Macedo Natália Gonçalves, Pappen Fernanda Geraldo, da Fonseca Orcina Bernardo, Mascarenhas Gustavo, Dos Santos Jean Nunes, da Silva Santos Paulo Sérgio, Vieira Carolina Clasen, Garcia Alexandre Simões, Soares Alini Cardoso, Schuch Lauren Frenzel, Gomes Ana Paula Neutzling, Vasconcelos Ana Carolina Uchoa
Diagnostic Center for Oral Diseases, School of Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
Department of Clinical Semiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
Aust Endod J. 2025 Aug;51(2):415-422. doi: 10.1111/aej.12956. Epub 2025 May 30.
This study aimed to report sociodemographic, clinicopathologic and radiological features of 12 cases of aggressive neoplasms that were clinically diagnosed as chronic endodontic lesions. The series comprised seven females (58.33%) and five males (41.67%), with a mean age of 48.9 ± 19.19 years (range: 16-75 years). In six cases (50%), the posterior maxillary region was involved. Internal appearance was radiolucent density (n = 12/100%). Eleven cases (91.67%) exhibited well-defined borders, while one (8.33%) showed ill-defined borders. Histopathologic diagnoses included metastasis (n = 4/33.33%), squamous cell carcinoma (n = 3/25%), mucoepidermoid carcinoma (n = 2/16.68%), acinic cell carcinoma (n = 1/8.33%), Ewing's sarcoma (n = 1/8.33%) and Langerhans cell histiocytosis (n = 1/8.33%). Survival status was retrieved for three patients (25.00%), all of whom were alive at the time of reporting. This study identified seven distinct histological types of aggressive neoplasms that mimic chronic periapical lesions. Given that such lesions often lack clinical or radiological signs of aggressive behaviour, it is imperative that all excised tissue undergo histopathological examination.
本研究旨在报告12例临床上被诊断为慢性牙髓病变的侵袭性肿瘤的社会人口统计学、临床病理和放射学特征。该系列包括7名女性（58.33%）和5名男性（41.67%），平均年龄为48.9±19.19岁（范围：16 - 75岁）。6例（50%）累及上颌后牙区。内部表现为透射密度（n = 12/100%）。11例（91.67%）边界清晰，1例（8.33%）边界不清。组织病理学诊断包括转移瘤（n = 4/33.33%）、鳞状细胞癌（n = 3/25%）、黏液表皮样癌（n = 2/16.68%）、腺泡细胞癌（n = 1/8.33%）、尤因肉瘤（n = 1/8.33%）和朗格汉斯细胞组织细胞增多症（n = 1/8.33%）。对3例患者（25.00%）进行了生存状态检索，报告时所有患者均存活。本研究确定了7种不同组织学类型的侵袭性肿瘤，这些肿瘤可模拟慢性根尖周病变。鉴于此类病变通常缺乏侵袭性行为的临床或放射学征象，所有切除组织均必须进行组织病理学检查。
