Jaw Neoplasms

颌骨肿瘤
  • 文章类型: Letter
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  • 文章类型: Case Reports
    唾液腺肿瘤占所有头颈部肿瘤的3%。多形性腺瘤(PA)是最常见的唾液腺肿瘤,主要发生在腮腺,其次是口腔的小唾液腺,然而,下颌骨内PA的发生极为罕见,文献中报道的病例很少。在颌骨内部,这些病变倾向于模仿大型溶骨性病变,这包括诊断挑战。详尽的文献回顾显示仅10例中央多形性腺瘤。我们介绍了一例罕见的原发性PA病例,该病例发生在下颌骨内部,并被暂时诊断为成釉细胞瘤。
    Salivary gland neoplasms account for 3% of all head and neck tumours. Pleomorphic adenoma (PA) is the most common salivary gland tumour that mainly occurs in the parotid gland, followed by minor salivary glands of the oral cavity, however, the occurrence of PA inside the jaw bones is exceedingly rare and very few cases have been reported in the literature. Inside jaw bones these lesions tend to imitate large osteolytic lesions encompass a diagnostic challenge. An exhaustive review of the literature revealed only 10 cases of central pleomorphic adenoma. We present a rare case of primary PA that occurred inside the mandible and was provisionally diagnosed as ameloblastoma.
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  • 文章类型: Case Reports
    尤因骨肉瘤是一种罕见的头颈部恶性圆细胞瘤。下巴,尤其是下颌骨,占头部和颈部区域发生率的3%。据报道,这些肿瘤在男性中比在女性中更常见,他们通常在5到20岁之间。临床医生和病理学家难以仅根据临床和微观发现做出诊断。免疫组织化学提供了一种合理的工具,可以帮助病理学家得出确证的诊断。这种颌骨肿瘤在病程早期发现和治疗时预后最好,所以及时的重要性,准确的诊断怎么强调都不为过。该病例报告的突出特征是一名18岁男性,该男性通过免疫组织化学方法最初被检测为Ewing肉瘤,并位于受影响的左下颌磨牙。
    UNASSIGNED: Ewing\'s sarcoma of bone is a rare malignant round cell tumor of the head and neck. The jaw, particularly the mandible, accounts for 3% of occurrences in the head and neck area. These tumors have been reported more frequently in men than in women, and they are usually between 5- and 20-year-old. It is difficult for clinicians and pathologists to make a diagnosis based solely on clinical and microscopic findings. Immunohistochemistry presents a plausible tool that can help the pathologist to arrive at a confirmatory diagnosis. This jaw tumor has the best prognosis when detected and treated early in the disease course, so the importance of timely, and accurate diagnosis cannot be overemphasized. The highlighting feature of this case report of an 18-year-old male that was primary detected by immunohistochemically as Ewing\'s sarcoma and is localized to the impacted left mandibular molars.
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  • 文章类型: Case Reports
    遗传性原发性甲状旁腺功能亢进(PHPT)占所有PHPT病例的5-10%,诊断和管理需要基因检测。其中,甲状旁腺功能亢进-颌骨肿瘤综合征(HPT-JT)是由CDC73突变引起的常染色体显性疾病,临床表现多样,症状不完整.
    先证者,诊断为PHPT,41岁时接受甲状旁腺切除术,病理检查为甲状旁腺癌(PC)。由于早发性PHPT和家族史,最初怀疑遗传性PHPT。基因检测发现了一个杂合的CDC73突变,NM_024529.4:c。687_688delAG(p。Arg229Serfs*37).即使没有颌骨肿瘤,根据肾囊肿的发现证实了HPT-JT的诊断。进行了二次甲状腺切除术以降低复发风险。
    对于早发性PHPT,强烈建议进行基因检测,家族史,颌骨肿瘤,肾和子宫受累,非典型甲状旁腺肿瘤,和PC。此测试为个性化管理提供了有价值的信息,受影响的家庭可以获得咨询。
    Hereditary primary hyperparathyroidism (PHPT) accounts for 5-10% of all PHPT cases, necessitating genetic testing for diagnosis and management. Among these, hyperparathyroidism-jaw tumor syndrome (HPT-JT) is an autosomal dominant disorder caused by CDC73 mutations with variable clinical presentations and incomplete symptoms.
    The proband, diagnosed with PHPT, underwent parathyroidectomy at the age of 41 with pathological examination of parathyroid carcinoma (PC). Hereditary PHPT was initially suspected due to the early-onset PHPT and family history. Genetic testing identified a heterozygous CDC73 mutation, NM_024529.4: c. 687_688delAG (p. Arg229Serfs*37). Even in the absence of jaw tumors, the diagnosis of HPT-JT was confirmed based on the discovery of renal cysts. A secondary thyroidectomy was performed to reduce the risk of recurrence.
    Genetic testing is strongly recommended in cases of early-onset PHPT, family history, jaw tumors, renal and uterine involvement, atypical parathyroid tumors, and PC. This testing provides valuable information for personalized management, and counseling is available for affected families.
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  • 文章类型: Review
    背景:鬼细胞牙源性癌是一种罕见的恶性牙源性癌,其特征是存在鬼细胞。它具有非特异性的临床和影像学表现,可以是局部破坏性和侵入性的,有时有远处转移。然而,目前未推荐对此类患者进行有效的全身治疗.
    方法:患者无法再次接受手术或放疗。因此,他被转介给我们部门,多模式系统治疗方案。
    方法:组织病理学检查在形态学上提示鬼细胞牙源性癌。
    方法:我们报告一例31岁的中国男性局部浸润性原发性无法手术的牙源性影细胞癌,该患者接受了托里帕利马和化疗,6个周期后给予托里帕利马维持治疗。
    结果:治疗后部分缓解。治疗后生活质量明显改善。治疗期间无3/4级治疗相关不良事件发生。
    结论:本病例提示托里帕利单抗联合化疗可能是治疗牙源性鬼细胞癌安全有效的全身治疗方法。
    BACKGROUND: Ghost cell odontogenic carcinoma is a rare malignant odontogenic carcinoma characterized by the presence of ghost cells. It has a nonspecific clinical and radiographic presentation and can be locally destructive and invasive, sometimes with distant metastases. However, no effective systemic therapy is currently recommended for such patients.
    METHODS: The patient has been unable to undergo surgery or radiotherapy again. Therefore, he was referred to our department for a more aggressive, multimodal systematic treatment program.
    METHODS: The histopathological examination was morphologically suggestive of ghost cell odontogenic carcinomas.
    METHODS: We report a case of locally invasive primary inoperable odontogenic shadow cell carcinoma in a 31-year-old Chinese man who achieved treatment with Toripalimab and chemotherapy, followed by Toripalimab maintenance therapy after 6 cycles.
    RESULTS: He achieved partial remission after treatment. The quality of life significantly improved after treatment. There were no grade 3/4 treatment-related adverse events during treatment.
    CONCLUSIONS: This case presented that Toripalimab and chemotherapy may be a safe and effective systemic therapy for ghost cell odontogenic carcinoma.
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  • 文章类型: Case Reports
    下颌骨的骨内神经鞘瘤是罕见的,诊断和治疗的挑战。这项研究的目的是报告下颌骨骨内神经鞘瘤的新病例,并提出临床分类,为治疗方法提供建议。回顾了在作者医院接受治疗的13例患者和文献中先前报道的86例。最常见的临床特征是面部肿胀(60/93)。皮质变薄或扩张率为44.8%(43/96);在15例患者的X光片上观察到下牙槽神经管变宽。
    Intraosseous schwannoma of the mandible is rare, with diagnostic and therapeutic challenges. The aims of this study were to report new cases of intraosseous schwannoma of the mandible and to propose a clinical classification, providing suggestions for treatment methods. The cases of 13 patients treated at the authors\' hospital and 86 cases reported previously in the literature were reviewed. The most common clinical feature was facial swelling (60/93). The rate of cortical thinning or expansion was 44.8% (43/96); widening of the inferior alveolar nerve canal on radiographs was observed in 15 patients.
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  • 文章类型: Case Reports
    鬼细胞牙源性癌(GCOC)是一种极其罕见的骨内恶性牙源性肿瘤,具有明显的鬼细胞角化和牙样形成。这里,我们介绍了第一例GCOC出现在牙源性鬼细胞瘤(DGCT),外围。患者是一名60多岁的男子,下牙龈前部有外生性肿块。切除的肿瘤最大直径为4.5cm。组织学上,未包裹的肿瘤在牙龈中增殖,没有骨侵入。它主要由成釉细胞瘤样巢和基底细胞岛组成,在成熟的结缔组织中带有幽灵细胞和牙类,暗示DGCT,外围。作为次要成分,鉴定出非典型基底细胞和成釉细胞样巢,具有与恶性肿瘤一致的多态性和高增殖活性(Ki-67标记指数高达40%)。在良性和恶性成分中均观察到CTNNB1突变和β-catenin核易位。最终诊断为DGCT引起的GCOC,外围。GCOC显示与DGCT相似的组织学特征。在这个没有入侵的独特案例中,细胞学上的异型性和高增殖活性支持DGCT恶性转化的诊断。
    Ghost cell odontogenic carcinoma (GCOC) is an extremely rare intraosseous malignant odontogenic tumor with prominent ghost cell keratinization and dentinoid formation. Here, we present the first case of GCOC arising in dentinogenic ghost cell tumor (DGCT), peripheral. The patient was a man in his 60s with an exophytic mass in the anterior part of lower gingiva. The resected tumor measured 4.5 cm in maximum diameter. Histologically, the nonencapsulated tumor proliferated in the gingiva without bone invasion. It was predominantly composed of ameloblastoma-like nests and islands of basaloid cells with ghost cells and dentinoid in the mature connective tissue, suggesting DGCT, peripheral. As minor components, sheets of atypical basaloid cells and ameloblastic carcinoma-like nests with pleomorphism and high proliferative activity (Ki-67 labeling index up to 40%) consistent with malignancy were identified. CTNNB1 mutation and β-catenin nuclear translocation were observed in both benign and malignant components. Final diagnosis was GCOC arising in DGCT, peripheral. GCOC shows similar histological features to DGCT. In this unique case without invasion, the cytological atypia and high proliferative activity supports the diagnosis of malignant transformation from DGCT.
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  • 文章类型: Review
    本病例报告的目的是回顾和比较临床,放射学,组织病理学,和免疫组织化学特征,同时治疗1例牙源性鬼细胞癌。此外,将对现有已发表文献的报告进行描述,重点是治疗,以提供有关这种罕见但侵袭性肿瘤的信息。牙源性鬼细胞瘤家族包括一系列病变,其特征是牙源性上皮具有鬼细胞角质化和钙化。由于恶性转化的可能性很高,因此早期发现对于适当的治疗至关重要。
    The aim of this case report is to review and compare the clinical, radiologic, histopathologic, and immunohistochemical features, along with the treatment of a case of ghost cell odontogenic carcinoma. In addition, a report of the existing published literature with an emphasis on treatment will be described to provide information on this rare but aggressive tumor. The family of odontogenic ghost cell tumors comprises a spectrum of lesions characterized by odontogenic epithelium with ghost cell keratinization and calcifications. It appears that early detection is vital in proper treatment due to the high possibility of malignant transformation.
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  • 文章类型: Case Reports
    背景:牙源性纤维瘤(OF)是一种罕见的外胚间叶源性良性牙源性肿瘤,主要影响中年患者颌骨的牙齿支撑部分。虽然小病变在临床上往往无症状,不同的非特异性临床症状随着大小的增加而出现,并且可能模仿牙源性或其他颌面骨肿瘤,囊肿,或颌骨的纤维骨损伤。
    方法:一名31岁女性患者,右上颌骨前庭的非波动突出。在锥形束计算机断层扫描(CBCT)上可视化为占位性骨溶解,上颌窦的底面和面壁移位,模仿囊肿样病变。手术切除组织并在组织病理学检查中鉴定为OF。手术一年后,观察到规则窦解剖结构和生理口内发现的恢复。
    结论:本病例报告强调,就像所呈现的上颌,经常显示非特异性的临床和放射学结果。然而,临床医生需要考虑罕见实体作为可能的鉴别诊断,并据此制定治疗计划.组织病理学检查对于确定诊断至关重要。在适当的摘除后很少复发。
    Odontogenic fibroma (OF) is a rare benign odontogenic tumor of ectomesenchymal origin, mostly affecting the tooth-bearing portions of the jaws in middle-aged patients. Whilst small lesions tend to be clinically asymptomatic, varying unspecific clinical symptoms occur with an increase in size and may mimic odontogenic or other maxillofacial bone tumors, cysts, or fibro-osseous lesions of the jaws.
    A 31-year-old female patient presented with a hard, non-fluctuating protrusion in the vestibule of the upper right maxilla. It was visualized on cone beam computed tomography (CBCT) as space-occupying osteolysis with the displacement of the floor and facial wall of the maxillary sinus, mimicking a cyst-like lesion. The tissue was surgically removed and identified as an OF in the histopathological examination. One year after the surgery, restitution of regular sinus anatomy and physiological intraoral findings were observed.
    This case report emphasizes that rare entities, like the maxillary OF presented, often demonstrate nonspecific clinical and radiological findings. Nevertheless, clinicians need to consider rare entities as possible differential diagnoses and plan the treatment accordingly. Histopathological examination is essential to conclude the diagnosis. OF rarely recur after proper enucleation.
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    文章类型: Case Reports
    成釉细胞瘤是一种生长缓慢的牙源性上皮良性肿瘤,局部侵入性,可能导致面部不对称的膨胀。有袋形的牙源性肿瘤的保守治疗并不常见,但在囊性肿瘤中可以成功完成。此病例和文献综述的目的是提出袋状化将其作为治疗的初始程序。我们介绍了一例涉及56岁男性患者的成釉细胞瘤。直视断层扫描和计算机断层扫描显示,病变在下颌骨的右磨牙区和左磨牙区之间延伸,同时伴有颊和舌扩张以及牙根吸收。在临床检查中,观察到下颌骨扩张和轻微的牙齿迁移率。进行了切开活检,组织病理学检查发现成釉细胞瘤,尽管病变的临床特征更可能是囊肿。我们的病例通过闭孔袋化治疗,愈合良好。此病例和文献综述根据颌骨病变的宏观特征讨论了可用的治疗方案,并强调了最保守治疗方案的重要性。保守治疗可以保留骨骼的完整性,而根治性治疗可以留下主要的美容和功能后遗症,例如病理性骨折。重建钢板的并发症。
    Ameloblastoma is a benign tumor of odontogenic epithelium which is slow growing, locally invasive, expansive that may result with asymmetries of the face. Conservative treatment of odontogenic tumors with marsupialization is not common but can be done successfully in those with cystic pattern. The aim of this case and literature review is to propose marsupialization as an initial procedure for its treatment. We have presented a case of an ameloblastoma involving 56-year-old male patient. Orthopantomography and computed tomography showed the lesion extended between the right molar region and left molar region of mandible with both buccal and lingual expansion and root resorptions. On clinical examination, expansions of mandible and slight tooth mobilities were seen. An incisional biopsy was carried out and histopathologic examination revealed ameloblastoma although clinical features of lesion were more suggestive of cyst. Our case was treated by obturator marsupialization with a good healing. This case and review of the literature discusses the available treatment option according to macroscopic features of jaw lesions and emphasizes on the importance of the most conservative treatment option. Conservative treatment preserves integrity of bones while radical treatment can leave major cosmetic and functional sequelae such as pathologic fractures, complication with reconstruction plates.
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