8例青少年沙瘤样骨化纤维瘤临床分析  

Juvenile psammomatoid ossifying fibroma:clinical analysis of8consecutive cases

作　　者：仝春实 马欣 范明亮 王永功 彭利伟 骆书文 TONG Chun-shi;MA Xin;FAN Ming-liang;WANG Yong-gong;PENG Li-wei;LUO Shu-wen(Department of Stomatology,Henan Provincial People's Hospital,Zhengzhou University People's Hospital,Henan University People's Hospital,Zhengzhou 450003;Department of Tumor Radiotherapy,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,Henan Province,China)

机构地区：[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

出　　处：《中国口腔颌面外科杂志》2022年第3期287-291,共5页China Journal of Oral and Maxillofacial Surgery

基　　金：国家重点研发计划资助(2018YFC0114505)。

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。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,

关 键 词：骨化纤维瘤 青少年 沙瘤样骨化纤维瘤 骨肿瘤 

分 类 号：R739.8[医药卫生—肿瘤]