先天性牙龈瘤2例报告及文献回顾  

Congenital epulis of the newborn:2 cases report and a literature review

作　　者：刘思琪 陈亦阳 LIU Siqi;CHEN Yiyang(Guang-zhou Women and Children’s Medical Center,Guangzhou 510630,China)

机构地区：[1]广州市妇女儿童医疗中心,广东广州510630

出　　处：《口腔疾病防治》2024年第6期457-462,共6页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：广东省基础与应用基础研究基金项目(2022A151520112)。

摘　　要：目的探讨先天性牙龈瘤的临床特点、诊断及治疗方法,为临床诊治提供参考。方法报告2例分别发生于新生儿下颌骨和上颌骨的先天性牙龈瘤病例,通过超声、MRI的检查方式确定肿物边界及大小,全麻下外科手术切除。结合既往文献对先天性牙龈瘤的诊疗进行回顾分析。结果病例1患儿为男性,出生后即发现右下颌粉红色质韧肿物,大小约为20 mm×15 mm×10 mm,完善MRI检查后全麻下行肿物切除术,术后病理检查提示先天性牙龈瘤。病例2患儿为女性,母亲孕29周时B超发现胎儿口腔上颌肿物,大小约24 mm×23 mm×20 mm,孕晚期肿物迅速增长。患儿出生后全麻下行肿物切除术,术后病理检查提示先天性牙龈瘤。文献复习结果表明,先天性牙龈瘤女性发病率较高,且多好发于上颌骨,无骨侵袭性,不影响牙胚发育。当肿物影响患儿呼吸或吞咽时,需及时进行外科手术切除,肿物外科手术后一般无复发迹象。该病组织学来源及病因尚不明确。临床上常需与畸胎瘤相鉴别,畸胎瘤与牙龈瘤临床表现上看外观相似,主要鉴别要点在于病理表现,畸胎瘤镜下可见成熟或未成熟的来自各个胚层的组织,而牙龈瘤镜下则可见紧密排列、均质、多角形至微梭形、中等至大的细胞组成巢状和带状细胞。结论先天性牙龈瘤是新生儿罕见的一种口腔肿瘤,在诊断时需结合发病部位、年龄、临床表现、影像学检查,最终诊断取决于病理检查。对于影响患儿呼吸和进食的先天性牙龈瘤需尽早通过手术切除,术后基本不复发。Objective To investigate the clinical features,diagnosis and treatment of congenital epulis,to provide a reference for clinical diagnosis and treatment.Methods Two cases of congenital epulis in the mandible and maxilla of a newborn were reported,and the boundary and size of the tumor were determined by ultrasonography and MRI.The tu⁃mor was resected under general anesthesia.The previous literature on congenital epulis was reviewed and analyzed.Results Patient 1(male)had a hard mass of approximately 20 mm×15 mm×10 mm in the right mandible immedi⁃ately after birth.MRI was performed,and the mass was removed.In Patient 2(female),a mass approximately 24 mm×23 mm×20 mm in the oral cavity of the anterior maxillary region was shown on ultrasound at 29 gestational weeks,and the mass grew rapidly in the last trimester.The mass was removed after birth.Postoperative pathological examination re⁃vealed congenital epulis.The results of the literature review showed that the incidence of congenital epulis is greater in females than in males,and it mainly occurs in the maxillary incisor area.Congenital epulis does not invade bone and does not affect tooth development.When a mass affects a child’s breathing or swallowing,it must be surgically removed in a timely manner.Recent studies have shown that there is no evidence of recurrence after surgical resection.The histo⁃logical origin and etiology of the disease are not clear.Clinically,it is often necessary to distinguish between teratomas and congenital epulis.Regarding the clinical manifestations,teratomas and congenital epulis are similar in appearance,and the main distinguishing point lies in pathological manifestations.Under the microscope,teratomas are observed as mature or immature tissue from various embryonic layers,while congenital epulis involves tightly arranged,homoge⁃neous,polygonal to microspindle⁃shaped,medium to large cell compositions of nest⁃like and ribbon⁃like cells.Conclu⁃sion Congenital epulis is a rare oral tumor in neonates.The diagno

关 键 词：先天性牙龈瘤 上颌骨 下颌骨 诊断影像 口腔肿瘤 鉴别诊断 病理诊断 组织胚胎学 外科手术 

分 类 号：R78[医药卫生—口腔医学]