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The Histology of Adamantinoma

British Journal of Cancer
Nature Publishing Group
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VOL. V SEPTEMBER, 1951 NO. 3 TI-IE HISTOLOGY OF ADAMANTINOMA. R. B. LUCASANDA.C.THACKRAY. From the, Department of Pathology, The Royal Dental Hospital of London School Of Dental Surgery and The Bland-Sutton Institute of Pathology, The, Middlesex Hospital, London, W. 1. Received for publication August 15, 1951. THi. adamantinoma is one of the less common tumours of the jaw. Its long natural history and marked tendency to recur after inadequate surgery or radio- therapy make an evaluation of methods of treatment difficult. It is important, therefore, that as many detailed cases as possible should be recorded. In this paper the clinical and pathological features of 20 cases are presented and thehistogenesis of the tumour is discussed. CLINICAL FINDINGS. These tumours occur most often in early adult life, though cases have been reported in children, and in one case in this series the age of onset was 78. The tumour occurs in the lower jaw much more frequently than in the upper (I 7 cases and 3 cases respectively in this series), is usually a central lesion and gradually enlarges, in the majonty of cases without pain. In the course of time the bonebecomes absorbed, and if a cystic loculus is opened infection and discharge foRow. Local recurrence is- common foHowing inadequate treatment, but metastases are very rare. A case of pulmonary metastases has been reported by Waterworth and PuRar (1948), who review previous reports. The natural history of the disease is long; it is not always easy therefore to assess the efficacy of various methods of treatment. Most authorities consider radical excision of the tumour to be the treatment of choice. The tumou'r, if small, is removed with a surrounding margin of healthy tissue, though extensivelesions require resection of the jaw (Simmons, 1928; Stones,'1948; Thoma, 1948). Radiotherapy gives unsat'i'sfactory results. Table I summarizes the clinical findings in our series. HISTOLOGY. The -adamantinoma is an epithelial tumour in which the cellular

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