中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2022, Vol. 20 ›› Issue (3): 287-291.doi: 10.19438/j.cjoms.2022.03.015

• 临床总结 • 上一篇    下一篇

8例青少年沙瘤样骨化纤维瘤临床分析

仝春实1, 马欣1, 范明亮2, 王永功1, 彭利伟1, 骆书文1   

  1. 1.河南省人民医院,郑州大学人民医院,河南大学人民医院 口腔科,河南 郑州 450003;
    2.郑州大学第一附属医院 肿瘤放疗科,河南 郑州 450052
  • 收稿日期:2021-07-10 修回日期:2021-11-24 出版日期:2022-05-20 发布日期:2022-05-20
  • 通讯作者: 骆书文,E-mail:1464414759@qq.com
  • 作者简介:仝春实（1989-）,男,硕士,主治医师,E-mail:drtong2017@126.com
  • 基金资助:
    国家重点研发计划资助（2018YFC0114505）

Juvenile psammomatoid ossifying fibroma: clinical analysis of8consecutive cases

TONG Chun-shi1, MA Xin1, FAN Ming-liang2, WANG Yong-gong1, PENG Li-wei1, LUO Shu-wen1   

  1. 1. Department of Stomatology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital. Zhengzhou 450003;
    2. Department of Tumor Radiotherapy, First Affiliated Hospital of Zhengzhou University. Zhengzhou 450003,Henan Province, China
  • Received:2021-07-10 Revised:2021-11-24 Online:2022-05-20 Published:2022-05-20

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摘要： 目的: 分析青少年沙瘤样骨化纤维瘤（juvenile psammomatoid ossifying fibroma, JPOF）的临床及影像学特点、治疗方法和预后。方法: 收集2016 年 2月—2020 年 10 月收治的8 例JPOF患者的临床及影像学资料,并进行随访,总结其临床表现、影像学特征、治疗和预后情况。结果: 8例JPOF患者,男4例,女4例,年龄（14.1±7.9）岁;发生于下颌骨3例,筛窦2例,上颌骨（窦）1例,鼻腔1例,额窦1例;病灶大小为（37.0±9.7）mm,临床表现以鼻塞、流涕、局部膨隆和疼痛多见。CT显示为蛋壳样骨壳包绕着圆形或类圆形内核的占位性病变,MRI呈现为混杂信号的囊实性肿瘤。8例JPOF均采用手术治疗,筛窦、上颌骨（窦）及鼻腔患者于鼻内镜下行病灶刮除联合周围骨磨除;额窦患者行开放性手术病灶刮除联合周围骨磨除;2例下颌骨JPOF患者行刮除术并磨除周围部分骨质,半年后复发,即再次手术;1例下颌骨JPOF患者行下颌骨节段性切除,并应用血管化髂骨肌复合组织瓣修复。随访至今均未见复发。结论: JPOF是一种发生于青少年且极为罕见的良性骨纤维性肿瘤,临床及影像学特点无特异性,主要依靠病理检查诊断,生长具有一定侵袭性,治疗方法为病灶刮除联合周围骨磨除。

关键词: 骨化纤维瘤, 青少年, 沙瘤样骨化纤维瘤, 骨肿瘤

Abstract: PURPOSE: To analyze the clinical and imaging features, treatment options, and prognosis of juvenile psammomatoid ossifying fibroma (JPOF). METHODS: Clinical and imaging data of 8 JPOF patients (male, n=4; female, n=4) who were admitted during February 2016 and October 2020 were collected and follow-ups were made to summarize the clinical manifestations, imaging features, treatment options and prognosis. RESULTS: Eight JPOF cases were included into this study with an average age of 14.1±7.9 years. Among these JPOF cases, the lesions were found to originate in the jaw(n=3), ethmoid sinus (n=2), maxilla/maxillary sinus (n=1), nasal cavity (n=1), and frontal sinuses (n=1), averaging (37.0±9.7) mm in diameter. The clinical manifestations were predominantly nasal congestion and discharge, as well as local swelling and pain. Of the 8 JPOF patients, four received CT, three received MRI, and the remaining one was examined through CT and MRI. CT scans exhibited space-occupying lesions with a circular or oval inner core circumscribed by a sclerotic shell of bone, while MRI findings demonstrated mixed-signal of cystic-solid tumors. JPOF patients all received surgical treatments. To be specific, transnasal endoscopic procedures were adopted for radical curettage of JPOF in the ethmoid sinus, maxilla/maxillary sinus, and nasal cavity. JPOFs arising in the frontal sinuses were removed via open surgery; of the three patients with JPOFs in their jaws, two underwent curettage of the lesion involving the jaw and partial removal of the surrounding bone containing the lesional tissues, in which cases a relapse was identified 6 months later. Segmental resection of the jaw was performed on the third patient in combination with a vascularized iliac crest bone graft for jaw reconstruction, and no recurrent JPOF was detected up to the last follow-up date. CONCLUSIONS: JPOF is a rare benign bone tumor that most frequently occurs among teenagers. As the clinical and imaging features are inconspicuous, pathology remains to be the mainstay in diagnosing JPOF. Considering its invasive growth, it is recommended that radical curettage be carried out to reduce the risk of recurrence.

Key words: Ossifying fibroma, Juvenile, Psammomatoid ossifying fibromas, Bone neoplasms

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