良性成牙骨质细胞瘤12例临床病理分析

Clinical and pathological study of benign cementoblastoma(A report of 12 cases)

目的 分析12例良性成牙骨质细胞瘤的临床病理特征。方法 对12例良性成牙骨质细胞瘤分别从患者发病年龄、性别、发病部位、临床表现、X线特征，组织病理学表现及治疗方式等方面进行回顾性分析。结果12例良性成牙骨质细胞瘤患者，发病年龄13～58岁，平均33．8岁；好发于下颌骨（66．7％），后牙区较多见（91．7％）；最常见的症状是颌骨膨胀（75％）和疼痛（25％）。X线片特征是：肿瘤与牙根关系密切；肿瘤中央区为高密度阻射影，周围为环状低密度透射影。组织学上表现为不规则排列牙骨质样物体附着于牙根，有明显的嗜碱性反折线形成。采用摘除肿瘤并拔除受累牙的治疗方式可治愈。结论 良性成牙骨质细胞瘤好发于中青年，颌骨后牙区最常见，多表现为疼痛或颌骨膨胀，X线片特征与组织病理学表现结合有助于该肿瘤与骨母细胞瘤、化牙骨质纤维瘤和非典型骨肉瘤鉴别。

Objective To make a summary of clinical and pathological features of benign cementoblastoma. Methods We reported 12 cases of benign cementoblastoma, and analyzed their clinical and pathological data, including patient ages at diagnosis, sex, occurrence, clinical presentation, radiographic and pathological features and their treatment. Results Patient ages at diagnosis ranged from 13 to 58 years, with a mean age of 33.8 years. The tumors affected 6 males and 6 females. The main site of tumors involvement was mandibular（66.7 % ）, with retromolar area most commonly involved（91.7 % ）. Pain （25 % ） and swelling （75 % ） were the most common symptoms. Radiographically, most cemetoblastomas exhibited a central opacity surrounded by a radiolucent halo. Microscopically, cementoblastomas were formed by prollferating cementum-like tissue attached to tooth root and exhibiting prominent reversal lines. A regime of tumor resection and affected tooth extraction can get good therapeutic result. Conclusion Benign cementoblastoma occurs more commonly in youth and middle aged patients, with premolar-molar region of jaw frequently involved; usually it presents with pain or expansion of jaw; X ray and histopathologieal features combined can distinguish it from osteoblastoma, cemento-ossifying fibroma and atypical osteosareoma.