韩婧①, 田臻②, 张春叶②, 张陈平①, 孙坚①, 竺涵光①, 杨驰③, 朱凌④, 徐立群①. 颌骨青少年骨化纤维瘤—15例临床回顾分析*[J]. 中国肿瘤临床, 2015, 42(16): 834-840. DOI: 10.3969/j.issn.1000-8179.2015.16.864
引用本文: 韩婧①, 田臻②, 张春叶②, 张陈平①, 孙坚①, 竺涵光①, 杨驰③, 朱凌④, 徐立群①. 颌骨青少年骨化纤维瘤—15例临床回顾分析*[J]. 中国肿瘤临床, 2015, 42(16): 834-840. DOI: 10.3969/j.issn.1000-8179.2015.16.864
Jing HAN1, Zhen TIAN2, Chunye ZHANG2, Chenping ZHANG1, Jian SUN1, Hanguang ZHU1, Chi YANG3, Ling ZHU4, Liqun XU1. Fifteen cases of juvenile ossifying fibroma of the jaw[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2015, 42(16): 834-840. DOI: 10.3969/j.issn.1000-8179.2015.16.864
Citation: Jing HAN1, Zhen TIAN2, Chunye ZHANG2, Chenping ZHANG1, Jian SUN1, Hanguang ZHU1, Chi YANG3, Ling ZHU4, Liqun XU1. Fifteen cases of juvenile ossifying fibroma of the jaw[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2015, 42(16): 834-840. DOI: 10.3969/j.issn.1000-8179.2015.16.864

颌骨青少年骨化纤维瘤—15例临床回顾分析*

Fifteen cases of juvenile ossifying fibroma of the jaw

  • 摘要: 目的:分析发生于颌骨的青少年骨化性纤维瘤(juvenile ossifying fibroma,JOF )临床特点、影像学表现、病理分型,并讨论治疗方法及预后。方法:收集2005年1 月至2014年12月期间15例JOF 患者临床、影像资料并进行随访,病理学分型参考2005年WHO头颈肿瘤分类标准,将JOF 分为2 个亚型:砂砾样(juvenile psammomatoid ossifying fibroma,JPOF)和小梁状(juvenile trabecular ossifying fibroma ,JTOF)。 结果:15例JOF 患者,女性10例,男性5 例,发病年龄7~18岁,平均年龄10.93岁,发生于下颌骨9例,上颌骨6 例,临床多表现为颌骨的无痛性肿胀,20% 病例出现颌骨肿胀伴有疼痛。JOF 影像学表现多样,可表现为透射,混合或毛玻璃样,与周围组织界限较清楚。病理分型方面JTOF10例,JPOF5 例。在治疗上,4 例行保守手术,3 例为带瘤生存;11例行局部根治,未发现复发。共9 位患者同期行修复重建,5 例为腓骨肌瓣移植,3 例为游离髂骨移植,1 例发生于髁状突的患者为肋软骨移植。结论:JOF 是一种发生于青少年且较罕见的良性纤维骨病变,颌骨为其好发部位之一,因其生长具有侵袭性和较高的复发率,在临床诊治中应尽早发现,应行严密的临床及影像学随访。应根据患者的具体情况选择手术时机及治疗方案。

     

    Abstract: Objective:To analyze the clinical manifestations, radiographic features, and pathological classification of the juvenile ossifying fibroma (JOF) of the jaws and discuss its clinical management and prognosis. Methods:From January 2005to December 2014, 15patients with JOF who underwent surgery were retrospectively investigated with regard to clinical and radiologic data. On the basis of the standards of the World Health Organization in 2005, JOF was divided into juvenile psammomatoid ossifying fibroma (JPOF) and juvenile trabecular ossifying fibroma (JTOF). Results:Among the 15patients, 10were female and 5 were male. Patient age ranged from 7 years old to 18years old with a mean of10.93years old. Nine cases were located in the mandible and 6 in the maxilla. The clinical manifestation was painless swelling of the jaw, but 20% of the cases showed jaw swelling with pain. Various JOF radiolog-ic appearances, such as radiolucent, mixed radiopaque-radiolucent, or ground-glass pattern, were observed. Ten of the 15patients were JTOF and5 were JPOF With regard to treatment,4 patients underwent conservative surgery, 3 patients lived with tumors, and 11 pa -tients underwent radical surgery during the follow- up period; no lesion recurrence occurred. Nine patients underwent reconstruction, that is, 5 cases with fibula flap graft,3 cases with free iliac graft, and 1 case with costal cartilage graft. Conclusion:JOF is a rare form of benign fibro-osseous lesions and occurs in adolescents. Mandible and maxilla are two of the most common locations. Early diagnosis and treatment and strict clinical and radiological follow-up is important in the clinic because of the aggressiveness and high recurrence rate of JOF. Operation time and treatment options should be selected according to the patients' specific situation.

     

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