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具有不同转移部位的成釉细胞瘤:两例报告及文献复习

Ameloblastoma with varied sites of metastasis: report of two cases and literature review.

作者信息

Lin Yi, He Jian-feng, Li Zhi-yong, Liu Jian-hua

机构信息

Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou 310003, Zhejiang, PR China.

Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou 310003, Zhejiang, PR China.

出版信息

J Craniomaxillofac Surg. 2014 Jul;42(5):e301-4. doi: 10.1016/j.jcms.2013.10.010. Epub 2013 Nov 2.

Abstract

OBJECTIVE

We report two rare cases of lung metastasis from maxillary ameloblastoma, in order to review its risk and analyse the types of metastases that can present with this disease.

METHODS

A 40-year-old male with multiple recurrences and a 46-year-old female, who had undergone successful surgical treatment of a maxillary ameloblastoma, presented with metastatic lesions. The primary tumour and metastases were benign in both patients. We reviewed and analysed 20 cases of the same condition reported in recent years.

RESULTS

Our initial treatment for the primary maxillary lesion was performed more than 10 years before the pulmonary lesions presented. Due to the aggressive nature of this tumour, metastases in the lungs and cervical lymph nodes (male patient) were confirmed.

CONCLUSION

These cases presented a diagnostic challenge due to the multiple and varied sites of recurrence, which indicate the natural behaviour of this tumour. Different routes of metastasis can occur, including implanting, haematogenous, and lymphatic spread. CT-guided percutaneous transthoracic lung biopsy is an important method to confirm metastatic ameloblastoma.

摘要

目的

我们报告两例罕见的上颌成釉细胞瘤肺转移病例,以回顾其风险并分析该疾病可能出现的转移类型。

方法

一名40岁男性有多次复发情况,一名46岁女性曾成功接受上颌成釉细胞瘤手术治疗,现出现转移病灶。两名患者的原发性肿瘤和转移灶均为良性。我们回顾并分析了近年来报道的20例相同病症。

结果

我们对原发性上颌病变的初始治疗在肺部病变出现前10多年进行。由于该肿瘤具有侵袭性,证实肺部和颈部淋巴结(男性患者)出现转移。

结论

这些病例因复发部位多样且复杂而带来诊断挑战,这表明了该肿瘤的自然行为。可能发生不同的转移途径,包括种植、血行和淋巴转移。CT引导下经皮经胸肺活检是确诊转移性成釉细胞瘤的重要方法。

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