基底細胞母斑症候群における歯原性角化嚢胞の検討

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We have investigated the recurrence rate after surgical treatment of odontogenic keratocysts in basal cell nevus syndrome (BCNS) and non-BCNS patients, and examined the excised specimens histologically. Twenty-five cysts from 6 BCNS patients and one each from 17 non-BCNS patients were enrolled in this study. All of them had been histologically diagnosed as odontogenic keratocysts. These cysts were either extirpated or marsupialized. The patients were followed up and checked clinically and roentgenologically for three years postoperatively. The recurrence rate was much higher in BCNS patients than in non-BCNS patients. The extirpation of the cysts resulted in the recurrence of 8/21 instances (38.1%) in BCNS and 2/15 (13.3%) in non-BCNS patients. Furthermore, recurrence was observed in 2/4 (50.0%) of the BCNS patients who underwent marsupialization of the cysts, but in none (0/2; 0%) of the non-BCNS patients. Next, we examined the excised specimens histologically for the presence of the following features: i) infoldings of the cyst wall, ii) satellite cysts, iii) growth patterns like dental lamina, iv) islands of epithelial cells, v) proliferation of rete ridges, and vi) inflammatory cell infiltration. All features except inflammatory cell infiltration were demonstrated more markedly in the cysts from BCNS patients than in those from non-BCNS patients. In BCNS cysts (n=19), features i), ii), iii), iv), v), and vi) were present in 57.9%, 52.6%, 73.7%, 52.6%. 31.6%, and 15.8% of the cases, respectively, whereas in non-BCNS cysts (n=17) these features were observed in 35.3%, 41.2%, 47.1%, 29.4%, 11.8%, and 64.7% of the cases, respectively. These findings suggest that the epithelium of cysts in BCNS patients has a higher growth rate than that of cysts in non-BCNS patients, which would explain, at least in part, the higher recurrence of cysts in BCNS patients.
社団法人日本口腔外科学会の論文

基底細胞母斑症候群における歯原性角化嚢胞の検討

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