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Benigne epitheliale odontogene Tumoren

Benign epithelial odontogenic tumors

Zusammenfassung

Die Gruppe der benignen epithelialen odontogenen Tumoren besteht aus den 4 Mitgliedern der Ameloblastom-Familie (dem soliden/multizystischen Typ, dem extraossären/peripheren Typ, dem desmoplastischen Typ und dem unizystischen Typ), dem squamösen odontogenen Tumor, dem kalzifizierenden odontogenen Tumor, dem adenomatoiden odontogenen Tumor und neuerdings dem früher als „Keratozyste“ bezeichneten keratozystischen odontogenen Tumor. Der letztgenannte ist mit Abstand der häufigste Tumor in dieser Gruppe, gefolgt vom soliden multizystischen Ameloblastom. Obwohl die Ätiologie dieser Läsionen nach wie vor unklar ist, bestehen enge Verbindungen zur normalen Zahnentwicklung, die von einzelnen Tumoren in Teilen nachgeahmt wird. Trotz teilweise großer morphologischer Ähnlichkeiten untereinander ist das biologische Verhalten dieser Läsionen sehr unterschiedlich, ebenso die therapeutischen Konsequenzen. Die diagnostische Einordnung beruht im Wesentlichen auf der Lokalisation (intraossär/extraossär-peripher) und der Histologie, wobei die Korrelation der histologischen Befunde mit der Röntgenmorphologie wertvolle Hinweise geben kann. Immunhistochemische Untersuchungen sind wegen ihrer Variationsbreite im Einzelfall nicht hilfreich.

Abstract

The group of benign epithelial odontogenic tumors consists of the four member types of the ameloblastoma family (solid/multicystic, extraosseous/peripheral, desmoplastic, unicystic), squamous odontogenic tumors, calcifying odontogenic tumors, adenomatoid odontogenic tumors, and keratocystic odontogenic tumors, the former “keratocysts” that were recently reclassified by the World Health Organization and are now regarded as tumors. The latter are by far the most frequent tumors in this group, followed by solid/multicystic ameloblastoma. Although the etiology of these lesions is still unknown, a close relationship to normal tooth development is obvious, which is partially imitated by some tumors. Despite some similarities to each other, at least in part, the biological behavior of these lesions is quite different, as are treatment modalities. The diagnosis is essentially based on localization (intraosseous vs. extraosseous/peripheral) and histology, whereupon the correlation of histological findings with radiographic morphology may be of additional diagnostic value. Because of the range of variation, immunohistochemical investigations are not helpful in diagnosing a particular case.

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Correspondence to P.A. Reichart.

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

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Reichart, P., Jundt, G. Benigne epitheliale odontogene Tumoren. Pathologe 29, 175–188 (2008). https://doi.org/10.1007/s00292-008-0995-1

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