Gardner D G, Pecak A M
Cancer. 1980 Dec 1;46(11):2514-9. doi: 10.1002/1097-0142(19801201)46:11<2514::aid-cncr2820461133>3.0.co;2-9.
A number of important factors must be considered in planning the treatment of ameloblastoma. It is essential to distinguish among the three clinical types of ameloblastoma--the intraosseous solid or multicystic lesion, the well-circumscribed unicystic type, and the rare peripheral (extraosseous) ameloblastoma--because they require different forms of treatment. Unicystic ameloblastomas in which the tumor extends into the lumen of the cyst or involves only the cystic lining can be expected to be removed completely by enucleation. This approach, however, is inadequate if the tumor has invaded the periphery of the fibrous connective tissue wall. Ameloblastomas may invade the intertrabecular spaces of cancellous bone but do not invade compact bone, although they may erode it. Ameloblastomas in the posterior part of the maxilla should be treated more extensively than similar lesions in the mandible because of the proximity of the posterior maxilla to vital structures and the difficulty in treating any recurrences. This article discusses the treatment of ameloblastoma based on these pathologic and anatomic considerations and includes brief discussions of the role of cautery, cryotherapy, and radiotherapy.
在规划成釉细胞瘤的治疗方案时，必须考虑一些重要因素。区分成釉细胞瘤的三种临床类型至关重要，即骨内实性或多囊性病变、边界清晰的单囊性类型以及罕见的外周型（骨外型）成釉细胞瘤，因为它们需要不同的治疗方式。肿瘤延伸至囊肿腔内或仅累及囊肿衬里的单囊性成釉细胞瘤有望通过摘除术完全切除。然而，如果肿瘤侵犯了纤维结缔组织壁的周边，这种方法就不够了。成釉细胞瘤可能侵犯松质骨的小梁间隙，但不会侵犯密质骨，尽管可能会侵蚀它。由于上颌后部靠近重要结构且复发后治疗困难，上颌后部的成釉细胞瘤应比下颌类似病变接受更广泛的治疗。本文基于这些病理和解剖学因素讨论了成釉细胞瘤的治疗方法，并简要讨论了烧灼术、冷冻疗法和放射疗法的作用。
