Cumpătă Cristian Niky, Munteanu Maria Cristina, Andrei Elena Cristina, Liliac Ilona Mihaela, Busuioc Cristina Jana, Di Francesco Paolo, Moldovan Mădălina Anca, Enache Simona Iuliana, Burcea Alexandru, Pătru Ciprian Laurenţiu, Roman Călin Rareş
Department of Histology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania;
Rom J Morphol Embryol. 2024 Oct-Dec;65(4):617-625. doi: 10.47162/RJME.65.4.08.
Pindborg tumor is a calcifying epithelial odontogenic tumor possibly arising from developmental disturbances in dental lamina remnants. It predominantly affects individuals in their third decade of life, with women also experiencing later onset. The tumor exists in two forms, namely intraosseous (central) and extraosseous (peripheral), with the former showing higher post-surgery recurrence rates of about 14%. Despite its rarity, the tumor can be misdiagnosed due to symptoms resembling dental issues and headaches, or it may even be asymptomatic. Radiologically, it presents a mix of radiolucent and radiopaque areas, sometimes unilocular or multilocular. Histopathologically, it is characterized by nests and sheets of polygonal epithelial cells with eosinophilic cytoplasm and prominent nucleoli. The presence of eosinophilic amyloid-like material and calcifications is distinctive, ranging from small concretions to larger aggregates. The exact origin of amyloids is unknown, but they are thought to derive from degraded keratin filaments. Treatment varies by tumor location, with more invasive procedures required for jaw tumors, including bone resection, due to their aggressive growth and invasion of the surrounding tissues. Accurate, individualized treatment is crucial for patient outcomes, particularly in cases where the tumor's calcification is absent, indicating a severe impact on health. Our study included a case report of a 12-year-old patient who presented to the dental clinic complaining of sporadic pain in the area of the lower right front teeth. During a clinical examination of the area, we noticed a deformation of the alveolar bone, with a depressed mucosa. We followed the chronological steps of radiological examination, lesion excision, and histopathological examination to obtain a definitive diagnosis.
平博尔格瘤是一种钙化上皮性牙源性肿瘤,可能起源于牙板残余的发育紊乱。它主要影响30岁左右的人群,女性发病年龄稍晚。该肿瘤有两种形式,即骨内(中央型)和骨外(周边型),前者术后复发率较高,约为14%。尽管这种肿瘤罕见,但由于症状类似牙齿问题和头痛,或者甚至可能无症状,它可能会被误诊。在放射学上,它表现为透射区和阻射区的混合,有时为单房或多房。在组织病理学上,它的特征是多边形上皮细胞巢和片状结构,细胞质嗜酸性,核仁突出。嗜酸性淀粉样物质和钙化的存在很有特点,从小的结石到较大的聚集体不等。淀粉样物质的确切来源尚不清楚,但据认为它们源自降解的角蛋白丝。治疗方法因肿瘤位置而异,颌骨肿瘤由于其侵袭性生长和对周围组织的侵犯,需要更具侵入性的手术,包括骨切除。准确、个体化的治疗对患者的预后至关重要,特别是在肿瘤无钙化的情况下,这表明对健康有严重影响。我们的研究包括一例12岁患者的病例报告,该患者到牙科诊所就诊,主诉右下前牙区域有散发性疼痛。在对该区域进行临床检查时,我们注意到牙槽骨变形,黏膜凹陷。我们按照放射学检查、病变切除和组织病理学检查的时间顺序步骤来获得明确诊断。