Portal de Periódicos da CAPES

Intraosseous ameloblastoma

2010; Elsevier BV; Volume: 110; Issue: 5 Linguagem: Inglês

10.1016/j.tripleo.2010.02.040

1528-395X

Candice C. Black, Rocco R. Addante, Carrie A. Mohila,

Head and Neck Surgical Oncology

Ameloblastomas are benign slow-growing aggressive neoplasms with a poorly understood potential for rare metastasis. They are capable of reaching large sizes with extensive local bone erosion and destruction. They are composed of a mixture of ameloblastic epithelium and mesenchyme and arise from rests of outer and inner enamel epithelium and dental lamina. Microscopically, ameloblastomas are recognizable from their recapitulation of embryologic ameloblasts and stellate reticulum. There are 3 subtypes: the conventional or solid-multicystic variant, the unicystic variant, and the desmoplastic variant. Treatment planning for a given tumor includes consideration of location, primary versus recurrent, size, presence of cortical perforation, and age and health of the patient. Complete excision is recommended for conventional and desmoplastic variants. The unicystic variant requires additional subtyping to determine the best treatment approach. Ameloblastomas are benign slow-growing aggressive neoplasms with a poorly understood potential for rare metastasis. They are capable of reaching large sizes with extensive local bone erosion and destruction. They are composed of a mixture of ameloblastic epithelium and mesenchyme and arise from rests of outer and inner enamel epithelium and dental lamina. Microscopically, ameloblastomas are recognizable from their recapitulation of embryologic ameloblasts and stellate reticulum. There are 3 subtypes: the conventional or solid-multicystic variant, the unicystic variant, and the desmoplastic variant. Treatment planning for a given tumor includes consideration of location, primary versus recurrent, size, presence of cortical perforation, and age and health of the patient. Complete excision is recommended for conventional and desmoplastic variants. The unicystic variant requires additional subtyping to determine the best treatment approach. Diagnostic criteria for unicystic ameloblastoma: ameloblastic versus ameloblastomatous epitheliumOral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and EndodonticsVol. 111Issue 5PreviewBlack et al. recently ably reviewed the diagnosis and treatment of ameloblastoma.1 In their Fig. 5, they illustrate histologic features of a putative “unicystic ameloblastoma.” Histologically, its obliquely sectioned columnar lining epithelium lacks ameloblastomatous features. That is, it lacks evidence of “reverse polarization”: Palisaded columnar cells with tall dark nuclei polarized away from the basement membrane by subnuclear clear cytoplasmic vacuoles are not observed.2,3 The lining epithelium additionally demonstrates small islands and cords of odontogenic epithelium budding into the connective tissue in a pattern not characteristically seen in ameloblastoma but typically observed in dental follicular tissue. Full-Text PDF