上顎에 發生한 良性 自堊芽細胞腫의 症例報告

BENIGN CEMENTOBLASTOMA OF THE MAXILLA : REPORT OF CASE

The benign cementoblastoma is a rare benign odontogenic tumor of mesenchymal origin which has an unlimited growth potential. The benign cementoblastoma is most common in males younger than age 25 and in slow growing and asymptomatic. The benign cementoblastoma is attached to the tooth root and seen mostly in mandibular molars and premolars Radiologically, it is a well circumscribed radiopague mass with a peripheral radiolucent zone. Histologically, it is characterized by a hard tissue with very many reversal lines and sheets of cementum-like tissue, especially at periphery. Because of the aggressive nature of the lesion, complete excision of the tumor with the involved tooth is recommended. The following case is presented because of the unusual location of the lesion, its apparent inception from the maxillary first molar and second premolar. A 22 year old man complained of a painful response to percussion of the left maxillary second premolar and first physical examination showed that he was well developed, well nourished. Intraoral examination revealed buccal bony expansion from the left maxillary second premolar to the first molar. A normal appearing mucosa covered the tumor mass. Radiographic exanination showed a well circumscribed radiopaque mass (2cm in diameter) associated with the roots of the maxillary second premolar and first molar. With the patient under local anesthesia surgical excision of the lesion with the involved teeth was accomplished. Primary mucoperiosteal closure was performed with 3-0 black silk. Pathologic examination demonstrated that the lesion consisted of a mass of white, firm tissue which was easily cut, glistening material of cartilageneous consistency. Microscopically, diffuse sheets of cementum like tissue were seen to emanate from cementum attached to a root fragment. Toward the center of the lesion, many resting and reversal lines were present with intervening fibrous stroma.