Mandibular Neoplasms

下颌肿瘤
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    文章类型: Case Reports
    UNASSIGNED: Peripheral ossifying fibroma (POF) is a solitary gingival growth thought to arise from the gingiva, periosteum or the periodontal ligament. It is a slow-growing, benign, progressive lesion that is limited in size.
    UNASSIGNED: This article describes a case of ossifying fibroma of a peripheral variant that occurred in a 26-year-old female in the anterior region of the lower jaw and presented as a growth on the gingiva. Since it was difficult to diagnose clinically, a pathological evaluation was mandatory. Upon pathological confirmation of the diagnosis, the lesion was surgically excised up to the periosteum. This was deemed to be the required treatment yet, since the recurrence rate is high for POF (8% to 20%), the patient must be followed up yearly to check for recurrence.
    UNASSIGNED: Le fibrome ossifiant périphérique (FOP) est une excroissance gingivale solitaire dont on pense qu’elle provient des gencives, du périoste ou du ligament parodontal. Il s’agit d’une lésion progressive, bénigne et à croissance lente dont la taille est limitée.
    UNASSIGNED: Cet article décrit le cas d’une variante périphérique du fibrome ossifiant survenue chez une femme de 26 ans, dans la région antérieure de sa mâchoire inférieure et se présentant comme une excroissance sur la gencive. Comme il était difficile d’établir un diagnostic clinique, une évaluation pathologique a été nécessaire. Après confirmation pathologique du diagnostic, la lésion a été excisée jusqu’au périoste lors d’une opération chirurgicale. On a jugé ce traitement nécessaire, puisque le taux de récidive du FOP est élevé (entre 8 % et 20 %). La patiente doit faire l’objet d’un suivi annuel pour rechercher toute récidive éventuelle.
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  • 文章类型: Case Reports
    毛细血管扩张骨肉瘤(TOS)是骨肉瘤的一种罕见变体,通常会影响年轻人和长骨。正在讨论的病例出现在一名57岁女性的下颌骨中,并在一周内迅速增长。微观上,肿瘤的特征是被间变性细胞包围的大血管腔。在各个病灶均观察到了薄型花边肿瘤骨样。还注意到丰富的多核破骨细胞巨细胞以及坏死区域。肿瘤细胞SATB2阳性,而细胞角蛋白AE1/3、CD34阴性。在超过50%的肿瘤细胞中观察到Ki-67阳性。因此诊断为高度毛细血管扩张骨肉瘤。
    Telangiectatic osteosarcoma (TOS) is a rare variant of osteosarcoma that typically affects young individuals and long bones. The case under discussion was seen in the mandible of a 57-year-old female and had rapidly grown in size within a week. Microscopically, the tumour was characterised by large vascular cavities surrounded by anaplastic cells. Thin lacy tumour osteoid was observed at various foci. Abundant multinucleated osteoclastic giant cells along with areas of necrosis were also noted. The tumour cells were positive for SATB2, while negative for Cytokeratin AE1/3, CD 34. Ki-67 positivity was observed in more than 50% of tumour cells. A diagnosis of high grade telangiectatic osteosarcoma was thus made.
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  • 文章类型: Journal Article
    单囊性成釉细胞瘤(UAM)的颌骨可以通过减压有效地减少体积,促进骨骼再生并恢复下颌对称性。这项研究定量评估了下颌骨UAM减压后下颌骨体积和对称性的变化。这项研究包括17例接受手术减压,然后进行第二阶段刮治的下颌UAM患者。收集术前、术后三维计算机断层扫描(CT)图像。测量骨体积和皮质穿孔面积以评估减压期间的骨生长。通过计算下颌骨两侧的体积比,分析下颌骨的体积对称性。在病变区域的表面上识别出十二对标志,它们的坐标用于计算下颌骨的平均不对称指数(AI)。采用配对t检验和Mann-WhitneyU检验进行统计分析。p<0.05被认为指示有统计学意义。平均减压时间为9.41±3.28个月。平均骨量增加8.07±2.41%,皮质穿孔恢复率为71.97±14.99%。下颌骨的体积对称性明显改善(p<0.05),并且观察到AI的统计学显着下降(p<0.05)。总之,UAM减压可促进下颌骨的骨骼生长和对称恢复。本评估技术在临床上可用于定量评估下颌不对称性。
    Unicystic ameloblastoma (UAM) of the jaw can be effectively reduced in volume through decompression, which promotes bone regeneration and restores jaw symmetry. This study quantitatively evaluated changes in mandible volume and symmetry following decompression of mandibular UAM. This study included 17 patients who underwent surgical decompression followed by second-stage curettage for mandibular UAM. Preoperative and postoperative three-dimensional computed tomography (CT) images were collected. Bone volume and the area of cortical perforation were measured to assess bone growth during decompression. Mandibular volumetric symmetry was analyzed by calculating the volumetric ratio of the two sides of the mandible. Twelve pairs of landmarks were identified on the surface of the lesion regions, and their coordinates were used to calculate the mean asymmetry index (AI) of the mandible. Paired t-tests and the Mann-Whitney U test were used for statistical analysis, with p < 0.05 considered indicative of statistical significance. The mean duration of decompression was 9.41 ± 3.28 months. The mean bone volume increased by 8.07 ± 2.41%, and cortical perforation recovery was 71.97 ± 14.99%. The volumetric symmetry of the mandible improved significantly (p < 0.05), and a statistically significant decrease in AI was observed (p < 0.05). In conclusion, UAM decompression enhances bone growth and symmetry recovery of the mandible. The present evaluation technique is clinically useful for quantitatively assessing mandibular asymmetry.
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  • 文章类型: Journal Article
    背景:牙源性牙样癌(OCD)是一种罕见且有争议的实体,目前尚未纳入世界卫生组织牙源性病变分类。由于报告的案件数量很少,临床病理特征,生物学行为,预后,强迫症的适当治疗策略仍有待确定。在这里,我们介绍了另一例强迫症病例,重点是鉴别诊断和相关文献的回顾,以便使口腔临床医生和病理学家更好地识别并进一步表征该实体。
    方法:本文报告1例22岁女性下颌骨后部强迫症。射线照相术显示出不透射线的材料具有明确的单眼射线可透性。术中冰冻切片病理诊断为牙源性肿瘤,恶性潜能不确定。然后进行部分下颌骨切除术,并进行游离骨移植和钛植入物。微观上,肿瘤由床单组成,岛屿,以及与丰富的牙质基质相关的圆形至多边形上皮细胞的索。免疫组织化学,肿瘤细胞对CK19,p63和β-catenin(细胞质和细胞核)呈弥漫性阳性。未检测到EWSR1基因的重排。最终诊断为强迫症。术后58个月没有复发或转移的证据。我们还提供了强迫症病例的文献综述,包括1例以前从我们医院报告的鬼细胞牙源性癌。
    结论:强迫症是一种局部侵袭性低级别恶性肿瘤,无明显转移潜力。建议广泛的手术切除,边缘清晰,长期随访以确定任何可能的复发或转移。组织病理学检查对于确定诊断至关重要。必须特别注意将OCD与鬼细胞牙源性癌和透明细胞牙源性癌区分开来,因为误诊可能导致不必要的过度治疗。需要对其他病例进行研究,以进一步表征临床病理特征,并阐明该肿瘤的疾病状态和生物学行为。
    BACKGROUND: Odontogenic carcinoma with dentinoid (OCD) is a rare and controversial entity, which has not yet been included in the current World Health Organization classification of odontogenic lesions. Owing to the small number of reported cases, the clinicopathological characteristics, biological behavior, prognosis, and appropriate treatment strategies for OCD remain to be defined. Herein, we present an additional case of OCD with a focus on the differential diagnosis and review of the pertinent literature, in order to enable better recognition by oral clinicians and pathologists and further characterization of this entity.
    METHODS: This paper reports a case of OCD in the posterior mandible of a 22-year-old female. Radiography showed a well-defined unilocular radiolucency with radiopaque materials. The intraoperative frozen section pathology gave a non-committed diagnosis of odontogenic neoplasm with uncertain malignant potential. Then a partial mandibulectomy with free iliac crest bone graft and titanium implants was performed. Microscopically, the tumor consisted of sheets, islands, and cords of round to polygonal epithelial cells associated with an abundant dentinoid matrix. Immunohistochemically, the tumor cells were diffusely positive for CK19, p63, and β-catenin (cytoplasmic and nuclear). No rearrangement of the EWSR1 gene was detected. The final diagnosis was OCD. There has been no evidence of recurrence or metastasis for 58 months after surgery. We also provide a literature review of OCD cases, including one case previously reported as ghost cell odontogenic carcinoma from our hospital.
    CONCLUSIONS: OCD is a locally aggressive low grade malignancy without apparent metastatic potential. Wide surgical excision with clear margins and long-term period follow-up to identify any possible recurrence or metastases are recommended. Histopathological examination is essential to conclude the diagnosis. Special care must be taken to distinguish OCD from ghost cell odontogenic carcinoma and clear cell odontogenic carcinoma, as misdiagnosis might lead to unnecessary overtreatment. Study of additional cases is required to further characterize the clinicopathological features and clarify the nosologic status and biological behavior of this tumor.
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  • 文章类型: Journal Article
    Odontome gelten zusammen mit den Amelo- blastomen als die häufigsten odontogenen Tumoren. Sie entstehen während der embryo- nalen Zahnkeimentwicklung durch fehlerhaft differenziertes Keimgewebe und werden daher auch als Hamartome bezeichnet. Somit sind sie also strenggenommen keine klassischen Neoplasien.
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  • 文章类型: Case Reports
    背景:中央性巨细胞肉芽肿(CGCG)是一种良性,增殖性,骨内,非牙源性病变主要发生在儿童和年轻人中。在组织学层面上,它的特征是许多多核巨细胞随机散布在梭形间质基质细胞的海洋中,这些细胞分散在包含出血区域的纤维血管结缔组织基质中。说到射线照相特征,CGCG可以有一系列的变化,从明确定义的扩张性病变到不明确的破坏性病变,有或没有扩张。
    方法:本病例报告回顾了一名11岁的白种人患者,主要主诉为累及右下颌后区的缓慢增长的肿胀。锥形束计算机断层扫描(CBCT)显示出一个模糊的混合病变,模仿了纤维骨病变和血管瘤。然而,显微镜检查显示纤维基质中有多核巨细胞,提示中央性巨细胞肉芽肿。
    结论:我们报告此病例的目的是强调彻底临床的重要性,影像学和组织病理学检查,以进行准确的诊断和治疗干预,并强调在检查头颈部骨肿胀时考虑不同可能性的重要性。
    BACKGROUND: A central giant cell granuloma (CGCG) is a benign, proliferative, intraosseous, and non-odontogenic lesion occurring primarily in children and young adults. On the histological level, it is characterized by numerous multinucleated giant cells scattered randomly throughout a sea of spindle-shaped mesenchymal stromal cells which are dispersed throughout the fibrovascular connective tissue stroma containing areas of haemorrhage. When it comes to radiographic features, CGCG can have an array of variations, ranging from well-defined expansile lesions to ill-defined and destructive lesions, with or without expansion.
    METHODS: This case report reviews an 11-year-old Caucasian patient with a chief complaint of slow-growing swelling involving the right posterior mandibular region. The cone beam computed tomography (CBCT) revealed an ill-defined mixed lesion mimicking both fibro-osseous lesion and hemangioma. However, microscopic examination revealed multinucleated giant cells in a fibrous stroma suggestive of central giant cell granuloma.
    CONCLUSIONS: Our intent in reporting this case is to highlight the importance of thorough clinical, radiographical and histopathological examination for accurate diagnosis and therapeutic interventions as well as to emphasize the importance of taking different possibilities into consideration when examining bony swellings in the head and neck region.
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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: English Abstract
    UNASSIGNED: To explore the feasibility and effectiveness of mixed reality technology for localizing perforator vessels in the repair of mandibular defects using free fibular flap.
    UNASSIGNED: Between June 2020 and June 2023, 12 patients with mandibular defects were repaired with free fibular flap. There were 8 males and 4 females, with an average age of 61 years (range, 35-78 years). There were 9 cases of ameloblastomas and 3 cases of squamous cell carcinomas involving the mandible. The disease duration ranged from 15 days to 2 years (median, 14.2 months). The length of mandibular defects ranged from 5 to 14 cm (mean, 8.5 cm). The area of soft tissue defects ranged from 5 cm×4 cm to 8 cm×6 cm. Preoperative enhanced CT scans of the maxillofacial region and CT angiography of the lower limbs were performed, and the data was used to create three-dimensional models of the mandible and lower limb perforator vessels. During operation, the mixed reality technology was used to overlay the three-dimensional model of perforator vessels onto the body surface for harvesting the free fibular flap. The length of the fibula harvested ranged from 6 to 15 cm, with a mean of 9.5 cm; the size of the flap ranged from 6 cm×5 cm to 10 cm×8 cm. The donor sites were sutured directly in 7 cases and repaired with free skin grafting in 5 cases.
    UNASSIGNED: Thirty perforator vessels were located by mixed reality technology before operation, with an average of 2.5 vessels per case; the distance between the exit point of the perforator vessels located before operation and the actual exit point ranged from 1 to 4 mm, with a mean of 2.8 mm. All fibular flaps survived; 1 case had necrosis at the distal end of flap, which healed after dressing changes. One donor site had infection, which healed after anti-inflammatory dressing changes; the remaining incisions healed by first intention, and the grafts survived smoothly. All patients were followed up 8-36 months (median, 21 months). The repaired facial appearance was satisfactory, with no flap swelling. Among the patients underwent postoperative radiotherapy, 2 patients had normal bone healing and 1 had delayed healing at 6 months.
    UNASSIGNED: In free fibular flap reconstruction of mandibular defects, the use of mixed reality technology for perforator vessel localization can achieve three-dimensional visualization, simplify surgical procedures, and reduce errors.
    UNASSIGNED: 探讨在游离腓骨皮瓣修复下颌骨缺损中,使用混合现实技术定位穿支血管的可行性和效果。.
    UNASSIGNED: 2020年6月—2023年6月,采用游离腓骨皮瓣修复12例下颌骨缺损患者。男8例,女4例;年龄35~78岁,平均61岁。下颌骨成釉细胞瘤9例,侵犯下颌骨口腔鳞癌3例。病程15 d~2年,中位病程14.2个月。下颌骨缺损长度5~14 cm,平均8.5 cm;软组织缺损范围为5 cm×4 cm~8 cm×6 cm。术前均行颌面部增强CT和下肢CT血管造影检查,将所得数据制成下颌骨、下肢穿支血管三维模型。术中使用混合现实技术将穿支血管三维模型重叠于患者体表,制取游离腓骨皮瓣修复缺损。腓骨切取长度为6~15 cm,平均9.5 cm;皮瓣切取范围6 cm×5 cm~10 cm×8 cm,供区拉拢缝合(7例)或游离植皮修复(5例)。.
    UNASSIGNED: 12例患者术前使用混合现实技术定位穿支血管30支,每例平均2.5支;术中测量术前定位穿支血管穿出点与实际穿出点距离为1~4 mm,平均2.8 mm。术后12例腓骨瓣顺利成活;1例皮瓣远端边缘坏死,换药后延期愈合。供区发生感染1例,经抗炎换药治疗后愈合;其余患者切口Ⅰ期愈合,植皮顺利成活。患者均获随访,随访时间8~36个月,中位时间21个月。修复面部外形好,皮瓣无臃肿。3例术后接受放化疗患者中,随访6个月时2例正常骨愈合、1例延迟愈合。.
    UNASSIGNED: 在游离腓骨皮瓣修复下颌骨缺损手术中使用混合现实技术,可以实现穿支血管三维可视化,手术操作简便,误差较小。.
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  • 文章类型: Journal Article
    Alberta重建技术(ART)是一种创新的外科手术,适用于接受原发性颌骨切除和重建的患者。ART程序是与医学重建科学研究所和耳鼻咽喉头颈外科部合作开发的,阿尔伯塔大学。
    The Alberta reconstructive technique (ART) is an innovative surgical procedure performed on patients undergoing primary jaw resection and reconstruction. The ART procedure was developed in collaboration with the Institute for Reconstructive Sciences in Medicine and the Division of Otolaryngology-Head and Neck Surgery, University of Alberta.
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  • 文章类型: Case Reports
    背景:骨化纤维瘤很少见,骨的非侵袭性良性肿瘤,通常涉及女性好发的中年人的后下颌骨。
    结果:临床表现包括无症状的下颌骨扩张伴罕见的上颌骨病变,疼痛,错牙合,以及包括审美感知在内的生活质量受损。由于特点的多样性,复发的趋势,以及恶性转化的可能性,诊断,治疗,骨化性纤维瘤的术后管理始终是一个挑战。
    研究旨在报告一例广泛肿胀的临床病例,涉及右侧的冠状突和髁穿过下颌骨中线,功能和美学受损。这篇文章描述了临床,组织病理学,和病例的放射学特征。讨论了可能的治疗方法和遇到的挑战。
    BACKGROUND: Ossifying fibromas are rare, non-aggressive benign tumours of the bone, commonly involving the posterior mandible in middle-aged individuals with a female predilection.
    RESULTS: Clinical manifestations include asymptomatic expansion of the mandible with infrequent maxillary lesions, pain, malocclusion, and compromised quality of life including aesthetic perception. Owing to multiplicity of features, tendency of recurrence, and possibility of malignant transformation, the diagnosis, treatment, and post-operative management of ossifying fibroma are always a challenge.
    UNASSIGNED: Study aims to report a clinical case of extensive swelling involving the coronoid process and condyle on the right side to crossing the mid-line of the mandible with compromised functions and aesthetics. The article describes the clinical, histopathological, and radiological features of the case. The possible treatment and challenges encountered are discussed.
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