伴有骨水泥骨发育不良的骨肉瘤:巧合还是两个相关实体?

IF 1.6 3区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE
Oral Radiology Pub Date : 2024-10-01 Epub Date: 2024-06-09 DOI:10.1007/s11282-024-00758-2
Suvarna Indermun, Fadi Titinchi, Julandi Alwan, Jean Morkel, Christoffel Johannes Nortje
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引用次数: 0

摘要

背景:颌骨骨肉瘤是一种罕见的原发性恶性肿瘤:颌骨骨肉瘤是一种罕见的原发性恶性骨肿瘤。本文介绍了一例与骨水泥骨发育不良有关的病例的临床、放射学和组织病理学特征:病例报告:一名 57 岁的混血女性因右下颌骨大面积、进行性肿胀而就诊。影像学检查发现了两个相关病变。左下颌骨出现部分清晰的不规则放射斑,从前臼齿延伸至臼齿区。病变呈棉絮状,类似纤维骨病变,即骨水泥骨发育不良。在下颌骨右角发现了第二个大的、扩张性的、不规则的、不透光的病变,延伸到下颌骨下皮质以外。内部结构不均匀,类似不规则骨形成。从前后视图和 CBCT 三维重建图中可以看到典型的放射状骨刺 "旭日 "外观,表明肿瘤基质正在生长。组织病理学检查最终确诊为骨肉瘤,与骨水泥骨发育不良密切相关。患者接受了氟脱氧葡萄糖-18(FDG)正电子发射断层扫描(PET),结果显示左肺有转移,右下颌骨摄取增加。患者最初接受了化疗,计划切除肿瘤,但由于医疗并发症而死亡:文献中仍然存在这样的疑问:这两种肿瘤是巧合发现的,还是相互产生的。尽管如此,临床医生仍应密切监测骨水泥骨发育不良患者,并对可能发展为骨肉瘤的可疑病变进行活检。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Osteosarcoma associated with cemento-osseous dysplasia: co-incidence or two related entities?

Osteosarcoma associated with cemento-osseous dysplasia: co-incidence or two related entities?

Background: Osteosarcoma of the jaws is a rare primary malignant tumor of bone. The clinical, radiological and histopathological features of a case associated with cemento-osseous dysplasia is presented.

Case report: A 57-year-old mixed-race female presented with a large, progressive, swelling of the right mandible. Radiographic examination revealed two associated lesions. Partially defined irregular radiopacities were noted in the left mandible, extending from the premolar to the molar region. The lesion had a cotton-wool appearance and resembled a fibro-osseous lesion; i.e. cemento-osseous dysplasia. A second large, expansive and irregular, radiopaque lesion was noted on the right angle of the mandible, extending beyond the inferior cortex of the mandible. The internal structure was heterogeneous and resembled irregular bone formation. The classic "sunburst" appearance of radiating bony spicules can be seen in the posterior-anterior view and the CBCT 3D reconstruction, indicating the outgrowth of the tumor matrix. Histopathological exam confirmed a final diagnosis of osteosarcoma closely associated with cemento-osseous dysplasia. The patient underwent a fludeoxyglucose-18 (FDG) positron emission tomography (PET) scan which indicated metastasis in the left lung and increased uptake in the right mandible. Chemotherapy was initially administered with a plan to resect the tumor, however, the patient demised as a result of medical complications.

Conclusion: The question in the literature remains whether these two entities are coincidentally found or arise from each other. Nevertheless, it is important for clinicians to closely monitor patients with cemento-osseous dysplasia and biopsy any suspicious lesions that may develop into osteosarcoma.

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来源期刊
Oral Radiology
Oral Radiology DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
4.20
自引率
13.60%
发文量
87
审稿时长
>12 weeks
期刊介绍: As the official English-language journal of the Japanese Society for Oral and Maxillofacial Radiology and the Asian Academy of Oral and Maxillofacial Radiology, Oral Radiology is intended to be a forum for international collaboration in head and neck diagnostic imaging and all related fields. Oral Radiology features cutting-edge research papers, review articles, case reports, and technical notes from both the clinical and experimental fields. As membership in the Society is not a prerequisite, contributions are welcome from researchers and clinicians worldwide.
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