幼年性玻璃样变纤维瘤病1例及文献回顾  

Juvenile hyaline fibromatosis: a case report and literatures review

作　　者：夏亮[1,2] 乌丹旦 陈阳[1,2] XIA Liang;WU Dandan;CHEN Yang(Department of Oral and Cranio-maxillofacial Surgery,the Ninth People’s Hospital,Shanghai Jiao Tong Uni-versity School of Medicine,Shanghai 200011,China;National Center of Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,Chinese Academy of Medical Sciences Oral and Max-illofacial Regenerative Medicine Innovation Unit,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔颅颌面科,上海交通大学口腔医学院,上海200011 [2]国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,中国医学科学院口腔颌面再生医学创新单元,上海200011

出　　处：《口腔疾病防治》2022年第7期505-510,共6页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家重点研发项目(2016YFC1000502);上海交通大学医学院附属第九人民医院医学研究培育基金项目(JYZZ114)。

摘　　要：目的 探讨幼年性玻璃样变纤维瘤病的临床病理特点、影像学表现、遗传学模式及诊治。方法 报道1例幼年性玻璃样变纤维瘤病的临床表现、影像学检查、组织病理学检查、遗传学改变,同时对以往文献进行回顾,重点讨论该疾病的临床诊断、治疗以及预后情况。结果 幼年性玻璃样变纤维瘤病好发于婴幼儿及儿童,本例患者具有典型的临床和病理学表现,临床征状为枕后部肿块、皮肤及皮下结节、牙龈过度增生、关节挛缩和关节溶骨性病变,病理学病变特征为组织内单一的梭形细胞增殖并伴有大量无定形透明嗜酸性物质聚集。对手术切除后病变组织行基因检测,进一步明确ANTXR2基因突变,符合幼年性玻璃样变纤维瘤病的遗传学改变。对该患者术后6个月随访结果显示,牙龈及面部肿块切除后均无明显复发。该疾病的治疗除了手术外,还需结合康复性治疗和多学科联合对症支持治疗,才能取得较好的预后效果。结论 幼年性玻璃样变纤维瘤病是一种罕见的非肿瘤性常染色体隐性遗传病,与ANTXR2基因突变相关,其临床表现为皮下结节、牙龈增生、关节挛缩和溶骨性破坏等;治疗需要多学科联合对症支持治疗。Objective To investigate the clinicopathological characteristics,imaging manifestations,genetic manifestations,diagnosis and treatment of juvenile hyaline fibromatosis.Methods A case of juvenile hyaline fibromatosis was reported,and the patient’s clinical manifestations,imaging examinations,histopathological examinations,genetic changes and treatment were summarized and analyzed.Results Juvenile hyaloid fibromatosis is more common in infants and children.This patient had typical clinical and pathological manifestations,including posterior occipital masses,skin and subcutaneous nodules,gum hyperplasia,joint contractures,and joint osteolytic lesions.The histopathological lesions were characterized by the proliferation of spindle cells in the tissue accompanied by a large amount of amorphous transparent matrix.Genetic testing was performed to confirm an ANTXR2 gene mutation,consistent with the known genetic changes of juvenile hyaline fibromatosis.The 6-month follow-up of the patient showed that there was no obvious recurrence after resection of the gum and facial mass.In addition to surgery,the treatment of this disease requires multidisciplinary symptomatic treatment combined with rehabilitation and supportive treatment to achieve a better prognostic effect.Conclusion Juvenile hyaline fibromatosis is a rare nonneoplastic autosomal recessive genetic disease.Mutations in the ANTXR2 gene lead to disorders of collagen synthesis and metabolism in the tissues and further cause subcutaneous nodules,gingival hyperplasia,joint contractures and bone dissolution.

关 键 词：玻璃样变纤维瘤病 幼年性 ANTXR2 牙龈增生 皮下结节 关节挛缩 溶骨性破坏 手术切除 多学科联合治疗 病例报告 

分 类 号：R78[医药卫生—口腔医学]