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颌骨牙源性肿瘤和囊性病变全景:单机构经验

Panorama of Odontogenic Tumours and Cystic Lesions of Jaw: A Single Institutional Experience.

作者信息

Ramesh M, Kale Karan Datta, Balasubramaniam R, Satishkumar M, Gurumoorthy A N

机构信息

Department of Surgical Oncology, Madurai Medical College, Madurai, Tamil Nadu India.

A/204, Ekta Bhoomi Gardens I&II, Rajendra Nagar, Borivali East, Mumbai, 400066 India.

出版信息

Indian J Surg Oncol. 2025 Feb;16(1):47-52. doi: 10.1007/s13193-024-02014-9. Epub 2024 Jul 15.

Abstract

Odontogenic tumours are relatively rare tumours presenting with varied behaviour ranging from hamartomatous lesion to malignant neoplasm. Majority of them are benign, whereas few cases are malignant which may arise de novo or in background of benign tumour. The aim of this study is to evaluate the pattern of presentation, epidemiological characteristics, histological types and management of a series of odontogenic tumours and cystic lesions of jaw. A prospective observational study was undertaken on all treated cases of odontogenic tumours and cystic lesion of jaw in the Department of Surgical Oncology of a state-affiliated Regional Cancer Centre of Tamil Nadu. Twenty-six cases fulfilled the inclusion criteria of the total 32 cases of odontogenic tumour and cystic lesions of jaw encountered at our institution between february 2021 and july 2023 were enrolled for study. The epidemiological data, clinical presentation and modalities used for treatment were noted and data analysis done with SPSS software. Ameloblastoma was the most common pathology accounting for 50% of total cases. Ameloblastoma was commonly present in male, with male to female ratio of 3:1 and a relatively uniform distribution through 2 to 7 decade, with a mean diameter of 9.3 cm. Mandibular/maxillary resection was needed for 91.7% cases. Cervical lymph nodes were enlarged in 31% of cases of ameloblastoma but none was metastatic. Other pathologies identified were cemento-osseus fibroma (7.7%), odontogenic myxoma (7.7%) and odontogenic keratocyst (7.7%). Mandible was commonly involved site in 93% in odontogenic tumour. No case of recurrence was noted amongst 81% cases on follow-up. Ameloblastoma is the most common histology amongst all odontogenic tumours and cystic lesion of jaw. Indolent course leads to large dimensions of these tumours with treatment challenge and some forms of mandibular/maxillary resections are required for majority of cases thus incurring variable degree of morbidity. On contrary, larger the diameter of tumour required less of flap reconstruction due to redundant skin and mucosa post excision of tumour. There is low recurrence rate with margin negative resections.

摘要

牙源性肿瘤是相对罕见的肿瘤,其行为多样,从错构瘤性病变到恶性肿瘤不等。它们大多数是良性的,而少数病例是恶性的,可能是原发性的,也可能发生在良性肿瘤的背景下。本研究的目的是评估一系列颌骨牙源性肿瘤和囊性病变的表现模式、流行病学特征、组织学类型及治疗方法。对泰米尔纳德邦一家州立附属区域癌症中心外科肿瘤学部门所有接受治疗的颌骨牙源性肿瘤和囊性病变病例进行了一项前瞻性观察研究。在2021年2月至2023年7月期间,我们机构共遇到32例颌骨牙源性肿瘤和囊性病变,其中26例符合纳入标准并被纳入研究。记录了流行病学数据、临床表现和治疗方式,并使用SPSS软件进行数据分析。成釉细胞瘤是最常见的病理类型,占总病例的50%。成釉细胞瘤常见于男性,男女比例为3:1,在2至7个十年中分布相对均匀,平均直径为9.3厘米。91.7%的病例需要进行下颌骨/上颌骨切除。31%的成釉细胞瘤病例出现颈部淋巴结肿大,但均无转移。其他确定的病理类型有骨化纤维瘤(7.7%)、牙源性黏液瘤(7.7%)和牙源性角化囊肿(7.7%)。在牙源性肿瘤中,下颌骨是最常受累的部位,占93%。随访中81%的病例未发现复发情况。成釉细胞瘤是所有颌骨牙源性肿瘤和囊性病变中最常见的组织学类型。病程进展缓慢导致这些肿瘤体积较大,带来治疗挑战,大多数病例需要进行某种形式的下颌骨/上颌骨切除,从而导致不同程度的发病率。相反,肿瘤直径越大因肿瘤切除后皮肤和黏膜冗余而所需的皮瓣重建越少。切缘阴性切除的复发率较低。

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