40.8 岁。临床上,病变通常表现为肿胀(53.3%),影像学上表现为界限清楚的透光区(33.4%)。手术切除(40%)是最常采用的治疗方法,30%的病例复发。大多数 AdAM 病例的显微镜检查显示筛状区域(93.3%);100%的病例可见管状结构和螺旋细胞凝聚。
由于报道的病例数量较少,存在错误诊断,以及采用初始保守治疗,因此难以确定 AdAM 的复发风险是否高于传统成釉细胞瘤,或者其生物学行为是否更具侵袭性。