A Diagnostically Challenging Case of an Infarcted Adenomatoid Tumor of the Epididymis

장선희,심상화,곽지은,주미,김한성,지제근,이건철 대한병리학회 2008 Journal of Pathology and Translational Medicine Vol.42 No.4

We describe a case of an infarcted adenomatoid tumor of the epididymis that was challenging to diagnose. A 20-year-old man presented with acute left scrotal pain. He was found to have a 2×1.5×1 cm tumor that was relatively well circumscribed on gross examination. There was a central necrotic area that exhibited gaping spaces and ghost outlines of epithelial cells. The periphery of the necrotic lesion showed focally viable adenomatoid tumor. The majority of the tissue adjacent to the necrosis consisted of granulation tissue, fibroblastic and myofibroblastic proliferation, and neutrophils. The fibroblasts and myofibroblasts showed plump nuclei, often with small nucleoli. No mitotic activity was present. The differential diagnosis for an infarcted adenomatoid tumor includes malignant mesothelioma, inflammatory myofibroblastic tumor, and inflammatory conditions. The key to diagnosing an infarcted adenomatoid tumor is to consider it in the differential diagnosis of any spindle cell tumor with necrosis occurring in the genital tract. We describe a case of an infarcted adenomatoid tumor of the epididymis that was challenging to diagnose. A 20-year-old man presented with acute left scrotal pain. He was found to have a 2×1.5×1 cm tumor that was relatively well circumscribed on gross examination. There was a central necrotic area that exhibited gaping spaces and ghost outlines of epithelial cells. The periphery of the necrotic lesion showed focally viable adenomatoid tumor. The majority of the tissue adjacent to the necrosis consisted of granulation tissue, fibroblastic and myofibroblastic proliferation, and neutrophils. The fibroblasts and myofibroblasts showed plump nuclei, often with small nucleoli. No mitotic activity was present. The differential diagnosis for an infarcted adenomatoid tumor includes malignant mesothelioma, inflammatory myofibroblastic tumor, and inflammatory conditions. The key to diagnosing an infarcted adenomatoid tumor is to consider it in the differential diagnosis of any spindle cell tumor with necrosis occurring in the genital tract.

고환과 부고환 사이에 발생한 유선종

지영환,박성찬,이승규,추현수,김준,최혜정,문경현 대한남성과학회 2008 The World Journal of Men's Health Vol.26 No.4

Adenomatoid tumor is the most common paratesticular tumor with an anatomic distribution limited to the epididymis and it rarely invades to the tunica vaginalis, spermatic cord and ejaculatory duct. Adenomatoid tumor is a benign neoplasm that is thought to be of a mesothelial origin. The treatment of choice for adenomatoid tumor is local excision because of its benign nature and the absence of distant metastasis. We report here on a rare case of adenomatoid tumor that was found between the epididymis and the testis, and it was treated by local excision of tumor.

하악 소구치 부위에 발생한 석회화상피성치성종양이 혼재된 선양치성종양: 증례보고

노량석,조형우,최소영,김진수,Noh, Lyang-Seok,Jo, Hyung-Woo,Choi, So-Young,Kim, Chin-Soo 대한악안면성형재건외과학회 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.2

Adenomatoid odontogenic tumors represent 3 to 7 percent of all odontogenic tumors. These tumors are more common in the maxilla than the mandible and usually include the anterior region. Clinically, the most common symptom is painless swelling and the tumor is associated with an unerupted tooth, typically a maxillary or mandibular cuspid. The adenomatoid odontogenic tumor appears radiographically as a unilocular radiolucency around the crown of an impacted tooth, resembling a dentigerous cyst. More often, it contains fine calcifications. Histopathologically, there is a thick wall cystic structure with a prominent intraluminal proliferation of the odontogenic epithelium. The most striking pattern is varying-sized solid nodules of spindle-shaped or cuboidal epithelial cells forming nests or rosette-like structures with minimal stromal connective tissues. Conspicuous within the cellular areas are structures of tubular or duct-like appearance. The duct-like spaces are lined with a single row of cuboidal or low columnar epithelial cells, of which the ovoid nuclei are polarized away from the luminal surface. Small foci of calcification may also be scattered throughout the tumor. These have been interpreted as abortive enamel formations. In some adenomatoid odontogenic tumors, the material has been interpreted as dentoid or cementum.

선양치성종양으로 오진하여 수 차례 재발한 상악동의 선방세포암종

윤정훈,조세인,김수관 大韓顎顔面成形再建外科學會 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.6

A 46-year-old male appealed severe palatal and buccal swelling in the Lt. maxilla in 1990. In 1986, the patient was already carried out the clinical and radiological examination in our hospital. Multiple radiolucency was seen from #21 to #25 periapical area and Lt. maxillary sinus in the panoramic view at this time. But, the patient came home without special examination or inspection for itself. January 1990, the mass took an impression to grow bigger and the patient had visited again. Partial maxillectomy was carried out at this time and pathologic diagnosis was an adenomatoid odontogenic tumor. After 3 years, lesion was recurred and carried out hemimaxillectomy with Weber-Furgusson incision. September 2001, facial swelling was recurred again and patient was suffered from nasal breathing, lacrimal obstruction and exopthalmus. In this case, the tumor cells composed of nodular and papaillary cystic pattern with microcyst formation, highly suggestive of an adenomatoid odontogenic tumor. Histopathologically, the recurrent tumor was proved to be the same pattern of the primary tumor, which is compatible with acinic cell carcinoma. However, adenomatoid odontogenic tumor did not appear destructive multilocular radiolucency. In addition, this tumor had frequently observed amyloid-like or calcified materials in biopsy specimen. Therefore, oral pathologists had kept in mind into the correlative analysis of histopathologic and oral radiographic features, which is essential for definitive diagnosis.

선종양 치성종양과 석회화 상피성 치성종양이 혼합된 혼합 상피성 치성종양의 면역조직화학 특성

유미현,김현실,차인호,박광호,윤정훈,김학균,김진 대한구강악안면병리학회 2006 대한구강악안면병리학회지 Vol.30 No.6

Combined epithelial odontogenic tumors are very rare and represent hybrid lesion comprising adenomatoid odontogenic tumor intermixed with calcifying epithelial odontogenic tumor. The authors present 3 cases of combined epithelial odontogenic tumor which contained diagnostic areas for both adenomatoid odontogenic tumor and calcifying epithelial odontogenic tumor. Their behaviour and histogenesis were discussed.

Current Concepts and Occurrence of Epithelial Odontogenic Tumors: I. Ameloblastoma and Adenomatoid Odontogenic Tumor

이석근,김연숙 대한병리학회 2013 Journal of Pathology and Translational Medicine Vol.47 No.3

Ameloblastomas and adenomatoid odontogenic tumors (AOTs) are common epithelial tumors of odontogenic origin. Ameloblastomas are clinico-pathologically classified into solid/multicystic, unicystic, desmoplastic, and peripheral types, and also divided into follicular, plexiform, acanthomatous, granular types, etc., based on their histological features. Craniopharyngiomas, derived from the remnants of Rathke’s pouch or a misplaced enamel organ, are also comparable to the odontogenic tumors. The malignant transformation of ameloblastomas results in the formation of ameloblastic carcinomas and malignant ameloblastomas depending on cytological dysplasia and metastasis, respectively. AOTs are classified into follicular, extrafollicular, and peripheral types. Ameloblastomas are common, have an aggressive behavior and recurrent course, and are rarely metastatic, while AOTs are hamartomatous benign lesions derived from the complex system of the dental lamina or its remnants. With advances in the elucidation of molecular signaling mechanisms in cells, the cytodifferentiation of epithelial tumor cells in ameloblastomas and AOTs can be identified using different biomarkers. Therefore, it is suggested that comprehensive pathological observation including molecular genetic information can provide a more reliable differential diagnosis for the propagation and prognosis of ameloblastomas and AOTs. This study aimed to review the current concepts of ameloblastomas and AOTs and to discuss their clinico-pathological features relevant to tumorigenesis and prognosis.

여성 생식기에 발생한 샘모양 종양 (adenomatoid tumor)의 임상양상: 195예 분석

이지은 ( Ji Eun Lee ),조연진 ( Yeon Jean Cho ),김미라 ( Mi La Kim ),김주명 ( Joo Myoung Kim ),주관영 ( Kwan Young Joo ),전종영 ( Jong Young Jun ),한호원 ( Ho Won Han ),구유진 ( Yu Jin Koo ),김윤영 ( Yun Young Kim ),전이경 ( Yi Kye 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.8

목적: 자궁절제술 또는 보존적 수술로 치료한 샘모양 종양 (adenomatoid tumor)의 임상적 특징 및 향후 임신력에 대해 알아보고자 하였다. 연구 방법: 1995년 1월부터 2009년 4월까지 본원 산부인과에서 양성 자궁 질환으로 자궁절제술 및 보존적 수술을 받은 44,984명 중, 조직학적으로 샘모양 종양을 진단받은 195명을 대상으로 하였다. 수술 후 의무기록을 이용하여 후향적 분석을 통해 샘모양종양의 발생부위, 동반 병변 등을 살펴보고, 보존적 수술을 받은 가임기 여성의 경우 향후 임신 성공 여부 및 재발 여부를 분석하였다. 결과: 양성 자궁질환 중 자궁 샘모양 종양을 진단받은 195명으로 빈도는 0.42%이다. 환자들의 주 증상은 통증 (25.1%), 출혈(30.2%), 복부에서 촉지되는 종괴였으며, 동반되는 부인과 질환으로는 자궁 근중 (46.6%), 자궁선근증 (25.1%) 및 자궁내막증(13.1%)이 가장 많았다. 보존적 수술을 시행받은 환자는 46명이었으며, 그 중 13명이 임신에 성공하고 분만하였으며, 샘모양 종양이 재발한 경우는 없었다. 결론: 샘모양 종양은 자궁근종과 주로 동반하며, 임상양상도 비슷하기 때문에 수술 전 진단이 어려운 질환이나, 재발은 거의 없으며, 가임기 여성의 경우 임신 능력을 보존하기 위하여 보존적 수술을 시행할 수 있다. 이러한 결과는 향후 환자의 상담에 도움이 될 것이다. Objective: Adenomatoid tumors of female genital tracts are benign lesions derived from mesothelium, occurring most commonly during the reproductive years. The aim of this study was to evaluate the overall incidence of adenomatoid tumors in Korean women and to analyze the clinical characteristics. Methods: One hundred and ninety five patients with adenomatoid tumors were found in a retrospective medical records review of pathologic reports for 44,984 benign uterine diseases at Cheil General Hospital, from January 1995 to April 2009. Results: The overall incidence rate was 0.42% of all benign uterine disease. Among them, 149 patients received hysterectomy, and 46 patients received uterine conservative surgery. Main symptoms of the patients were pain (25.1%), bleeding (30.2%), and palpable mass (18.5%). Most common associated pathologies were leiomyoma (46.6%), adenomyosis (25.1%) and endometriosis (13.1%). Most of the diagnosis was made postoperatively. Among 46 patients with conservative treatment, 13 patients showed successful pregnancy outcome. No recurrence occurred during the follow up period. Conclusion: Adenomatoid tumors are associated with fibroids and tend to mimic them clinically, making pre-operative diagnosis difficult. The recurrence is rare even after conservative operation. Our data about this benign neoplasm may be helpful for counseling patients after operations.

함치성 낭에서 발생한 선양치성종양의 재발 증례

윤정훈,김수관 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.2

The authors reported an unusual example of an adenomatoid odontogenic tumor arising from a dentigerous cyst, which had been recurred 2 years following an enucleation. Microscopic examination revealed the presence of an adenomatoid odontogenic tumor components direct continuity to the lining epithelium of a dentigerous cyst. It would be seemed that this tumor was derived from the reduced enamel epithelium of post-secretory ameloblasts. Adenomatoid odontogenic tumor is entirely benign, encapsulated lesion. No aggressive behavior of this tumor has been described, and recurrences are very rarely observed. In this case, there was an tumor islands in the fibrous connective capsule. It assumed that the presence of tumor components in the capsule might be a primary cause of recurrence. However, the possibility of an inadequate surgical intervention could not be completely excluded. Therefore, meticulous follow-up evaluation is necessary in the event of the presence of tumor islands in the tumor capsule.

하악 우측 측절치에 발생한 선양 치성 종양

박미선,박호원,서현우,이주현 大韓小兒齒科學會 2011 大韓小兒齒科學會誌 Vol.38 No.4

선양 치성 종양(adenomatoid odontogenic tumor)은 악골에 드물게 발생하는 치성 기원의 종양이다. 이전에는 법랑모세 포종(ameloblastoma)의 한 종류로 여겨졌으나 양성이며 재발되는 경우는 극히 드물다. 상악 견치에 호발하며 대개는 무증 상이지만 크기가 천천히 커져 무통성 종창을 일으킬 수 있다. 방사선학적으로 함치성 낭종(dentigerous cyst) 및 단방성 법 랑모세포종(unicystic ameloblastoma)과 매우 유사하다. 일반적으로 보존적인 소파술(curettage) 및 적출술(enucleation) 을 통해 치료한다. 본 증례는 하악 우측 측절치 미맹출을 주소로 내원한 10세 여자 환아에서 방사선 사진 검사를 통해 치아의 매복 및 병소를 확인하고 적출술을 시행하였다. 치아에는 브라켓을 부착하여 교정적 정출을 유도하였다. 조직학적 검사를 통해 선양 치성 종 양으로 확진되었으며 양호한 치료 결과를 보였기에 보고하는 바이다. Adenomatoid odontogenic tumor(AOT) is an infrequent odontogenic tumor which arise in the jaw. It was considered as a variant of ameloblastoma. The adenomatoid odontogenic tumor is clearly benign and, in contrast to the ameloblastoma, present a very low recurrence. It most often appears in the canine region of the maxilla. The adenomatoid odontogenic tumor is frequently asymptomatic, however it may cause painless swelling. The radiological findings of adenomatoid odontogenic tumor frequently share characteristics of dentigerous cyst and unicystic ameloblastoma. Conservative surgical enucleation and curettage are the treatment of choice. In this case a 10-year-old child was presented with mandibular right lateral incisor in unerupted. Radiographically, the tooth was impacted and a radiolucency was seen in the area. The lesion was enuclated without extraction of the tooth. Bracket was attached on the tooth for orthodontic extrusion installed. Histopathologically adenomatoid odontogenic tumor was revealed.

자궁에 발생한 선종양종양

안승희 ( Seung Hee An ),차상헌 ( Sang Heon Cha ),김미경 ( Mi Kyung Kim ),김지영 ( Ji Young Kim ),최규연 ( Gyu Yeon Choi ),이정재 ( Jeong Jae Lee ),이임순 ( Im Soon Lee ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.5

Adenomatoid tumor of uterus is described by Golden and Ash as a tumor that similar to adenoma but found obscured histogenesis. Adenomatoid tumor is a rare benign disease that originated from mesothelium and mostly occurred in male and rarely in female, and can be treated by simple excision of tumor because there is no recurrence or malignant change. We describe the clinical and histologic findings with references to other reported cases. We herein report a case of adenomatoid tumor of the uterus that gets an operation under clinical impression of myoma uteri.