From Big Medical Encyclopedia

ADAMANTINOMA (adamantinoma; Greek adamas, adamantos — solid metal + oma; synonym: adenoameloblastoma, ameloblastoma) — an epithelial benign tumor, in a cut the structures reminding enamel body of laying of tooth form. Meets rather seldom; there is an Adamantinoma more often in the thickness of a mandible in the field of a corner at the level of painters, is much more rare — in an upper jaw, in isolated cases — in a tibial bone, and also in a hypophysis and ovaries.

Fig. 1. Adamantinoma, solid form. Characteristic epithelial complexes among fibrous fabric.

Macroscopically distinguish two forms of the Adamantinoma — solid (adamantinoma solidum) and polycystic (adamantinoma polycysticum). These two forms of a tumor are not independent. The solid form — earlier stage of development of a tumor, a thicket is observed in an upper jaw and grows quicker, than polycystic. On a section the solid Adamantinoma represents a node of a softish or plotnovaty consistence dirty-gray or reddish, the capsule can be absent. Polycystic form A. it is characterized by existence of several cysts. Cysts are executed by light or brown liquid of various consistence. At microscopic examination (fig. 1) the characteristic branching epithelial tyazh or roundish sites come to light, between to-rymi there pass the connective tissue layers containing circulatory and limf. vessels. On the periphery of these epithelial complexes high cylindrical cells with large kernels are located in one row, for to-rymi cubic and polygonal cells follow. In the center of epithelial complexes star-shaped cells are located. The specified picture is similar to a structure of the developing enamel body of tooth.

Question of an origin And. to a crust. time still it is finally not solved. Most likely, it develops from a dental germ, including from the remains of a tooth plate or enamel body of tooth in various stages of its development.

It is observed in most cases at persons aged from 20 up to 40 years, is slightly more often at women.

The adamantinoma develops slowly, long time does not cause disturbance to the patient, pains happen seldom. In process of growth of a tumor the uniform thickening of the site of a jaw develops or there are protrusions merging with each other. Owing to thinning of a bone wall during the pressing on a tumor the pergament crunch is sometimes felt. Over time there can be disorders of the movements in a maxillary joint, ulcerations, pains.

Fig. 2. Adamantinoma of a mandible, polycystic form (roentgenogram).

X-ray pattern And. it is diverse. The solid form of a tumor is presented in the form of a cavity with accurately outlined polycyclic contours. Polycystic form A. it is characterized by a set of preferential roundish or oval cavities of various sizes separated from each other by thin partitions. Projective imposing of such cysts creates a typical picture of a cellular structure (fig. 2) on the roentgenogram. Between these two versions And. a number of transitional forms is had. With an expansive growth And. swelling of the affected bone, and also thinning and a prervannost of a cortical layer of a jaw, rassasyvany fangs or their loss is observed. In a tumor teeth can contain.

At localization of the Adamantinoma in an alveolar shoot of an upper jaw cystic educations are found. Define extent of penetration of a tumor into a genyantrum or a nasal cavity by tomograms.

At localization And. in a tibial bone in a diaphysis continuous or, more often, the located center of destruction cellular longwise with the raised or destroyed bast layer without periosteal reaction radiological comes to light.

Differential diagnosis Adamantinomas with dontogenous cysts, a giant-cell tumor and cancer defeat it is sometimes quite difficult since a X-ray pattern in each separate case And. various.

Forecast at timely treatment good, malignant transformation is observed extremely seldom. Innidiations And. it is not observed.

Recognition And. is based on data of X-ray inspection and hl. obr. on a biopsy from the center of defeat.

Treatment surgical: a resection of the site of a jaw within healthy fabrics with leaving of the bridge from a bone tissue in the field of defect.

Bibliography: A. I apricots. Pathological anatomy of an oral cavity and teeth, M., 1914; Evdokimov A. I. and Vasilyev G. A. Surgical stomatology, M., 1964; Zedgenidze G. A. and Mechanic R. S. Rentgenodiagnostika of diseases of teeth and jaws. M, 1962; Kozyreva A. L. Clinic and treatment of adamantinomas, odontomas, cementomas, M., 1959; Lukomsky I. G. Dontogenous tumors, M., 1927; Reykberg S.A. Rentgenodiagnostika of diseases of bones and joints, book 2, page M., 1964, bibliogr.; Shekhter I. A., Vorobyov GUO. And. and Kotelnikov M. V. The atlas of roentgenograms iubshch And jaws in norms And GGOLOGII. M, 1968 Lucas R. Century of Pathology at tumors the oral tissues, L., bibliogr.

H. H. Trapeznikov; M. V. Kotelnik (stalemate. An.).