Garas George, Stacey-Clear Adam, Whitaker Steve, Collyer Jeremy
East Surrey Hospital, Breast and Endocrine Surgery, Canada Avenue, Redhill, Surrey, RH1 5RH, UK.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.10.2008.1061. Epub 2009 Mar 5.
A 78-year-old woman heard a crack in her left mandible while eating a biscuit and reported to her dentist, who urgently referred her to the oral and maxillofacial surgery department. On examination she had a lesion in the body of her left mandible, which had eroded through the lower border and caused a pathological fracture. Her past medical history included a left mastectomy and level II axillary lymph node dissection for a 27 mm grade III invasive ductal carcinoma of the left breast 9 months prior to her mandibular fracture. A transoral incisional biopsy was performed which confirmed the mandibular lesion to be an osteolytic metastasis from the breast. The metastasis was subsequently surgically removed and the remaining mandible repaired with a reconstruction plate followed by postoperative radiotherapy. The patient regained full function of her mandible and is now eating normally. She is being closely followed-up in the oncology outpatient department.
一名78岁女性在吃饼干时听到左下颌骨有爆裂声，遂告知其牙医，牙医紧急将她转诊至口腔颌面外科。检查发现她左下颌骨体部有一病变，已侵蚀至下颌骨下缘并导致病理性骨折。她的既往病史包括9个月前在下颌骨骨折之前因左乳27毫米III级浸润性导管癌行左乳切除术及II级腋窝淋巴结清扫术。进行了经口切开活检，证实下颌骨病变为乳腺溶骨性转移瘤。随后手术切除转移瘤，并用重建钢板修复剩余下颌骨，术后进行放疗。患者下颌骨功能完全恢复，现在饮食正常。她正在肿瘤门诊接受密切随访。
