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成釉细胞纤维瘤:一种罕见牙源性病变的临床视角

Ameloblastic Fibroma: Clinical Perspectives on a Rare Odontogenic Lesion.

作者信息

Panthula Veerendranath Reddy, Reddy G V, Reddy M R Haranadha, Fatima Sarah, Mir Suhail, G Shivani, Shingade Vyshnavi

机构信息

Department of Periodontics, Panineeya Mahavidyalaya Institute of Dental Sciences & Research Centre, Hyderabad, IND.

Department of Oral and Maxillofacial Surgery, Panineeya Mahavidyalaya Institute of Dental Sciences & Research Centre, Hyderabad, IND.

出版信息

Cureus. 2025 Jul 23;17(7):e88629. doi: 10.7759/cureus.88629. eCollection 2025 Jul.

Abstract

Ameloblastic fibroma (AF) is a rare non-cancerous growth in the jaw that involves abnormal development of the epithelial and connective tissue parts of a tooth. A 33-year-old female presented with bleeding gums, mobile anterior mandibular teeth, and persistent halitosis. Initial oral examination and orthopantomogram revealed a unilocular radiolucent lesion with partially sclerotic borders, associated with an unerupted supernumerary tooth in the mandibular ramus. Computed tomography demonstrated cortical plate thinning around the lesion. Given the clinical and radiographic presentation, a differential diagnosis included odontogenic keratocyst and ameloblastoma. Histopathological evaluation following incisional biopsy and surgical enucleation performed under local anesthesia confirmed the diagnosis of AF, characterized by distinctive epithelial islands and mesenchymal stroma. This case highlights the imperative for meticulous differential diagnosis, supported by histopathological examination, to distinguish AF from related lesions with overlapping features. Given its potential for recurrence and the rare risk of malignant transformation into ameloblastic fibrosarcoma, long-term radiologic surveillance remains essential for optimal patient management.

摘要

成釉细胞纤维瘤(AF)是一种罕见的颌骨非癌性生长病变,涉及牙齿上皮和结缔组织部分的异常发育。一名33岁女性出现牙龈出血、下颌前牙松动和持续口臭。初次口腔检查和全景曲面断层片显示一个单房性透射性病变,边界部分硬化,与下颌支内一颗未萌出的多生牙有关。计算机断层扫描显示病变周围皮质板变薄。根据临床和影像学表现,鉴别诊断包括牙源性角化囊肿和成釉细胞瘤。在局部麻醉下进行切开活检和手术摘除后进行的组织病理学评估证实为AF诊断,其特征为独特的上皮岛和间充质基质。该病例强调了在组织病理学检查支持下进行细致鉴别诊断的必要性,以将AF与具有重叠特征的相关病变区分开来。鉴于其有复发的可能性以及罕见的恶变为成釉细胞纤维肉瘤的风险,长期影像学监测对于优化患者管理仍然至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68d0/12373520/4955adf0aa83/cureus-0017-00000088629-i01.jpg

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本文引用的文献

1
Solitary ameloblastic fibroma with impacted teeth: A case report.孤立性成釉细胞瘤伴牙阻生:一例报告。
J Craniomaxillofac Surg. 2024 Oct;52(10):1055-1062. doi: 10.1016/j.jcms.2024.06.010. Epub 2024 Jun 18.
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Epidemiological study of odontogenic tumours: An institutional experience.牙源性肿瘤的流行病学研究:机构经验。
J Infect Public Health. 2017 May-Jun;10(3):324-330. doi: 10.1016/j.jiph.2016.05.014. Epub 2016 Jul 15.
5
Ameloblastic fibroma: an uncommon entity.成釉细胞纤维瘤:一种罕见的病变。
BMJ Case Rep. 2013 Jul 9;2013:bcr2013010279. doi: 10.1136/bcr-2013-010279.
7
Rare peripheral odontogenic tumors: report of 5 cases and comprehensive review of the literature.罕见的外周性牙源性肿瘤:5例报告及文献综述
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Oct;106(4):e22-8. doi: 10.1016/j.tripleo.2008.05.064. Epub 2008 Aug 20.

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