Yamamoto Aya, Sakamoto Junichiro, Muramatsu Takashi, Hashimoto Sadamitsu, Shibahara Takahiko, Shimono Masaki, Sano Tsukasa
Department of Oral and Maxillofacial Radiology, Tokyo Dental College, Japan.
Bull Tokyo Dent Coll. 2011;52(4):201-7. doi: 10.2209/tdcpublication.52.201.
Osteosarcoma of the head and neck is relatively rare and accounts for less than 10 percent of all osteosarcomas in general. We report a case of osteosarcoma in which imaging and histopathology of the hard palate of an 11-year-old boy yielded atypical findings. An approximately 8×15mm lesion found in the center of the palate was hard and healthy in color. Subsequent biopsy resulted in a diagnosis of nonepithelial malignant tumor. No abnormalities were observed in the maxillary bone or tooth on panoramic or occlusal radiographs. Computed tomography images revealed a mass lesion approximately 7×9×9mm in size on the hard palate extending into the maxilla. The cortex of the maxilla adjacent to the lesion was unclear in parts. The internal structures were slightly inhomogeneous and its density was lower than that of muscle. On magnetic resonance images, the lesion was represented by low signal intensity on T1-weighted (T1W) images and high signal intensity on T2-weighted images with fat-suppression. The margin of the lesion was a little unclear and the internal structures were slightly inhomogeneous. The lesion was enhanced homogeneously on post-contrast T1W images with fat-suppression. The histopathological diagnosis was fibrogenesis-type osteosarcoma. No findings specific to osteosarcoma such as localized enlargement of the periodontal ligament space alongside the root, cortical destruction, periosteal ossification or osteogenesis were found in this case.
头颈部骨肉瘤相对罕见，一般占所有骨肉瘤的比例不到10%。我们报告一例骨肉瘤病例，该病例为一名11岁男孩硬腭的影像学和组织病理学检查结果均显示为非典型表现。在腭部中央发现一个大小约为8×15mm的病变，质地坚硬，颜色正常。随后的活检诊断为非上皮性恶性肿瘤。全景片或咬合片显示上颌骨和牙齿未见异常。计算机断层扫描图像显示硬腭上有一个大小约为7×9×9mm的肿块病变，延伸至上颌骨。病变相邻的上颌骨皮质部分不清晰。内部结构稍不均匀，密度低于肌肉。在磁共振图像上，病变在T1加权（T1W）图像上呈低信号强度，在脂肪抑制T2加权图像上呈高信号强度。病变边缘稍不清晰，内部结构稍不均匀。在脂肪抑制的增强后T1W图像上病变呈均匀强化。组织病理学诊断为纤维生成型骨肉瘤。该病例未发现骨肉瘤的特异性表现，如牙根旁牙周膜间隙局限性增宽、皮质破坏、骨膜骨化或骨生成等。
