Cheng Xiao-Bing, Li Yun-Peng, Lei De-Lin, Li Xiao-Dong, Tian Lei
Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, PR China.
J Craniofac Surg. 2011 Mar;22(2):594-7. doi: 10.1097/SCS.0b013e31820745ff.
Cemento-ossifying fibroma, also known as ossifying fibroma, usually occurs in the mandible and less commonly in the maxilla. The huge example in the skull base is even rare. We present a case of a huge cemento-ossifying fibroma arising below the skull base of a 30-year-old woman patient. Radiologic investigations showed a giant, lobulated, heterogeneous calcified hard tissue mass, which is well circumscribed and is a mixture of radiolucent and radiopaque, situated at the rear of the right maxilla to the middle skull base. The tumor expands into the right maxillary sinus and the orbital cavity, fusing with the right maxilla at the maxillary tuberosity and blocking the bilateral choanas, which caused marked proptosis and blurred vision. The tumor was resected successfully by intraoral approach, and pathologic examination confirmed the lesion to be a cemento-ossifying fibroma. This case demonstrates that cemento-ossifying fibroma in the maxilla, not like in the mandible, may appear more aggressive because the extensive growth is unimpeded by anatomic obstacles and that the intraoral approach can be used to excise the tumor in the skull base.
骨化性纤维瘤，也称为骨化纤维瘤，通常发生在下颌骨，在上颌骨较少见。发生在颅底的巨大骨化性纤维瘤甚至更为罕见。我们报告一例30岁女性患者，其颅底下方出现巨大骨化性纤维瘤。影像学检查显示，在右上颌骨后部至中颅底有一个巨大的、分叶状、不均匀钙化的硬组织肿块，边界清晰，是透射线与不透射线的混合体。肿瘤扩展至右侧上颌窦和眶腔，在上颌结节处与右上颌骨融合，阻塞双侧后鼻孔，导致明显眼球突出和视力模糊。通过口内入路成功切除肿瘤，病理检查证实病变为骨化性纤维瘤。该病例表明，上颌骨的骨化性纤维瘤与下颌骨不同，可能表现得更具侵袭性，因为广泛生长不受解剖结构的阻碍，并且口内入路可用于切除颅底的肿瘤。
