Nastri A L, Wiesenfeld D, Radden B G, Eveson J, Scully C
Department of Oral and Maxillofacial Surgery, Royal Melbourne Hospital, Victoria, Australia.
Br J Oral Maxillofac Surg. 1995 Feb;33(1):28-32. doi: 10.1016/0266-4356(95)90082-9.
Ameloblastoma is uncommon in the maxilla, comprising about 15% of all reported ameloblastomas. Ameloblastomas are locally aggressive and, when involving the maxilla, potentially lethal. The long term outcome of 13 patients with ameloblastoma in the maxilla for whom surgery was the primary treatment between 1951-1990 was studied. Patient records from both private and public practices in Melbourne, Australia were examined as were those cases reported to the Bone Tumour Registry at the University of Bristol, England. The study showed that control of disease was achieved in all patients where the tumour was limited to the confines of the maxilla (10 cases). The mean follow-up period in this group was 7 years (range 2-20 years). In the three cases that recurred all had preoperative radiological evidence of posterior maxillary sinus wall destruction and/or pterygoid plate erosion. Two patients died of extensive local recurrence and one has persistence of the disease. Histopathological examination confirmed the diagnosis of ameloblastoma in each case with a variety of histological patterns being noted. It is concluded that notwithstanding histological type, the extent of the tumour at presentation and the adequacy of the surgical approach and removal were the main factors in successfully managing the disease.
成釉细胞瘤在上颌骨中较为少见，约占所有报道的成釉细胞瘤的15%。成釉细胞瘤具有局部侵袭性，累及上颌骨时可能致命。本研究对1951年至1990年间接受手术作为主要治疗方法的13例上颌骨成釉细胞瘤患者的长期预后进行了研究。对澳大利亚墨尔本私立和公立医疗机构的患者记录以及向英国布里斯托大学骨肿瘤登记处报告的病例进行了检查。研究表明，所有肿瘤局限于上颌骨范围内的患者（10例）疾病均得到控制。该组患者的平均随访期为7年（范围2至20年）。在复发的3例患者中，术前影像学检查均显示上颌窦后壁破坏和/或翼板侵蚀。2例患者死于广泛局部复发，1例患者疾病持续存在。组织病理学检查在每例病例中均确诊为成釉细胞瘤，并观察到多种组织学模式。研究得出结论，尽管组织学类型不同，但肿瘤的呈现范围、手术方法的适当性和切除程度是成功治疗该疾病的主要因素。
