Seper László, Bürger Horst, Vormoor Josef, Joos Ulrich, Kleinheinz Johannes
Department of Craniomaxillofacial Surgery, University of Münster, Germany.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005 Jan;99(1):30-8. doi: 10.1016/j.tripleo.2004.03.026.
Aggressive fibromatosis (AF) involving the mandible is rare, and surgery is often complicated by a high recurrence rate.
A 4-year-old boy was referred because of a fast growing painless mass which involved the entire left angle of the mandible. Excisional biopsy revealed AF, and local excision of the tumor was performed. Six months after surgery a recurrence was detected. The tumor was determined to be unresectable and the boy was treated with low-dose chemotherapy including methotrexate and vinblastine for 1 year. With combined chemotherapy and surgical debulking, mutilating surgical resection will be delayed as long as possible or until completion of facial growth.
According to the literature, surgery is the most common treatment of AF in the head and neck region. However, particularly in children, alternative modes of therapy must be considered because of the high recurrence rate and to avoid mutilating operations.
累及下颌骨的侵袭性纤维瘤病（AF）较为罕见，手术常常因高复发率而复杂化。
一名4岁男孩因左侧下颌骨角部迅速生长的无痛性肿块前来就诊。切除活检显示为AF，并对肿瘤进行了局部切除。术后6个月检测到复发。肿瘤被判定无法切除，该男孩接受了为期1年的包括甲氨蝶呤和长春碱的低剂量化疗。通过联合化疗和手术减瘤，尽可能推迟或直到面部生长完成后再进行致残性手术切除。
根据文献，手术是头颈部AF最常见的治疗方法。然而，特别是在儿童中，由于高复发率以及为避免致残性手术，必须考虑替代治疗方式。
