Adenomatoid Odontogenic Tumor-A Retrospective Study and Review of the Literature

腺瘤樣齒源性瘤－回溯性研究與文獻回顧

Chia-Jung Tsai(蔡佳容)；Chin-Yu Yen(顏欽堉)；Chien-Feng Li(李健逢)；Hsi-Chien Yu(于錫倩)

Adenomatoid odontogenic tumor ； Ameloblastoma ； Odontogenic cyst ； Differential diagnosis ； 腺樣齒源性腫瘤 ； 造釉細胞瘤 ； 齒源性囊腫 ； 鑑別診斷

臺灣口腔顎面外科學會雜誌

35卷3期（2024 / 09 / 01）

185 - 198

英文;繁體中文

Objective: The adenomatoid odontogenic tumor (AOT) is a rare epithelial neoplasm of odontogenic origin that is frequently misdiagnosed at initial presentation. This study aims to analyze cases diagnosed with AOT by summarizing the clinical characteristics and comparing these findings with the literature, with the goal of improving clinical practice through more accurate diagnosis and treatment planning. Material and Methods: A retrospective study was conducted on all AOT cases diagnosed at the Department of Oral and Maxillofacial Surgery and the Department of Dentistry at Chi Mei Medical Center from January 1999 to May 2024. Data on patient demographics and pathological characteristics were collected and comprehensively analyzed. Results: A total of 6 reports with a pathologic diagnosis of "AOT" were included in this research. The majority of patients were between 10 to 15 years old, with one exception being 43 years old. There was a higher prevalence in females (83.3%, n=5). The lesions were equally distributed between the maxilla and mandible. Notably, 66.7% of the cases were associated with impacted teeth. Preoperative biopsies were rarely performed, except in one case where the initial diagnosis suggested ameloblastoma. An aggressive pattern was observed in one case. No recurrences were reported in all cases during the follow-up period. Conclusion: AOTs can be easily misdiagnosed as more frequently encountered odontogenic lesions based on radiographic and clinical examinations, such as odontogenic cysts, odontogenic keratocysts, or ameloblastomas. Our findings align with the current literature, underscoring the necessity for meticulous evaluation and differential diagnosis to ensure appropriate treatment planning, especially in cases where AOTs resemble other aggressive odontogenic tumors.

目的：腺樣齒源性腫瘤為臨床罕見的齒源性上皮性腫瘤，診斷上因與其他齒源性腫瘤相似，容易出現誤診。本研究希望能透過回溯病歷的分析，呈現該類型腫瘤的臨床特徵，並與現有文獻進行比較，增加臨床診斷及治療的效率。材料和方法：本研究搜尋自1999年1月至2024年5月間，於奇美醫學中心病理科病理資料庫中，來自口腔顎面外科及牙科部並診斷為腺樣齒源性腫瘤之病理報告，並對其病例進行回顧性分析。結果：本研究共納入6例病理診斷為「腺樣齒源性腫瘤」的報告。多數患者年齡分布於10至15歲，唯一的例外為43歲。女性患者比例較高（83.3%，n=5）。病灶於於上、下顎骨的發生率相同。66.7%的案例中腫瘤與埋伏齒相關。大多病例未在進行術前切片，而唯一進行術前切片之案例初步診斷為造釉細胞瘤。其中一項案例出現較具侵犯性的特徵。在案例術後追蹤期間，皆未發現復發之情形。結論：腺樣齒源性腫瘤容易因影像、臨床檢查和發生率而被誤診為更常見的齒源性病變，如齒源性囊腫、角化囊腫性齒源性腫瘤或造釉細胞瘤。本篇研究的搜尋結果中，案例的臨床特性大致與現有文獻相符，更加確認臨床特徵作為鑑別診斷依據的重要性。尤其當腺樣齒源性腫瘤與其他較具侵犯性的腫瘤表現相似時，透過正確及仔細地診斷，更能確保患者獲得適當的治療。