Arzul L, Vincent C, Mercier J-M
Service de Chirurgie Maxillo-Faciale et Stomatologie, CHU de Nantes, Hôtel-Dieu, 1, Place Alexis-Ricordeau, 44093 Nantes cedex, France.
Rev Stomatol Chir Maxillofac. 2012 Jun;113(3):169-72. doi: 10.1016/j.stomax.2012.03.002. Epub 2012 May 21.
Osteomas are benign bone tumors with a slow progressive growth. These lesions are predominantly located in craniofacial sinuses, but other locations including mandible have been described. Their etiopathogenesis remains controversial. We report a case of post-trauma mandibular osteoma. Gardner syndrome was ruled out.
A 31-year-old female patient consulted for a peri-mandibular swelling present for the previous two years. On radiological examination, a bone sclerotic lesion was observed, located on the right lower mandibular edge. Patient history documented an initial trauma at the lesion site. Surgery was performed and anatomopathological examination confirmed the diagnosis of compact osteoma. There was no recurrence one year after surgery.
The etiopathogenesis of osteomas is controversial and several hypotheses are suggested. It is regarded as a true benign tumoral process, or abnormality of development, or as a reaction to trauma or infection. The development of osteoma after trauma has been described in several cases, notably in mandibular locations exposed to shocks (angle and lower edge). Multiple osteomas must mandatorily lead to screening for a Gardner's syndrome, because of the associated risk of colon cancer.
骨瘤是一种生长缓慢的良性骨肿瘤。这些病变主要位于颅面窦,但也有其他部位的报道,包括下颌骨。其发病机制仍存在争议。我们报告一例创伤后下颌骨骨瘤病例,排除了加德纳综合征。
一名31岁女性患者因下颌骨周围肿胀前来就诊,该肿胀已持续两年。影像学检查发现右下颌骨边缘有一处骨质硬化病变。患者病史记录显示病变部位曾有过一次初始创伤。进行了手术,病理检查确诊为致密性骨瘤。术后一年无复发。
骨瘤的发病机制存在争议,有多种假说。它被认为是一种真正的良性肿瘤过程、发育异常,或是对创伤或感染的反应。创伤后骨瘤的发生在多例病例中已有描述,尤其是在下颌骨受冲击的部位(角部和下缘)。由于存在结肠癌的相关风险,多发性骨瘤必须进行加德纳综合征筛查。