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Benigne „gemischte“ odontogene Tumoren

Benign “mixed” odontogenic tumors

  • Schwerpunkt: Zahnpathologie
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Zusammenfassung

Die gutartigen „gemischten“ odontogenen Tumoren weisen neben einer epithelialen Komponente auch ektomesenchymale Anteile auf. Außerdem können sie fakultativ Hartsubstanz (Dentin, Schmelz oder Zement) bilden. Dadurch sind sie z. T. bereits radiologisch von den epithelialen odontogenen Tumoren zu unterscheiden. Einige Läsionen dieser Gruppe werden als echte Tumoren angesehen (ameloblastisches Fibrom, Odontoameloblastom, dentinogener Geister-/Schattenzelltumor), während andere zu den Hamartomen gerechnet werden (komplexes und zusammengesetztes Odontom, wahrscheinlich auch ameloblastisches Fibrodentinom und ameloblastisches Fibrodontom). Während die Odontome nach dem keratozystischen odontogenen Tumor die zweithäufigsten odontogenen Tumoren sind, sind die übrigen Läsionen dieser Gruppe wesentlich seltener. Odontoameloblastom und dentinogner Schattenzelltumor sind lokal aggressiv und müssen komplett reseziert werden. Bei allen übrigen gemischten odontogenen Läsionen reicht eine lokale Exzision. Da sich auf dem Boden eines ameloblastischen Fibroms ein ameloblastisches Fibrosarkom entwickeln kann, sollten diese Patienten in Langzeitkontrolle verbleiben.

Abstract

Benign “mixed”odontogenic tumors consist of an epithelial and ectomesenchymal tumor component, distinguishing them from pure epithelial and pure ectomesenchymal odontogenic tumors. In addition, they may have the ability to produce dentin, enamel or cementum. Therefore, they can sometimes already be differentiated radiologically from epithelial odontogenic tumors. Some of the mixed odontogenic lesions are regarded as true tumors (ameloblastic fibroma, odontoameloblastoma, dentinogenic ghost cell tumor), while others are assumed to represent hamartomatous lesions (complex and compound odontoma, probably also ameloblastic fibrodentinoma and ameloblastic fibroodontoma). Preceded by keratocystic odontogenic tumor, complex and compound odontomas are the second most common odontogenic tumors, while other members of the “mixed” odontogenic tumor group are far less frequently diagnosed. Odontoameloblastoma and dentinogenic ghost cell tumors are locally aggressive lesions that require total resection. All other lesions of this group are treated by local excision. Since ameloblastic fibrosarcoma may evolve from ameloblastic fibroma, patients with ameloblastic fibroma should remain in long-term follow-up.

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  1. Abteilung Oralchirurgie und Zahnärztliche Röntgenologie, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland

    P.A. Reichart

  2. Institut für Pathologie, DÖSAK-Zentralregister am Knochentumor-Referenzzentrum, Universitätsspital Basel, Basel, Schweiz

    G. Jundt

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  1. P.A. Reichart
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Correspondence to P.A. Reichart.

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Widmung

Herrn Professor Dr. med. Wolfgang Remagen zu seinem 80. Geburtstag gewidmet.

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Reichart, P., Jundt, G. Benigne „gemischte“ odontogene Tumoren. Pathologe 29, 189–198 (2008). https://doi.org/10.1007/s00292-008-0996-0

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  • DOI: https://doi.org/10.1007/s00292-008-0996-0

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