Ameloblastoma: 25 Year Experience at a Single Institution

被引：45
作者：
Milman T. [1 ]
Ying G.-S. [2 ]
Pan W. [2 ]
LiVolsi V. [1 ]
机构：
[1] Departments of Pathology and Laboratory Medicine, Perelman School of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, 19104, PA
[2] Department of Ophthalmology, Center for Preventive Ophthalmology and Biostatistics, Scheie Eye Institute, Perelman School of Medicine, Philadelphia, PA
来源：
Head and Neck Pathology | 2016年 / 10卷 / 4期
关键词：
Ameloblastoma; Ameloblastoma histologic pattern; Ameloblastoma management; Ameloblastoma pathology; Ameloblastoma prognosis; Ameloblastoma recurrence;
D O I：
10.1007/s12105-016-0734-5
中图分类号：
学科分类号：
摘要：
Ameloblastoma is a rare, locally aggressive odontogenic neoplasm, accounting for fewer than 1 % of head and neck tumors. Recent literature suggests that the initial surgical approach and histologic growth patterns are the most important prognostic determinants in ameloblastoma. The aim of this study was to compare the clinical presentation, management, and outcomes of patients with ameloblastoma with data reported in the literature; the study spanned 2 decades at a single institution. The institution’s database was searched for all patients with pathologically confirmed ameloblastoma, diagnosed between 1990 and 2015. The data collected included sex, age, clinical and imaging findings, management, histologic pattern, clearance of surgical margins, length of follow-up, time to recurrence, and disease-related mortality. The potential risk factors of recurrence were evaluated using log-rank test, proportional hazard model, and Fisher exact test. Review of the database yielded 54 patients with pathologically confirmed ameloblastoma and follow-up. Recurrence was noted in 13 (24 %) patients. Surgical approach was associated with the risk of recurrence (6.1 % following radical resection vs. 52 % following limited surgery, p = 0.002). There were trends toward higher recurrence rate in the group with pathologically documented positive margins (p = 0.054) and in follicular ameloblastoma (p = 0.35). Transformation into ameloblastic carcinoma was identified in two patients. There was no disease-related mortality. Our study confirms the recent data regarding the importance of radical surgical resection in management of ameloblastoma. Surgical approach appears to be the strongest predictor of tumor clearance. © 2016, Springer Science+Business Media New York.
引用
收藏
页码：513 / 520
页数：7
相关论文
共 22 条
  • [1] Reichart P.A., Philipsen H.P., Sonner S., Ameloblastoma: biological profile of 3677 cases, Eur J Cancer Part B Oral Oncol, 31B, pp. 86-99, (1995)
  • [2] Zwahlen R.A., Gratz K.W., Maxillary ameloblastomas: a review of the literature and of a 15-year database, J Craniomaxillofac Surg, 30, pp. 273-279, (2002)
  • [3] Barnes L., Eveson J.W., Reichart P., Sidransky D., World Health Organization classification of tumors. Pathology and genetics of head and neck tumours, (2005)
  • [4] McClary A.C., West R.B., McClary A.C., Pollack J.R., Fischbein N.J., Holsinger C.F., Sunwoo J., Colevas A.D., Sirjani D., Ameloblastoma: a clinical review and trends in management, Eur Arch Otorhinolaryngol, (2015)
  • [5] Luo D.Y., Feng C.J., Guo J.B., Pulmonary metastases from an ameloblastoma: case report and review of the literature, J Craniomaxillofac Surg, 40, pp. e470-e474, (2012)
  • [6] Kyriazis A.P., Karkazis G.C., Kyriazis A.A., Maxillary ameloblastoma with intracerebral extension. Report of a case, Oral Surg Oral Med Oral Pathol, 32, pp. 582-587, (1971)
  • [7] Daramola J.O., Abioye A.A., Ajagbe H.A., Aghadiuno P.U., Maxillary malignant ameloblastoma with intraorbital extension: report of case, J Oral Surg, 38, pp. 203-206, (1980)
  • [8] Hayashi N., Iwata J., Masaoka N., Ueno H., Ohtsuki Y., Moriki T., Ameloblastoma of the mandible metastasizing to the orbit with malignant transformation. A histopathological and immunohistochemical study, Virchows Arch, 430, pp. 501-507, (1997)
  • [9] Hong J., Yun P.Y., Chung I.H., Myoung H., Suh J.D., Seo B.M., Lee J.H., Choung P.H., Long-term follow up on recurrence of 305 ameloblastoma cases, Int J Oral Maxillofac Surg, 36, pp. 283-288, (2007)
  • [10] Pogrel M.A., Montes D.M., Is there a role for enucleation in the management of ameloblastoma?, Int J Oral Maxillofac Surg, 38, pp. 807-812, (2009)
123