medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2017-14-128-131medsovet-2178Research ArticleДИССЕРТАНТDISSERTANTК ВОПРОСУ ОБ ОСОБЕННОСТЯХ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ РАЗЛИЧНЫХ ГИСТОЛОГИЧЕСКИХ ВАРИАНТОВ АМЕЛОБЛАСТОМЫON THE ISSUE OF THE PECULIARITIES OF SURGICAL TREATMENT OF VARIOUS HISTOLOGICAL VARIANTS OF AMELOBLASTOMAЦимбалистН. С.TsimbalistN. S.

Москва

РыбальскаяВ. Ф.RybalskayaV. F.

Москва

СёмкинВ. А.SemkinV. A.

Доктор медицинских наук, профессор.

Москва

MD, Prof.

НеробеевА. И.NerobeevA. I.

Доктор медицинских наук, профессор.

Москва

MD, Prof.

БабиченкоИ. И.BabichenkoI. I.

Доктор медицинских наук, профессор.

Москва

MD, Prof.

Российский университет дружбы народов.РоссияОтделение хирургической стоматологии Центрального научно-исследовательского института стоматологии и челюстно-лицевой хирургииРоссияКлиника челюстно-лицевой хирургии и стоматологии Центрального научно-исследовательского института стоматологии и челюстно-лицевой хирургииРоссияРоссийский университет дружбы народовРоссия201714112017014128131Copyright © Цимбалист Н.С., Рыбальская В.Ф., Сёмкин В.А., Неробеев А.И., Бабиченко И.И., 20172017Цимбалист Н.С., Рыбальская В.Ф., Сёмкин В.А., Неробеев А.И., Бабиченко И.И.Tsimbalist N.S., Rybalskaya V.F., Semkin V.A., Nerobeev A.I., Babichenko I.I.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2178

Хирургический метод является основой лечения амелобластомы. Однако в послеоперационном периоде нередко отмечаются рецидивы, на формирование которых, по данным различных авторов, может влиять вид оперативного вмешательства, гистологический  вариант амелобластомы и неполное удаление опухолевого узла. В лаборатории патологической анатомии ЦНИИС и ЧЛХ было исследовано 76 случаев различных гистологических вариантов амелобластомы, проанализированы такие данные, как рецидивы заболевания и размер опухоли, выраженный в условных единицах. Полученные результаты показали, что базальноклеточный и плексиформный варианты амелобластомы  по объему поражения и частоте рецидивов относятся к вариантам с агрессивным клиническим течением. Самый благоприятный прогноз можно отметить при выявлении периферического, десмопластического и монокистозного варианта амелобластомы.

The typical treatment of ameloblastoma is by surgery. The result of the procedure nevertheless  does  not always lead to complete healing of the sickness but to a recurrence during the post-operative period. It has been reported by a number of authors that the recurrence of the condition is influenced by a number of factors such as the kind of surgical intervention, the histological variant of the ameloblastoma and the incomplete removal of the tumor. The purpose of this research is to study the incidence of recurrence of ameloblastoma after surgery, taking into consideration type of surgery and size of the tumor. A study of 76 cases of ameloblastoma with different histological structures was undertaken in the laboratory of pathological anatomy of Central Research Institute of Dental and Maxillofacial Surgery. Data such as the recurrence of the disease and tumors size was collected, registered and analysed. The size of the tumors was expressed in conventional units. The analysis showed that basal cell and plexiform variants of ameloblastoma are often relate to cases with aggressive clinical courses. The tendency to the recurrence of the disease was also observed in the follicular and acanthomatous variants. According to the results of this study, cases of peripheral variants of ameloblastoma have the best prognosis.

рецидив амелобластомырезекция челюстиразмер опухолипрогнозrecurrence of ameloblastomatumor sizeprognosisReferencesKurppa KJ, Catón J, Morgan PR, Ristimäki A, Ruhin B, Kellokoski J, Elenius K, Heikinheimo K. High frequency of BRAF V600E mutations in ameloblastoma. J Pathol, 2014 Apr, 232(5): 492-8. doi: 10.1002/path.4317.Kurppa KJ, Catón J, Morgan PR, Ristimäki A, Ruhin B, Kellokoski J, Elenius K, Heikinheimo K. High frequency of BRAF V600E mutations in ameloblastoma. J Pathol, 2014 Apr, 232(5): 492-8. doi: 10.1002/path.4317.Dandriyal R, Gupta A, Pant S, Baweja HH. Surgical management of ameloblastoma: Conservative or radical approach. Natl J Maxillofac Surg, 2011 Jan, 2(1): 22-7. doi: 10.4103/0975-5950.85849Dandriyal R, Gupta A, Pant S, Baweja HH. Surgical management of ameloblastoma: Conservative or radical approach. Natl J Maxillofac Surg, 2011 Jan, 2(1): 22-7. doi: 10.4103/0975-5950.85849Laborde A, Nicot R, Wojcik T, Ferri J, Raoul G. Ameloblastoma of the jaws: Management and recurrence rate. Eur Ann Otorhinolaryngol Head Neck Dis, 2017 Feb, 134(1): 7-11. doi: 10.1016/j.anorl.2016.09.004.Laborde A, Nicot R, Wojcik T, Ferri J, Raoul G. Ameloblastoma of the jaws: Management and recurrence rate. Eur Ann Otorhinolaryngol Head Neck Dis, 2017 Feb, 134(1): 7-11. doi: 10.1016/j.anorl.2016.09.004.Catunda IS, Vasconcelos BC, Macedo Neres BJ, de Araujo RA, Ponzi EA. Conservative treatment of an aggressive odontogenic tumor: a case report. Gen Dent, 2013 Sep-Oct, 61(6): 8-12.Catunda IS, Vasconcelos BC, Macedo Neres BJ, de Araujo RA, Ponzi EA. Conservative treatment of an aggressive odontogenic tumor: a case report. Gen Dent, 2013 Sep-Oct, 61(6): 8-12.Калакуцкий Н.В., Тюрин А.Г., Журавлев И.В. Патоморфологические аспекты амелобластомы, ее диагностика и подход к лечению. Институт стоматологии, 2012, 1(54): 56-57.Калакуцкий Н.В., Тюрин А.Г., Журавлев И.В. Патоморфологические аспекты амелобластомы, ее диагностика и подход к лечению. Институт стоматологии, 2012, 1(54): 56-57.Milman T, Ying GS, Pan W, LiVolsi V. Ameloblastoma: 25 Year Experience at a Single Institution. Head Neck Pathol, 2016 Dec, 10(4): 513-520. doi: 10.1007/s12105-016-0734-5.Milman T, Ying GS, Pan W, LiVolsi V. Ameloblastoma: 25 Year Experience at a Single Institution. Head Neck Pathol, 2016 Dec, 10(4): 513-520. doi: 10.1007/s12105-016-0734-5.Cunha EM, Fernandes AV, Versiani MA, Loyola AM. Unicystic ameloblastoma: a possible pitfall in periapical diagnosis. Int Endod J, 2005 May, 38(5): 334-40. doi: 10.1111/j.1365-2591.2005.00956.x.Cunha EM, Fernandes AV, Versiani MA, Loyola AM. Unicystic ameloblastoma: a possible pitfall in periapical diagnosis. Int Endod J, 2005 May, 38(5): 334-40. doi: 10.1111/j.1365-2591.2005.00956.x.Smith I. Recurrent ameloblastoma of the mandible. J Maxillofac Surg, 1976, Mar, 4(1): 1-7. doi: 10.1016/s0301-0503(76)80002-1.Smith I. Recurrent ameloblastoma of the mandible. J Maxillofac Surg, 1976, Mar, 4(1): 1-7. doi: 10.1016/s0301-0503(76)80002-1.Philipsen HP, Reichart PA, Nikai H, Takata T, Kudo Y. Peripheral ameloblastoma: biological profile based on 160 cases from the literature. Oral Oncol, 2001 Jan, 37(1): 17-27. doi: 10.1016/s1368-8375(00)00064-6.Philipsen HP, Reichart PA, Nikai H, Takata T, Kudo Y. Peripheral ameloblastoma: biological profile based on 160 cases from the literature. Oral Oncol, 2001 Jan, 37(1): 17-27. doi: 10.1016/s1368-8375(00)00064-6.Cranin AN, Bennett J, Solomon M, Quarcoo S. Massive granular cell ameloblastoma with metastasis: report of a case. J Oral Maxillofac Surg, 1987 Sep, 45(9): 800-4. doi: 10.1016/0278-2391(87)90207-2.Cranin AN, Bennett J, Solomon M, Quarcoo S. Massive granular cell ameloblastoma with metastasis: report of a case. J Oral Maxillofac Surg, 1987 Sep, 45(9): 800-4. doi: 10.1016/0278-2391(87)90207-2.Becelli R, Morello R, Renzi G, Matarazzo G, Dominici C. Treatment of recurrent mandibular ameloblastoma with segmental resection and revascularized fibula free flap. J Craniofac Surg, 2011 May, 22(3): 1163-5. doi: 10.1097/scs.0b013e318210bc34.Becelli R, Morello R, Renzi G, Matarazzo G, Dominici C. Treatment of recurrent mandibular ameloblastoma with segmental resection and revascularized fibula free flap. J Craniofac Surg, 2011 May, 22(3): 1163-5. doi: 10.1097/scs.0b013e318210bc34.Vayvada H, Mola F, Menderes A, Yilmaz M. Surgical management of ameloblastoma in the mandible: Segmental mandibulectomy and immediate reconstruction with free fibula or deep circumflex iliac artery flap (evaluation of the long-term estheticand functional results). J Oral Maxillofac Surg, 2006 Oct, 64(10): 1532-9. doi: 10.1016/j.joms.2005.11.065.Vayvada H, Mola F, Menderes A, Yilmaz M. Surgical management of ameloblastoma in the mandible: Segmental mandibulectomy and immediate reconstruction with free fibula or deep circumflex iliac artery flap (evaluation of the long-term estheticand functional results). J Oral Maxillofac Surg, 2006 Oct, 64(10): 1532-9. doi: 10.1016/j.joms.2005.11.065.Sammartino G, Zarrelli C, Urciuolo V, di Lauro AE, di Lauro F, Santarelli A, Giannone N, Lo Muzio L. Effectiveness of a new decisional algorithm in managing mandibular ameloblastomas: a 10-years experience. Br J Oral Maxillofac Surg, 2007 Jun, 45(4): 306-10. doi: 10.1016/j.bjoms.2006.08.023.Sammartino G, Zarrelli C, Urciuolo V, di Lauro AE, di Lauro F, Santarelli A, Giannone N, Lo Muzio L. Effectiveness of a new decisional algorithm in managing mandibular ameloblastomas: a 10-years experience. Br J Oral Maxillofac Surg, 2007 Jun, 45(4): 306-10. doi: 10.1016/j.bjoms.2006.08.023.Suma MS, Sundaresh KJ, Shruthy R, Mallikarjuna R. Ameloblastoma: an aggressive lesion of the mandible. BMJ Case Rep, 2013 Oct 9, 2013: 200483. doi: 10.1136/bcr-2013-200483.Suma MS, Sundaresh KJ, Shruthy R, Mallikarjuna R. Ameloblastoma: an aggressive lesion of the mandible. BMJ Case Rep, 2013 Oct 9, 2013: 200483. doi: 10.1136/bcr-2013-200483.Chae MP, Smoll NR, Hunter-Smith DJ, Rozen WM. Establishing the natural history and growth rate of ameloblastoma with implications for management: systematic review and meta-analysis. PLoS One, 2015 Feb 23, 10(2): e0117241. doi: 10.1371/journal.pone.0117241.Chae MP, Smoll NR, Hunter-Smith DJ, Rozen WM. Establishing the natural history and growth rate of ameloblastoma with implications for management: systematic review and meta-analysis. PLoS One, 2015 Feb 23, 10(2): e0117241. doi: 10.1371/journal.pone.0117241.Kovács A, Wagner M, Ghahremani M. Considerations on a long-term course of a plexiform ameloblastoma with a recurrence in the soft tissue. Rev Med Hosp Gen Mex, 1999, 62: 48-53.Kovács A, Wagner M, Ghahremani M. Considerations on a long-term course of a plexiform ameloblastoma with a recurrence in the soft tissue. Rev Med Hosp Gen Mex, 1999, 62: 48-53.Shaikhi K et al. Morphological variants of ameloblastoma and their mimickers. NAJ Med Sci, 2012, 5(1): 20-8. doi: 10.7156/v5i1p020.Shaikhi K et al. Morphological variants of ameloblastoma and their mimickers. NAJ Med Sci, 2012, 5(1): 20-8. doi: 10.7156/v5i1p020.Masthan KMK, Anitha N, Krupaa J, Manikkam S. Ameloblastoma. Journal of Pharmacy & Bioallied Sciences, 2015, 7(Suppl1): 167-170. doi: 10.4103/0975-7406.155891.Masthan KMK, Anitha N, Krupaa J, Manikkam S. Ameloblastoma. Journal of Pharmacy & Bioallied Sciences, 2015, 7(Suppl1): 167-170. doi: 10.4103/0975-7406.155891.Ueno S, Mushimoto K, Shirasu R. Prognostic evaluation of ameloblastoma based on histologic and radiographic typing. J Oral Maxillofac Surg, 1989 Jan, 47(1): 11-5.Ueno S, Mushimoto K, Shirasu R. Prognostic evaluation of ameloblastoma based on histologic and radiographic typing. J Oral Maxillofac Surg, 1989 Jan, 47(1): 11-5.Shakya H, Khare V, Pardhe N, Mathur E, Chouhan M. Basal cell ameloblastoma of mandible: a rare case report with review. Case Rep Dent, 2013, 2013: 187820. doi: 10.1155/2013/187820.Shakya H, Khare V, Pardhe N, Mathur E, Chouhan M. Basal cell ameloblastoma of mandible: a rare case report with review. Case Rep Dent, 2013, 2013: 187820. doi: 10.1155/2013/187820.Sridhar M, Bhaskar Reddy LR, Kharat S, Mahesh BS, Gandi L, Mahendra A, Nigam P, Grewal P. Basal cell ameloblastoma: a rare histological variant of an uncommon tumor. Niger J Surg, 2015 Jan-Jun, 21(1): 66-9. doi: 10.4103/1117-6806.152730Sridhar M, Bhaskar Reddy LR, Kharat S, Mahesh BS, Gandi L, Mahendra A, Nigam P, Grewal P. Basal cell ameloblastoma: a rare histological variant of an uncommon tumor. Niger J Surg, 2015 Jan-Jun, 21(1): 66-9. doi: 10.4103/1117-6806.152730Meshram M, Sagarka L, Dhuvad J, Anchlia S, Vyas S, Shah H. Conservative Management of Unicystic Ameloblastoma in Young Patients: A Prospective Single-Center Trial and Review of Literature. J Maxillofac Oral Surg, 2017 Sep, 16(3): 333-341. doi: 10.1007/s12663-016-0987-2.Meshram M, Sagarka L, Dhuvad J, Anchlia S, Vyas S, Shah H. Conservative Management of Unicystic Ameloblastoma in Young Patients: A Prospective Single-Center Trial and Review of Literature. J Maxillofac Oral Surg, 2017 Sep, 16(3): 333-341. doi: 10.1007/s12663-016-0987-2.Кириченко Е.Н. Использование стереолитографического моделирования у пациентов с амелобластомой нижней челюсти. Альманах современной науки и образования, 2014, 5-6(84):78-82.Кириченко Е.Н. Использование стереолитографического моделирования у пациентов с амелобластомой нижней челюсти. Альманах современной науки и образования, 2014, 5-6(84):78-82.

The authors declare that there are no conflicts of interest present.