成釉细胞瘤:发病机制、临床和放射学特征、分类和处理

G. Aoun
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摘要

背景:成釉细胞瘤是影响颌骨的良性上皮性牙源性肿瘤。目的:综述成釉细胞瘤的发病机制、临床和影像学特征、分类和治疗。方法:以Pubmed数据库为主要检索对象,检索关键词:“成釉细胞瘤发病机制”;“造釉细胞瘤分类”;“造釉细胞瘤历史”;《成釉细胞瘤的临床及影像学特征》;以及“成釉细胞瘤的治疗”。结果:2017年,世卫组织将成釉细胞瘤分为三类:a)单囊性,b)常规,c)骨外/外周性。临床表现为生长缓慢、局部、侵袭性肿瘤。影像学上,主要表现为广泛的、透光的、多房影像,典型的“肥皂泡样”外观,有较薄、扩大和侵蚀的皮质板。连在一起的未爆发的牙齿移位,相邻牙齿的牙根进行明显的吸收。结论:由于成釉细胞瘤的体征和症状较晚,通常在晚期才被发现。他们的治疗通常包括有安全边缘的大面积切除和可能时立即重建。术后定期长期随访是最佳治疗效果和预防复发的必要条件。
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Ameloblastoma: Pathogenesis, Clinical and Radiological Features, Classification, and Management
Background: Ameloblastoma are benign epithelial odontogenic tumors affecting the jaws. Objective: The main objective of this article is to review the pathogenesis, clinical and radiological features, classification, and management of ameloblastoma. Methods: A literature review mainly of the Pubmed database was done using the keywords: “ameloblastoma pathogenesis”; “ameloblastoma classification”; “ameloblastoma history”; “clinical and radiological features of ameloblastoma”; and “management of ameloblastoma”. Results: In 2017, ameloblastomas were classified by W.H.O into three categories: a) unicystic, b) conventional, and c) extraosseous/peripheral. Clinically, they are slow-growing, localized, aggressive neoplasms. Radologically, they mainly present as extensive, radiolucent, multilocular images, with a typical “soap bubble-like” appearance with a thinner, expanded, and eroded cortical plate. The linked non-erupted tooth is displaced and the roots of the adjacent teeth undergo clear resorption. Conclusion: Because of their late signs and symptoms, ameloblastomas are usually identified at an advanced stage. Their management typically includes a large resection with safety margins and immediate reconstruction when possible. Regular long-term postoperative follow-ups are mandatory for optimum treatment outcome and recurrence prevention.
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