Frezzini C, Maglione M, Rizzardi C, Melato M
UCO di Anatomia e Istologia Patologica Università degli Studi di Trieste, Trieste, Italy.
Minerva Stomatol. 2003 May;52(5):247-51.
Odontogenic myxoma is usually a benign neoplasm, although it has the ability to infiltrate surrounding tissues thus becoming locally invasive. Furthermore, it has a moderately high recurrence rate and can sometimes display a really aggressive behaviour. An unusual case of a 48-y-old woman in whom odontogenic myxoma recurred 11 years after excision of the primitive lesion is reported. Although rare, the possibility of malignant evolution led us to consider which was the most appropriate management of both the neoplasm and the recurrence. A careful assessment of the clinical, radiographical, tomographical, histological and, if necessary, immunohistochemical features of the lesion allows a distinction to be made between lesions that are only locally invasive and the rarer, more dangerous aggressive lesions. In the first case we suggest that, where possible, a conservative treatment should be preferred, followed by close monitoring of the lesion over time. Since odontogenic myxoma is limited to the facial bones, excision may be uselessly disfiguring, above all in young patients. More aggressive surgical treatment should be reserved for lesions for which there is a strong suspicion of malignant transformation.
牙源性黏液瘤通常是一种良性肿瘤,尽管它有浸润周围组织的能力,从而具有局部侵袭性。此外,它有中等偏高的复发率,有时还会表现出极具侵袭性的行为。本文报道了一例不寻常的病例,一名48岁女性在原始病变切除11年后牙源性黏液瘤复发。尽管罕见,但恶性演变的可能性促使我们思考对该肿瘤及其复发最合适的治疗方法。对病变的临床、影像学、断层扫描、组织学特征,必要时还有免疫组化特征进行仔细评估,有助于区分仅具有局部侵袭性的病变和更罕见、更危险的侵袭性病变。对于第一种情况,我们建议在可能的情况下,首选保守治疗,然后对病变进行长期密切监测。由于牙源性黏液瘤局限于面骨,切除可能会造成不必要的毁容,尤其是在年轻患者中。对于高度怀疑有恶变的病变,应采用更积极的手术治疗。